“How do I refer my own child for Early Intervention?” I pondered aloud one day in the kitchen while observing my two-year-old son playing with his Cookie Monster doll in the living room. We had just celebrated his birthday, and he was happily engaged with various new Sesame Street toys. While I could have done without the talking Elmo, I couldn’t deny how adorable he looked in that moment, sandy blond hair falling over his forehead and blue eyes focused on the cookie-loving monster in his lap. Perhaps I was a bit biased, but he was undeniably smart, affectionate, and funny—perfect, in my eyes. Yet, I found myself worrying.
I know this may sound like a typical parental concern, but my anxiety ran deeper. My son had needed ear tubes to eliminate persistent fluid in his middle ear around 18 months. Unlike many children who suffer repeated ear infections, his issue had gone unnoticed until a hearing test revealed that the fluid impaired his ability to hear clearly. This hearing loss contributed to a delay in his speech development, making it challenging for him to learn to speak when he couldn’t hear the words to mimic. Thankfully, I had started teaching him baby sign language at six months, which provided us with a vital means of communication before his surgery. However, I sometimes regretted teaching him signs for “Elmo” and “candy.”
After the tubes were in place and the fluid cleared, he made progress, but he still wasn’t where he should be developmentally for his age. I knew this well, as I work as a speech-language pathologist in early intervention (EI). For those unfamiliar, Early Intervention is a program designed for children under three years old who experience developmental delays or disabilities, often referred to as Birth to Three or Infants and Toddlers, depending on the region. Some states offer services until a child turns five, and while specifics may differ, the core concept remains the same. Children are evaluated at an EI center, at home, or even virtually due to COVID-19. If an evaluation reveals developmental delays, the child qualifies for services for the following 12 months or until the day before their third birthday.
Typically, these services are delivered at home, where a therapist or developmental specialist works with the family, usually weekly for about an hour. They coach parents on how to engage with their child to promote development. Essentially, it’s about providing suggestions for play—after all, children learn best through play.
Here I was, a mother with years of specialized education meant to help families navigate communication challenges, and I found myself needing assistance for my own child. It felt almost embarrassing. How could I successfully support so many other kids and their families but struggle with my own son? I took a deep breath and realized that was precisely the problem—I wanted to be his mother, not his speech therapist. I needed a fresh perspective and guidance from someone else. I had to remind myself that it was okay to ask for help.
In EI, we teach parents how to rethink play and interact with their children to help them reach developmental milestones. We identify toys and activities that interest the child and suggest ways to use those items effectively. For instance, if two-year-old Alex enjoys a farm animal puzzle, we might encourage his caregiver to incorporate language by labeling the animals and making their sounds, turning a simple game into an enriching vocabulary experience.
Despite my background, I needed to approach my son’s situation from a different angle. His language was gradually improving, but I also had concerns about his selective eating habits and sensory sensitivities. He refused to touch paint or Play-Doh, even with a mountain of Oreos as incentive, and he seemed to tire quickly during physical activities, indicating potential core muscle weakness.
Like any parent, I found it hard to accept that my child wasn’t perfect as he was. It was somewhat humbling to consider referring my son for a service I provided professionally. Yet, I knew I shouldn’t feel ashamed for seeking an evaluation. I realized the real shame would be to overlook available support due to my pride as a speech-language pathologist. So, I made the call and didn’t wait to see if he would eventually improve on his own. My son qualified for weekly sessions with a developmental specialist and an occupational therapist and also joined a weekly EI playgroup to foster peer interactions. His progress over the next year was remarkable.
Now, he is a vibrant three-year-old who never stops talking and enjoys playing with other kids. His diet has expanded, and his physical strength has improved significantly. I might be the only parent who cheered when he finally figured out how to climb up the slide, a feat that requires considerable core strength. I’m thankful I didn’t wait to seek help.
A common issue faced by early intervention providers is that parents and pediatricians often delay referrals for evaluations. Many families might not even be aware that EI services exist unless they know someone whose child has benefited from them. Others may think they need a doctor’s referral to seek an evaluation. While pediatricians, NICU staff, and other professionals often recommend EI, parents can also self-refer. Remember, you are the expert on your child and can initiate a referral if you have concerns.
Some pediatricians are reluctant to refer children too early, but it’s never too soon to seek help. Even if a child is evaluated and found to have no delays, they can be re-referred at any point before their third birthday if new concerns arise. It’s not a one-time assessment. For instance, a child might be discharged from services for meeting motor milestones only to be evaluated again later due to social skills issues or speech difficulties. Research indicates that while some children catch up without assistance, about 20% require long-term support, and predicting which group a child will fall into is challenging.
Even as a professional in the field, early intervention was incredibly valuable for our family. Having someone offer fresh ideas for activities and strategies to incorporate into our daily routines was invaluable. While it wasn’t always easy to confront challenges I hadn’t noticed, by my son’s third birthday, when we had to say goodbye to our service providers, I felt immense gratitude for their involvement. I learned a great deal about parenting and how to support my son’s success, proving that even with a master’s in communication disorders, I still needed guidance on being the mom he required.
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Summary:
As a speech-language pathologist and a mother, I faced the challenge of my son’s speech delay head-on, navigating the complexities of Early Intervention services. Despite my professional background, I realized the importance of seeking help and support for my child. Through weekly sessions with specialists, my son made significant progress, proving that it’s never too early to advocate for developmental support.
Keyphrase: speech delay intervention
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