While every child is unique, and develops on his or her own timeline, sometimes parents wonder if their child needs extra help. The American Academy of Pediatrics recently recommended that pediatricians conduct more formal screenings of early childhood development. This is easier said than done. Most pediatricians have to compress their exploration of your little one’s progress into a 15 minute appointment, while also conducting a physical and giving shots, all while the child is crying or hiding his face in your arm. It is even more difficult for pediatricians in a practice where the child sees a different physician every time. Pediatricians refer patients to other professionals such as psychologists, developmental pediatricians, and speech-language pathologists when they suspect that something about the child’s development is not proceeding as expected.
During early childhood testing, the psychologist makes a formal study of: social relatedness, intellectual functioning, receptive and expressive language, attention, memory, information processing, adaptive functioning, visual motor integration, and behavior (especially play). Sometimes we measure pre-academic goals like learning their numbers and letters. The trick is to do all of this with the most reliable, child friendly assessment tools while keeping it as fun for the child as possible. School and daycare observations are an important piece of assessment, as little children can look very different across settings. Little ones may need to come for more than one visit so that they can ‘settle in’ and feel comfortable.
When a parent calls, here are some of the ‘red flags’ we listening for: the child’s expressive or receptive language are well behind schedule, the child is having trouble relating to other people, the child is having temper tantrums that are causing problems at home/school/daycare, the child is having trouble learning at school, the child is exhibiting behaviors that are unusual or severe as compared to same aged peers. Assessment gives us the data to create a plan to build upon strengths and develop weaker areas.
As psychologists, we do make diagnoses when needed. This is different from the school system, where the goal is to determine eligibility for special education services (typically under the catch-all early childhood label ‘Developmental Delay’). Having a data based diagnosis is key, because its needed to access special education services (speech-language therapy, occupational therapy, self-contained pre-school, physical therapy, applied behavior analysis etc.). A diagnosis helps you to empathize with your child, advocate for him, meet his needs, and most importantly to plan for the future. Research has shown that early intervention is most effective, but as every child is different, every child needs his own unique intervention plan.