Recommending Help Before A Child is School-Age: Our Experience and Addressing Frequently Asked Questions

Our experience

When I noticed that my two year old was not speaking as clearly as his older brother had at his age, I decided to call for an evaluation by the Early Intervention team in our area. A date was scheduled for the team (a physical therapist, a speech therapist, and a special education teacher) to come out to our house to interact with us. While the physical therapist and speech teacher interacted somewhat with my two-year-old, they soon saw that there were no concerns within those areas of his development. His speech, on the other hand, received the majority of their evaluation. However, after tallying up the composite score on his speech assessment, he technically did not qualify to receive services because his high scores in the areas of “social communication” and “receptive language” skewed the lower score of “speech clarity.” In other words, because he was able to understand what was spoken to him, follow multi-step commands, point to objects, and get his point across, those strengths compensated quite a bit for his lack of clear output. Technically, he did not NEED speech therapy.

At this point, the team seemed to gauge my opinion as a parent. Is his lack of clear speech causing him frustration? Is it causing the family frustration? Is it frustrating to people outside of the home? Would the mother like to have more tools with which to help him develop his speech? After they determined that we would really appreciate the speech therapy for our son and tips and pointers on how to work with him on developing clarity of speech, they put in a call to their supervisor and asked if they could pull out the lower score of “speech clarity” and make an IEP (Individualized Education Program) for our two-year-old’s speech clarity in order to provide services for him. After consent, they wrote up several goals for him to achieve within a quarter of a year. As the quarter nears, his progress on the goals is assessed and new goals are written.

As part of the Early Intervention program, the speech therapist visits the home weekly. After the initial evaluation, we were asked what day of the week and time of the day we prefer. Upon hearing our preference, they lined us up with a speech therapist who had a similar opening in her schedule.

Since Early Intervention in our area transitions to IU13 once a child turns three, they have helped us to transition into IU13 (these Intervention Units differ in name across the state and country) which is designed to give students instruction within our local school system. Again, we had an initial evaluation, asked if we want the services, and set up an instruction time. The main difference in the IU13 program is that I will need to take him to their office (about three minutes from our house). This instruction time slot each week is a half hour and more instruction-focused, less play-focused. As the parent, I can either take the rest of my children along and wait outside the room or leave them with their father and accompany my son into the instruction area.

How much time does early intervention take out of a family’s daily schedule?

For us, a typical speech visit is about an hour in length; and it includes chatting with the parent on how the child’s week was, interactive play with the child, and speech instruction. While the speech therapist gives a short section of speech instruction each week, it is really throughout the week that the parent needs to take the time to practice what was learned/ worked on during the time with the speech therapist. This can be typically be completed with a few focused minutes throughout the day and within your normal day-to-day communication with your child.

What is involved in signing up for Early Intervention?

 You simply have to call the number to get the ball rolling. Google “Early Intervention in (the name of your state)” for the phone number. Each state differs a little in the way they handle Early Intervention but all states are required by federal law to provide a free developmental screening and evaluation. Depending on your state, the services the child qualifies for may or may not be free as well.

They wanted a report of a recent wellness visit from my child’s doctor, a copy of his birth certificate, and signed forms. As with any government process, there are a lot of legal forms such as parent consent, authorization to release information, parent’s rights agreement, and permission to evaluate and then re-evaluate. If you live in PA, you can find all the forms (and many that won’t be needed for your specific case) at this website.

I did not find the paperwork or signing up process to be cumbersome. The secretary was most helpful and was not overly concerned that I did not have his birth certificate since it was enroute to the passport office at that time.

Can any concerned adult refer a child?

Not exactly. While a healthcare provider or other professional can refer a child to Early Intervention, the parent or primary caregiver is the only one who can give consent for evaluation and services.

Is earlier better than later?

Yes, according to studies, the brain is the most malleable within the first three years of life. You want to try to catch any type of learning disability or difficulty as young as possible.

However, late is still better than never. If you have concerns about a child’s development, it is never too late to reach out for an evaluation. The public school system is required to give a free evaluation up to 18 years old. While they are not required to provide free services for you if you choose to enroll your child for private education, they are always required to give all students free screenings and evaluations. You can then use that recommendation or evaluation as a starting point with the teachers/tutors in the private school your child is enrolled in or you can hire private services/tutoring at the location of your choice.

How do you approach a parent about concerns you have for their child?

If you are a teacher, you know there is a delicate balance between supporting a family without usurping the authority or responsibility of a parent. It is the parent’s main job to care and provide for their children. The teacher is to walk alongside them and assist in the educational role. In a healthy family situation, a parent will know their child better than any teacher will. However, the teacher has a unique perspective as they see many children enter their doors year after year. Because they have seen multiple children from multiple homes in academic situations, a teacher can often spot or sense a disability or lack of development in a certain area before a parent may be aware of it.

As a community of people who are all working together to   better equip the next generation for God’s work, we all have a responsibility to speak into those lives. Here are tips for teachers for approaching a parent about concerns you have for their child:

• It is not about the parent. Approach the parent with the belief that the disability or lack of development is not the fault of the parent. Many parents are providing a home environment that is stimulating, language-rich, and engaging. A parent can be doing all the right things and a child can still have a disability or lack of development in a certain area. Assure the parents that the disability or difficulty the child is experiencing is not a result of something the parent did or did not do.
• Normalize the situation. All children have weaknesses and all children have strengths. Because we want to all children to learn to maximize their strengths and minimize their weaknesses, we give them tools with which compensate or overcome their weaknesses. We give glasses to the visually-weak, we give vitamins and supplements to the immune-weak, and we give training wheels and pull-ups to “children in training.” Would it be possible that this child could benefit from a little extra help that would help them to feel more confident in an area of difficulty?
• Give the parent hope. Often the parent may have a niggling feeling that their child is weaker in a certain area, and they may have been worrying about it before you ever approached them. Have you seen other children struggling who then received tools they needed to overcome or compensate for that difficulty? Do you know of anyone who has had a successful experience with Early Intervention? Or was tested by the public school system and now can use those recommendations and accommodations in the classroom for a less-stressful school experience for the child? Or that struggling child in your first grade whose parents took him for intensive therapy and by the end of second grade had risen to the top of the class?
• Speak your opinion but support the parent. As much as you may think you are right in your belief that the child would benefit from additional intervention, you are not the primary caregiver that God placed over the child. In the end, it is the parent’s choice whether to pursue the route that you recommend. Speak clearly. Speak with love. And then leave it in the parents’ hands.

Is Early Intervention more headache than it’s worth? What are the pros and cons?

Pros

• One-on-one instruction for child with a teacher. My child learns to interact with another authority figure and practices sitting attentively and interacting appropriately for an hour a week.
• Tools for the parent to use in future situations. I learn from the therapists even more than my child does; I am adding the tools to my tool bag that I can use in possible future situations with other children.
• Opens our home to more people from other backgrounds of life. I do not have to leave my house to be a godly influence in my world; the therapists and professionals are coming to me and see us in our natural home environment.
• More adults investing in my children. My children are blessed with so many caring, loving adults who want to see my children succeed.
• Accountability for parent to practice with child. When you have someone checking up with you each week on how the week went, you have an incentive to take those daily ten minutes to practice throughout the week.

Cons

• An additional “to-do” to add to an already full life. Mothers are already sacrificing precious amounts of personal time to change all the pampers, prepare all the food, and keep up with the daily washing. Finding the time to practice even ten minutes a day may seem overwhelming.
• Government hand-out. It has been said that the more we accept from an entity, the more control they can exercise over us. It is certainly true that if they ever ask us to compromise Biblical values in order to receive their services, we need to refuse their services. In addition, we need to realize that the government can choose to withhold services from us at any time.
• Managing the rest of your children while trying to focus on the therapist. Like myself, many mothers are trying to still care for their other littles while the therapist is working with the child receiving services. Helping my four-year-old not to feel “left-out” while his two-year-old brother is receiving the attention from the therapist as well as keeping my one-year-old from ripping the papers/activity pieces/game into shreds and still trying to communicate with the therapist and pay attention to the skills being taught, is not for the faint-of-heart.

Has it benefited us?

Yes, my two-year old has made significant progress in his speech clarity. Typically, when he has mastered a sound or other clarity concept during focused practice time, it will take about three to four weeks before I hear him use the concept/sound correctly in his own speech while playing or in other casual conversation. For example, he has had trouble saying his brother’s full name “Cameron” and would use the name he has called him since he first began to talk: “Fam.” About two months ago, he started correctly saying “Cameron” when we practiced with him. But it wasn’t until about a month ago that he was trying to get his brother’s attention while his brother was on the back porch by calling him “Fam.” When his brother didn’t respond, I heard him switch and say “Cameron.” His practice had finally transferred into learned behavior. In Early Intervention, you do not typically see immediate progress; but yes, in the long-term, he has made significant progress.

Would have he made this progress without Early Intervention? Possibly. I do not know. We do not have a clone of our son that we could have given one the services of Early Intervention and not the other in order to conduct a true science experiment. But we are grateful for the service, and recommend it to others!