License To Mom: A Mention for Early Intervention

Eip2 Stella, a Queens Mama and our
License to Mom expert is at it again with some informative info. Whether or not
you know about the Early Intervention Program this is some valuable information
that you are sure to benefit from.

There’s a valid concern out there
that all we do these days is pathologize kids.  Without the growth charts
and “Your baby, week-by-week” books and email blasts, we would not be so hung
up on when kids do what.  On the flipside, delays identified earlier rather
than later can often be addressed quickly, before it causes a child to have
difficulty in his academic and/or social life, potentially affecting his
behavior and self-confidence.  Common
developmental concerns can include not talking, crawling, walking or displaying
the social skills within the typical timeframe that most kids do. 


If the goal of thoughtful
parenting is to find the logical middle ground, where is the tipping point
between overzealous evaluations and complete denial?  Of course, that
answer will vary from parent to parent (even the parents of the same child will
likely disagree!), but there may be some good general guidelines to consider.

Listen to others’ concerns
When a child has a delay, more than half the work can be helping parents
recognize it. I’ve experienced this with a few clients, and many of my teacher
friends agree they’ve worked with at least one parent who could not be talked
into addressing their child’s delays.  If you find yourself with a
teacher, pediatrician, or friend talking with you about your child’s
development, try and listen.  It is true that there are folks out there
who could really work on their delivery, but even so, no one wants to have that
conversation unnecessarily.  A conversation is not a diagnosis or a

Be open to it:
If a child was, say, having difficulty breathing, it’s unlikely that any parent
would think “He just needs more time to learn to breathe better”.  But
there does seem to be a different mindset when it comes to development. Just as
a doctor should evaluate a child who is having difficulty breathing, the Early
Intervention program should evaluate a child who is having difficulty sitting
up or crawling.  An evaluation is just that: a review of your child’s
skills, usually in your home, by a licensed practitioner.


& prepare yourself:

All children under the age of 3 qualify for free (oh yes, free), Early
Intervention (EI) Services. Private agencies and individual providers are
contracted by the New York City Department of Health & Mental Hygiene to
provide EI services.  These include:
Physical Therapy for kids who need help with gross motor skills (sitting up,
crawling, walking), Occupational Therapy for kids who need help with fine motor
skills (holding objects, picking objects up, using a utensil or crayon, or any
other “small” refined movements, as age appropriate), Speech Therapy for kids
who need help with starting to speak (enunciating, forming sounds, stuttering,
or even simply learning how to control their mouth and tongue to make the
sounds they are intending to make) and Family Counseling for kids and families
who need help with social skills (this can include helping families with
discipline and creating a consistent routine, play skills, and general family
support as it fits the child’s needs).  In
addition, there a few other more specialized services, such as respite care and
assessment for mobility equipment for kids. Families can access information
about the Early Intervention program and the Queens Service Provider
directory here.


Parents can contact these
agencies directly, or may get a referral through pre-school or their pediatrician.
 The first step is scheduling an evaluation, so depending on the agency
staffing as well as budget cuts (of which there have been many!) you may be
waiting anywhere from a few weeks to up to 3 months.  This sounds like a long time, but for
families who could benefit from these services; this is no reason to be
discouraged.  Call around and see if
someone can do the evaluation sooner, and if they can’t, use that time to
collect data.  If your child isn’t
crawling, what is she doing instead? 
Does she do the commando crawl (down on knees and elbows), but can’t
seem to get her belly up off the floor, or is she sitting up and doing a crab
crawl (dragging herself on her butt with her arms), but not using her legs at
all?  Your evaluator will want to know
these things, and the more information you can provide, the more thorough your
child’s assessment will be.  After the
evaluation, you will wait a few weeks for the report, which will tell you if
your child qualifies for services.  The important thing here is not
whether or not your child has a delay, but if there's enough of a delay
to need Early Intervention.  


If you learn that your child does
not qualify for services, the evaluation itself can be an incredible
resource.  You’ll get a gauge of where your child is in relation to other
kids (which can help you then figure out if this is something to further pay
attention to), and you can learn a few new games or activities to engage your
child in (which can help her to catch up a bit if her delays are not
significant).  Watch the therapist, note what she does, ask her questions
about what speech therapy involves, and ask her to show you 2 or 3 specific


If your child does qualify for
services, congratulate yourself for meeting his needs…and get to work. 
Start asking your Queens Mama friends if they have any experience with
EI.  Many Mamas have told me that once they explained their situation,
throngs of parents came out of the woodwork, offering referrals and
assistance.  In fact, when I asked my Mama friends for names of providers
for this column, there was such an overwhelming response, I could not possibly
include them all.  There is no dark, dirty secret here, and there
certainly is no reason not to get the names of the best Occupational Therapists
in town.  Many providers can see kids at school or in your home.  If
your child has sensory delays, you may need to come in to a center that has a “sensory
gym” for services.  I can tell you from
the 2 EI agencies I’ve worked for, the set up is similar to a Gymboree or
Little Gym: kids love it!


Once they’ve started services,
pay attention to what’s happening – you’ll be thrilled to see your child
suddenly singing new songs that focus on making “L” sounds when he could never
do that before, or watch your daughter intently trying to perfect her ability
to draw a circle, when she may not have been able to close her fingers tightly
enough to grasp a crayon only weeks before. 
One of my teacher friends told me that she has a student who was really
struggling to keep up, but then her parents’ accessed speech therapy services
for her – my friend was both happy and sad to report that she was losing this
child in her class, as this little girl was moving into the gifted


Finally, we cannot have an honest
conversation about children’s development without acknowledging that twisty
nervous feeling in our gut when we play the “worst-case scenario” game. 
Not a one of us can help it – but it is quite pointless and can cause a
“mountain out of a molehill” series of events. Some parents will indeed
experience the worst-case scenario, and they deserve our respect (and support,
when we can give it), but most families will not.  Try to quell the
doomsday voices and remember that from the best-case scenario to the worst, all
we can do is meet our children’s needs, help them meet their highest potential,
and expect nothing more or less of ourselves in the process.