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What
should I do if I am worried about a child's development?
Professionals
working with children on regular basis often instinctually
know when something is unusual or different with a child in
their care. There are also instances when family members have
expressed concerns about a child's development or behavior.
Conducting a developmental screen may be a good way to either
confirm the observations or offer reassurance.
Several
organizations have developed step-by-step instructions to
help you with these decisions. The American Academy of Pediatrics
created a developmental screening algorithm
for pediatric health care providers in July, 2006.
The Wisconsin Early childhood Collaborating Partners Healthy
Children Committee created a similar decision making guide
(Word document) for early childhood professionals in November,
2006.
The tools
like the Ages
and Stages Questionnaire (ASQ)and Parents'
Evaluation of Developmental Status (PEDS) are designed
to be self-taught and don't require formal training prior
to their use. Professionals prepared to administer the tool
could conduct one after obtaining parental consent. For professionals
who don't feel comfortable conducting the screen, it is important
to know community partners who offer developmental screening.
Examples
of programs performing screening include:
- Birth
to 3 Program Birth to 3 is an early intervention program
available to eligible children in all Wisconsin counties.
Birth to 3 Programs are required by law to identify children
with developmental delays or disabilities. Developmental
screenings are conducted free of charge. Call Wisconsin
First Step at 1-800-642-7837) for contact information for
the Birth to 3 Program in your county.
- Public
Schools for children over the age of 3 years (Early
Childhood Special Education). Every school district in the
state of Wisconsin is required to provide early childhood
special education services to children who are found to
have a disability and are in need of these services. These
services are provided in a variety of setting including
settings with typically developing children.
- Head
Start/Early Head Start
- Pediatricians
or family doctors
- Child
care providers
- Public
Health nurses
- Home
Visiting Programs
- Family
Resource Center Staff in your community
- Child
Development Days in your community
After
conducting the screen (or obtaining results of the screen
if conducted by someone else) it is essential that professionals
have conversations with family members about the results.
To prepare, it is best to review the results in advance
to learn if your concerns about a child's development were
validated. If the results are concerning, the conversations
with family members may be difficult. Make sure to hold
them in private and allow for sufficient time. Parents may
feel vulnerable, so be empathetic and choose your words
carefully. Consider inviting other professionals involved
in the child's care to these conversations.
For children
with concerning screens it is important to help families find
available resources and to offer ongoing, individualized support
to the child. Birth
to 3 and Early
Childhood Special Education Programs are available in
every community. These programs offer further assessment and
appropriate developmental intervention for eligible children.
Information
for Families
When
to ask . . .
All children
develop at their own speed. Some children's development, however,
is different from same-aged peers. Many parents have an intuitive
sense of what to expect at certain ages. To see a research-based
timeline organized by a child's age click here (from Talaris
Research Institute. It outlines typical development in
5 general areas:
- Social
- Emotional - how children feel and how they learn to relate
to others
- Cognitive
- how children learn and think
- Language
- how children learn sounds, words, and sentences
- Sensory
- how children hear, see, taste, smell and feel
- Motor
Skills - how children learn to sit up, crawl, walk, and
run
Some physicians
are conducting screening of all children at 9-, 18- and 24-
(or 30-) month well child exams. Screens can also be conducted
at any time to see whether a child's development is on-track.
If you have concerns about a child's development, ask for
a screen.
Who
to ask . . .
There
are many resources available to parents with concerns about
their child's development. Some programs, such as Birth to
3, have federal mandates to find and serve children with developmental
delays. Possibilities include:
What to expect . . .
Expect
a conversation with a professional about a typical day in
your child's life, his or her strengths and challenges. You
will be able to share your concerns and have an opportunity
to ask questions. The professional may suggest that a tool
be used to assess how your child's development compares with
other children his or her age.
Children
with reassuring screening results are likely to be on-track
with their development. The American Academy of Pediatrics
recommends that these children are re-screened at regular
intervals to make sure their development continues as expected.
Children with concerning screening results need referral for
additional assessment and appropriate supports and services.
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