June 2009

Don't Wait and See

The Importance of Early Intervention

By Kristin Olsen, Ph.D.

In recent years, there has been increasing awareness of the importance of evaluating and treating problems early for children and families. Among professionals, such as pediatricians and preschool teachers (who are often the first to identify a child with a developmental delay or other problems), early screening tools are being used much more frequently, and referrals to local early intervention programs are increasing steadily. More funding has been provided, and programs have continued to be developed to try and meet the needs of children and their families soon after problems are noted.

Early Intervention Services for Young Children

Whether the difficulty a young child is experiencing is related to speech and language development, sensory issues, motor development or behavioral concerns, early assessment and planning can be very valuable. The human brain has the most plasticity (flexibility) during early childhood, meaning that new connections can be formed through experiences most easily during this window of time. New ways of communicating, moving, learning or handling situations can be introduced and practiced. Also, specific types of stimulation and therapy can create positive developmental progress in many areas.

The first early intervention programs focused on providing what was called “infant stimulation” for children with readily identified conditions and disabilities. Similar programs were encouraged, and finally mandated by federal legislation, primarily in the 1980s and 1990s. The educational system was required to serve children with disabilities beginning in 1975 and, in 1990, the Individuals with Disabilities Education Act (IDEA) services were extended downward to preschool-age children and finally, to infants and toddlers. Legislation in 1997 included the Program for Infants and Toddlers with Disabilities (referred to as “Part C” of IDEA), which requires that children under 3 who meet criteria be provided with assessment, development of an Individualized Family Service Plan (IFSP) and some coordination of the services that are deemed necessary for the child’s needs.

In Washington, D.C., as well as Maryland and Virginia, these services can be reached through a referral by a pediatrician or other professional or frequently by a phone call from a parent. Most often, a screening will be performed in the child’s home and, if the child’s areas of difficulty meet certain criteria (which may differ based on location), further evaluation, monitoring of the problem or initiation of services will be recommended. Families often receive free services in their home until the child is 3. At that point, the child will be transitioned into services provided at local public schools or within specific programs, depending on the level and type of need identified.

Examples of the Impact of Intervening Early

While development is ongoing, and children’s skill areas do continue to change over time, addressing developmental delays or differences early is almost always more effective than waiting until they become more severe or children are seen as different from their peers. These types of concerns can become exacerbated as demands increase in school years.
In the case of a child with autism, the “wait and see” attitude could cause a family to miss an opportunity to determine the underlying difficulties their child is facing, get the appropriate diagnosis and begin to advocate for the services that can (as research has clearly shown) make a big difference in terms of the child’s functioning and quality of life down the road. Increased screening and awareness about the early signs of autism have helped many families receive this difficult diagnosis earlier, which allows them to begin the process of planning interventions that can bring positive changes.

Another example is a child who has early difficulty learning to read and who is not provided with any assessment, intervention or additional support at the first sign of problems. By third or fourth grade, he still may be struggling to read a paragraph while his classmates have begun reading longer chapter books and using textbooks to glean information about science and social studies. Early intervention and improvement in basic reading skills prior to this level could have reduced the frustration he feels and avoided the more intensive intervention or support he may require as school progresses.

For a child with behavioral and emotional issues, it is also important to intervene earlier rather than later. By addressing concerns before cycles and patterns of behavior become more deeply ingrained, problems may be rectified through briefer, more focused individual, group or family therapy. Many techniques, in combination with the right match of a counselor or therapist, can result in a corrective influence on interactions, behaviors and the structure of the environment that can help a child and family avoid more chronic and increasingly severe problems in the home, school and community down the road.

Importance of Parental Awareness and Advocacy

While professional awareness and action, as well as legislative and budgetary support, are moving in a very positive and helpful direction, some children may still slip through the cracks and miss being provided with necessary support early in their development. Parents know their children best and can be the first to notice problems or issues. They may need to press or advocate for evaluation of the problem and appropriate intervention if they are told to wait and see. At times, after screening measures are completed, parents may continue to have concerns after being told that their child’s development is not delayed enough to be provided with intervention. Being told to wait one to two or three years, when their child’s areas of difficulty have increased and are impacting his functioning even more, can be very hard on the child, his parents and the family as a whole. Many parents choose instead to advocate and appeal for more assessment or services from early intervention agencies or the school system or seek out private evaluations and services.

Parents can, and should, feel comfortable asking questions, seeking out resources and advocating for appropriate and beneficial services for their children. More often than not, the advocacy efforts of parents have driven legislation, research and funding to address the special needs of children. Professionals and parents alike can understand the value of early intervention in offsetting the development of more severe difficulties later in life, and a true collaboration between parents and professionals can result in significant improvements in a child’s life.

Kristin Olsen is a psychologist for the Testing and Tutoring Service of TLC— The Treatment and Learning Centers, a nonprofit organization based in Rockville that offers multiple services for children and adults with learning disabilities.