| Early
Childhood Development
Listen to your heart and act.
PARENTGUIDE NEWS DECEMBER 2006
Where do parents turn when they have concerns about their child’s
development? From birth through the magical day when a child enters kindergarten,
parents universally wonder if their child is developing normally and if
there is something they should be doing to help their child.
These concerns are shared by the vast majority of parents and the accuracy
of the answers to these questions depends on both the child’s age
and the knowledge base of your child’s primary care providers. Many
times, in an effort to make parents ‘feel better,’ they’ll
be told: “Oh, there’s nothing wrong” or “He’ll
grow out of it” or “Let’s wait and see how she develops
in a year.” These words are meant to be reassuring but often are
not the best advice.
When a parent is concerned, there is usually a reason. What a parent needs
to know is that there are options available to address those concerns
and they are available at no cost, and without regard to financial or
legal status.
First, we must start with the understanding that the issue of child development
falls largely in the educational realm of services, not into the medical
model of care. What this means is that although a medical diagnosis might
be involved, the evaluation procedures and educational programs of early
childhood (birth through 5 years old) are regulated and run by the non-medical
departments of city, county and state agency partnerships. What this means
is that physicians can only suggest that a child receive early childhood
evaluations or educational services and programs. The ultimate decision
of whether or not to utilize services and programs, and whether they want
to share that information with a child’s physician, is entirely
up to the parents.
The first program that is made available to families who have concerns
about their child’s development is called The Early Intervention
Program, otherwise known as EI. The goal of early intervention is to identify
areas of developmental delay and address them as early in a child’s
life as possible, thus minimizing the delays that would otherwise exist
when the child enters the school system. This program provides a wide
variety of services including special education and occupational, speech
and physical therapies for children from birth through 3 years old.
This program requires a multidisciplinary evaluation of the child’s
development in order to determine eligibility and may include the participation
of a developmental pediatrician and other medical diagnostic tests. This
program is unique in its structure of placing the family as the “driver,”
which means that the family is a full partner with all providers and plays
a critical role as decision-maker and participant in the program. All
services can be provided either in the child’s home, in an early
intervention classroom or in other locations where the child spends his/her
time (daycare center, etc.). It should be noted that all services provided
under the Early Intervention Program are strictly confidential and, as
such, are not part of a child’s ongoing school record.
The second program that is available to parents with concerns about early
childhood development is the “Committee on Preschool Special Education”
otherwise known as: “CPSE.” This program for children ages
3-5 is designed to either continue services that were started in the EI
program through the “Transition” process, or to initiate services.
Similar to qualification for early intervention, children must be evaluated
by an interdisciplinary team for services and be determined to have a
significant need. Parents continue to play a significant role in the process
with the major difference being that CPSE is officially run by the local
departments of education and/or school districts and all records of services
become part of the child’s ongoing educational record. Services
for CPSE are provided primarily in a Center-based classroom with an option
for some home-based services when necessary.
Choosing the right program for your child requires a bit of legwork and
a lot of discussion. Is the location of the program easy for you to get
to when needed? Do you have a good rapport with the center’s administrator
and teachers, does the school have a welcoming attitude and is information
about your child listened to and heard? Is the teacher-to-child-ratio
sufficient to provide your child with the necessary attention and if your
child has a medical diagnosis, does the school have the necessary understanding
and staff to address your child’s needs? Does the school have a
clean and child-friendly environment? Is there adequate and safe outdoor
space for your child to learn to explore his or her environment and interact
with others outdoors? Investigate whether there are any special activities
such as music and art to enhance the required services. If you have any
concerns or the hairs on the back of your neck stand up, be sure to check
the status of the school or center with the Bureau of Day Care to find
out its licensure and safety record. Listen to your heart and act on it.
It is worthy to say that there is no one perfect school for everyone.
You need to be comfortable and confident in the school or center you choose
and stay in close contact with its administrators throughout the year
in order to ensure that your child’s needs are addressed and that
the services remain appropriate and adequate.
Recognizing potential problems in your child’s development is never
easy. We all want to believe that our children will develop normally and
that any problems we see will resolve themselves without intervention.
However, the early detection and treatment of developmental issues has
demonstrated very positive results for countless children. Our children
need our persistence and follow-up on any concerns we have.
Susan Lehrer, RN, BSN, is the assistant director of Business Development
at St. Mary’s Healthcare System for Children. Vivian Babin, OTR/L,
M.Ed., is the assistant vice president of Rehabilitation.
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