Updated: June 3, 2021
Originally Published: November 16, 2020
“Is it possible to refer my own child for Early Intervention?” I pondered this question one day while I observed my two-year-old son, Jack, playing with his favorite Cookie Monster doll in the living room. We had recently celebrated his birthday, showering him with a collection of new Sesame Street toys. Although I could have done without the talking Elmo, he was clearly thrilled. Jack looked adorable, with his tousled blond hair and bright blue eyes fixed on the cookie-loving creature in his lap. He was smart, affectionate, and funny—everything a mother could wish for. But in the back of my mind, I couldn’t shake my worries.
While it might seem like typical parental concern, my anxiety had roots in reality. Jack had undergone surgery to insert ear tubes at 18 months to alleviate fluid buildup in his ears. Unlike many children, he hadn’t suffered from a slew of ear infections that might have indicated the problem. Yet, a hearing test confirmed that the fluid was hindering his ability to hear clearly, which in turn delayed his speech development. After all, it’s challenging to learn to speak when you can’t hear the words. I was grateful that I had introduced baby signs to him at six months. American Sign Language had allowed us to communicate before his surgery, even if I regretted teaching him the signs for “Elmo” and “candy.” While he was making progress post-surgery, he still lagged behind in his developmental milestones.
As a speech-language pathologist specializing in early intervention, I was aware of these delays. Early Intervention (EI) is a program designed for children under three years old who are experiencing developmental delays or disabilities. Depending on the state, these programs may be referred to as Birth to Three or Infants and Toddlers, among other names. In Massachusetts, where I work, children are evaluated at an EI center, at home, or even virtually. If assessments reveal delays in areas such as communication or motor skills, children qualify for services that last until they turn three.
Typically, these services are home-based, with a developmental specialist or therapist visiting families weekly for about an hour. They guide parents on how to engage with their children in a way that promotes growth in areas of delay. It often looks like playful suggestions to enhance learning through fun activities because play is how children learn best.
So there I was, a mother trained to help other families navigate similar situations, now needing assistance for my own child. It felt almost embarrassing. How could I support countless children and their families but struggle to help my own? I longed to just be his mother, not his therapist, and realized I needed an outside perspective and new strategies. It was crucial to seek help, and I reminded myself that there was no shame in doing so.
In EI, we coach parents on rethinking play and interaction to help children reach their developmental milestones. Providers identify toys and activities that engage a child and suggest ways to incorporate learning. For instance, if a child enjoys a farm animal puzzle, the provider might encourage the caregiver to label the animals or make their sounds while playing. Simple strategies can turn a familiar activity into a rich learning experience. Therapists trained in a transdisciplinary approach work creatively to address multiple areas of need simultaneously.
While I could have implemented these strategies, I needed to experience the situation from a different angle. Jack’s speech was improving gradually, but I also noticed issues with his picky eating and sensory sensitivities. He refused to touch paint or Play-Doh, and I suspected he had weak core muscles, which made activities like climbing challenging.
It was tough to admit my child needed help, but I knew there was no shame in seeking an evaluation or services if warranted. Ignoring available support due to my pride as a speech-language pathologist would have been the real mistake. So, I made the call. I didn’t wait to see if he would improve on his own. Jack qualified for regular visits from a developmental specialist and an occupational therapist, along with a weekly EI playgroup where he could practice social skills and routines. His progress over the next year was remarkable.
Today, Jack is a cheerful three-year-old who loves interacting with other children. He has expanded his diet and significantly improved his strength. I might be the only parent who cheered when he was finally able to climb up the slide, a feat requiring considerable core strength. I am so grateful I didn’t delay seeking help, as he would have missed out on valuable services.
One issue that early intervention providers are encountering is that many parents and pediatricians delay referrals for evaluations. Some families might not even know EI exists unless they know someone who has used the services. Others think a doctor’s prescription is required for evaluation. While pediatricians often recommend EI, parents can refer their children themselves. You are the expert on your child and can initiate the process if you have concerns.
Pediatricians may also hesitate to refer children too early. However, it’s never too soon. Even if a child is evaluated and found to have no delays, they can be re-referred anytime before turning three if new issues arise. It’s not a one-time opportunity. Children frequently exit services after meeting specific milestones only to be re-evaluated later due to new concerns. Research indicates that while some children may catch up without help, a significant percentage will require longer-term support, and there’s no way to predict which group your child will fall into.
Even as a professional in the field, early intervention proved to be a lifesaver for our family. Having someone to offer activity suggestions, guide me on implementing strategies during daily routines, and provide a fresh perspective on my son was invaluable. It wasn’t always easy, and sometimes it was challenging to confront issues I hadn’t noticed. Yet, by the time Jack turned three, I was immensely grateful for the support we had received. I learned much about myself as a parent and what Jack needed to flourish. Despite holding a master’s degree in communication disorders, I realized I needed guidance on being the best mom for my son—and we are all the better for it.
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Summary:
As a Speech Language Pathologist and a mother, I faced the unexpected challenge of my son’s speech delay despite my professional background. After his surgery for ear tubes, I recognized that my son needed help beyond what I could provide. Seeking Early Intervention services was essential, allowing him to gain vital skills and support. Today, Jack is thriving, demonstrating the importance of accessing resources and not letting pride hinder a child’s development.