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What Is a Developmental Assessment and Does My Baby Need One?
By Nancy Kennedy

“Is my baby okay?”

It’s the first question that a new mother asks. And sometimes, a mother has a gut feeling that her baby is not developing as he or she should. Maybe she’s making silent comparisons between her baby and the other babies in their play group, and her baby seems a bit behind the others. She tells her pediatrician, who may respond to her questions with reassurance and encouragement to “to give it more time.”

During infancy, time is a precious commodity, because the first three years of life are critically important to a child’s development and progression toward independence and fully realized potential. The foundation of the child’s life is being laid in these years, say several of the region’s infant development experts, as the child acquires the skills of walking, speech, learning, and others. According to Sharon Richards, M.Ed., CIMI, vice-president of Early Intervention at Achieva, these skills emerge gradually, on a general schedule, and are known as developmental milestones. When an infant does not reach a milestone at the expected time, it is considered a developmental delay.

“A parent should insist on a developmental assessment if they believe it is needed,” states Richards. “Delays can be in motor skills, speech, feeding behaviors and cognitive development, and can have many causes. I tell mothers, ‘Trust yourself – your doubts are reason enough to have an assessment.’ New parents think they need permission from the pediatrician but that’s not true. If your baby is behind on any milestone, an assessment is important, and you can initiate it on your own.”

The developmental assessment evaluates the baby’s physical, cognitive, communication and social/emotional development and determines the need for Early Intervention (EI), a system of services and supports for children from 0 - 3 that promotes development through various types of therapy. Providers of these therapies are experienced pediatric professionals who provide therapy in the home and teach the family to utilize the interventions themselves. EI therapy looks like play and builds on the baby’s strengths.

A developmental assessment can give a parent peace of mind, Richards says. “The assessment will either indicate that there is no reason for concern, or it will validate your concerns and lead to the next step of getting your baby the services he needs in order to gain skills and reach their milestones. You’ll be validated as a mother, too, because you sensed a problem and advocated for your child. Mothers need to trust themselves and ask for what they need. Early Intervention is a great resource and the impact is lifelong.”

Resources for Early Intervention

Early Intervention is a federal program, publicly funded and available in every state. A developmental assessment determines eligibility for EI and is free of charge to the family. EI is usually provided in the home but may sometimes take place at an out-patient center or other setting.

In Pennsylvania, every county has its own 0-3 Early Intervention program.

The first step to Early Intervention is service coordination. The parent should call the EI hotline, called CONNECT, at (800) 692-7288. They’ll send a professional to the home to collect information about the baby that will determine the composition of the team who will conduct the developmental assessment. Once the child is deemed eligible for EI services, the next step is to choose an Early Intervention provider and develop an Individualized Family Service Plan.

In Washington County, the Children’s Therapy Center (CTC) of Washington Health Systems is a provider of out-patient services, and children can qualify for both in-home and out-patient services. “There are lots of red flags that indicate that a baby may need a developmental assessment and EI,” says Debra Lawson, PT, DPT, coordinator of physical therapy at CTC. “Asymmetries are an example: hand preference doesn’t happen until age two so if your baby is only using one hand, it may be due to a birth injury or torticollis, in which the baby tilts the head to one side. If the baby is standing and walking but falling a lot, isn’t feeding well, or seems to have sensory aversions, then an assessment will help determine the source of the problem. It is important for the child to be assessed as early as there is a concern.”

One of the advantages of an assessment, Lawson says, is that the baby will be seen by a child development expert: “A pediatrician is a generalist; therapists are specialists. We provide an expert opinion and that gets the ball rolling for services. A child with a mild developmental delay should still get services: EI means that a small delay doesn’t become a big problem. It’s important to remember that other children of the same age are continuing to move forward; a baby with a delay can fall further behind if there is no intervention. EI helps prepare the child for the education system.”

Lawson adds that developmental delays can happen when an infant is spending too much time in a container, such as a swing or car seat. This can lead to decreased strength and coordination, facial asymmetry, flattening of the skull in spots and torticollis. Containers, she explains, confine an infant, decreasing sensory experiences and preventing the baby from moving all parts of the body. Physical therapy can reverse this by improving muscle strength and motor skills.

With referral for developmental assessment and individualized Early Intervention, babies with developmental delays get the help they need to reach age-appropriate milestones and get the best possible start in life. Both Debra Lawson of CTC and Sharon Richards of Achieva Early Intervention encourage mothers who have concerns about their infant’s development to trust themselves. “Mothers know their kids, and doctors need to listen to mothers,” Lawson says. “In my experience, mothers – even new mothers – are usually right.”

If you would like to learn more about Achieva’s Early Intervention services, call (412) 995-5000 or visit www.achievaearlyintervention.org
 
If you would like to learn more about WHS Children’s Therapy Center, visit whs.org/ctc or call (724) 942-6100.

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