Early Intervention & Delays in Children

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Trust your instincts if something seems “off” with your child. The earlier you can get him help, the better his chances for later success.

Rewind three years … my oldest was just shy of his second birthday. He endured severe acid reflux and multiple ear infections since birth. He received tubes just before turning 2 and the infections were better, but something was still “off.”

At the time, working as a special education teacher, I knew which checklists to follow. I knew that free early intervention services were available if he qualified, and who to contact for support. I followed all of his developmental milestones, answered all of the developmental questions at his well-child visits (he was meeting them), but my gut told me his language articulation was not where it should be.

Pediatricians only get to see a brief “snapshot” of children at each visit, and although mine did not express any concerns about my son’s articulation, I was still concerned. He would easily become frustrated if I didn’t understand what he was trying to tell me, would often point to things versus talking, very few people could understand what he was saying, and most of his words missed the ending sounds.
I contacted our pediatrician requesting an evaluation, and then called the local early intervention provider dedicated to providing parents of children 0 – 2  the support and education necessary to help them enjoy long-term success.

It was helpful having an unbiased set of eyes evaluate him. They picked up on speech patterns that I hadn’t noticed, but I was right: he qualified for speech and language services. An Individual Family Support Plan (IFSP) was created and my son immediately began receiving intervention support. We were provided fun activities to work on at home to help build his articulation skills. It helped me become a better parent and educator.

Fast forward to the present. My son will be 5 this month and was just re-evaluated. He’s meeting all of the articulation milestones for his age. Without early intervention he would not be where he is at today. He would not have the deep understanding of letters, their sounds and how to make blends (all great for early literacy skills, too!), and he would probably still be calling cookies “tooties.” Unfamiliar listeners can understand him now, but even more importantly his self-confidence has skyrocketed.

Early Intervention is Priceless

Having free access to early intervention services is priceless when it comes to helping your child succeed, whether for learning or development issues. It’s important to help a child stay on track in order for him to achieve his maximum potential.

In Tennessee, a child with a diagnosis from the list below (or children whose test results show that they have a 25 percent delay in two developmental areas or a 40 percent delay in one area) may be eligible for Tennessee Early Intervention Services (TEIS). A child may have a developmental delay if he is far behind other children their age in one or more of the five major skill areas:

• Motor (crawling, walking, using his hands to play)

• Communication (babbling, indicating wants and needs, talking)

• Cognitive (thinking skills including making choices and solving problems)

• Social (playing near or with other children or adults)   

• Adaptive (taking care of one’s needs)

The U.S. Department of Education reports that there are three primary reasons for early intervention: 1) to enhance the child’s development, 2) to provide support and assistance to the family and 3) to maximize the child’s and family’s benefit to society.

The U.S. Department of Education research in childhood development has found “that the rate of human learning and development is most rapid in the preschool years. Timing of intervention becomes particularly important when a child runs the risk of missing an opportunity to learn during a state of maximum readiness.”

Just remember … although there are general guidelines, ALL kids develop at different rates. Don’t panic if your child isn’t walking as soon as your neighbor’s son or if a 4-year-old playmate is reading already and your child is not.  Do trust your instincts, and if something doesn’t seem right, contact your pediatrician.



One Month

• Raises head slightly when on stomach

• Holds head up briefly when supported

• Briefly watches and follows object with eyes

• Avoids mildly annoying sensations (cloth on face)

• Some “noise in throat” sounds

Two Months

• Holds head erect, bobbing, when supported in sitting position

• Follows moving person with eyes

• Imitates or responds to smiling person with occasional smile

• Vocalizes

Three Months

• Lifts head and chest when lying on stomach

• Vigorous body movement

• Head control is improving

• Recognizes bottle or breast

• Coos and chuckles

Four Months

• Good head control

• Rolls from side to side

• Takes objects held near hand

• May begin reaching

• Follows moving object when held in sitting position

• Laughs aloud

• Enjoys play

Six Months

• Sits with minimal support

• Rolls from back to stomach

• Transfers objects from hand to hand and from hand to mouth

• Babbles more than two sounds

Nine Months

• Sits alone and changes position without falling

• Plays with two objects at the same time

• Says “Ma-Ma” or “Ba-ba”

One Year

• Pulls self to standing — may step with support

• Picks up things with thumb and one finger

• Stacks two blocks

• Gives toys on request

• Gives affection

• Follows simple directions accompanied by gestures

• May say a couple of words

Learn more about early intervention in Tennessee by visiting Tennessee Early Intervention Services.



Learning issues are difficult to detect prior to school age, but some traits may provide early indicators for you:

• Doesn’t enjoy being read to; squirms from your lap

• Has trouble learning the alphabet

• Learns language late and has limited vocabulary

• Has trouble following directions)

• Has trouble organizing thoughts and what he wants to say

• May stand too close to a person who’s listening

• May misread numbers

• May not be able to retell a story in order

• May not know where to begin a task or how to go from there



Tina Pratt is a mom of two and a behavior intervention coach. She has a masters in special education and early childhood education.

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