In 1988, I became a mother for the second time. Our first son, Matt, was a normal three-year-old boy, enjoying all the things that little boys liked. He loved to play outside, read books, interact with others and talk. After our second son became nine months old and we began to watch for milestones, we noticed something was different. Chris was different. He wasn’t trying to walk or climb, he didn’t like to read books or concentrate on simple tasks and motor skills were not developing. Was I jumping to conclusions? I was a mother working in the field of early childhood and I felt lost. After months of doctor appointments and evaluations, we found out that Chris was diagnosed with severe apraxia. This is a speech and neurological delay that presents problems with communication, fine motor and comprehension skills. I was experiencing anxiety on both sides of the fence—educator and parent. I needed support, more education, understanding and answers.
Knowing what is “typical” versus problematic when it comes to communication can be difficult for parents and educators. In their first years, children form foundational communication skills. If issues develop during this period, children generally respond well to treatment. Below are five behaviors an early childhood professional or parent should pay attention to:
- A child isn’t making eye contact or smiling. Much of early speech and language development is non-verbal. One of the first ways an infant communicates with a parent is through eye contact. As early as age 6 to 8 weeks, a child should be able to hold a gaze—particularly with a parent or other caregiver. A social smile should be present as well.
- A child isn’t using gestures. Also in the category of non-verbal communication, an infant should begin using gestures by the time he is between age 6 to 12 months. These include clapping, pointing and waving.
- A child isn’t cooing or babbling. Well before the long-anticipated first word is spoken, a child should be verbalizing sounds. Cooing typically occurs by the time a child is age 2 to 4 months old, and babbling by 6 months. By age 1, a child generally should say one or two words. By age 2, a child should be stringing two or more words together.
- A child is not understood by others. Parents are wonderfully attuned to their children’s needs. They can tell the differences in their cries of being hungry, tired or in pain. As the months progress, parents get even better at deciphering what their child wants. But even if they understand a child’s sounds or words, they should pay close attention to whether other people, including a caregiver, can understand what their child says. If others cannot understand a child by age 18 months to 2 years, this is an indicator of a potential speech or language issue.
- A child is not responding to his own name. This can be a sign of hearing impairment. Parents or caregivers may not realize the need for vigilance about hearing because most newborns undergo hearing screening before leaving the hospital. However, hearing problems can emerge weeks or months following birth. Ear infections can also lead to hearing problems. Hearing issues may not be obvious. If a child is not responding to his or her own name by age 7 months to 1 year, a problem may exist.
If you suspect a child has a developmental delay and believe a parent is unaware of it, use the following guidelines to make the conversation go smoother:
- Highlight some of the child’s strengths, letting the parent know what the child does well.
- Always use facts. Let the parent know that you are using solid examples of milestone criteria versus your feelings. Talk about specific behaviors that you have observed in caring for the child. For example, “Most four year old children participate in ‘pretend play’ with other children. I have noticed that Joey does not interact with others in the class.”
- Make the conversation a discussion. Pause often, giving the parent time to think and to respond.
- Listen to and watch the parent to decide on how to proceed. Pay attention to tone of voice and body language. Expect if a child is the oldest in the family, the parent might not have experience to know the milestones the child should be reaching. This might be the first time the parent has become aware that the child might have a delay.
- Let the parent know that she should talk with her child’s health care provider soon to relay any concerns or other information is needed. Parents can also be advised to look into Early Intervention programs in their state, or seek an assessment with a certified speech-language pathologist or audiologist.
- Lastly, remind the parent that you do your job because you love and care for children, and that you want to make sure that the child does his very best. It is also okay to say that you “may be over concerned,” but that it is best to check with the child’s doctor and be certain, since early action is important if there is a real delay.
Early intervention works and is crucial for the development of a child. Support is crucial for parents and caregivers. I was given both. My son received the services that he needed to reach milestones and his caregivers received support through professional services. Continue to advocate for children with special needs because every child deserves the chance to succeed in school and in life.