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I think my child is delayed. What next?

As parents, we are constantly analyzing our child's every move and comparing them to other children we see. Maybe your 2 year old son only says a couple of words. Maybe your 15 month old daughter does not walk independently yet. Maybe you Googled "normal development for an 18 month old" and your child is not yet doing the things listed. Where do you go from here? Thankfully, there are several ways of getting help!

Here is my action list:

1. Call your pediatrician.

Your pediatrician is an expert in normal child growth and development. They have seen the entire range of normal development, and will be able to give additional insight on whether to be concerned or not. Your pediatrician can also administer a developmental screening tool, which compares your child's skills to other children of the same age in a standardized manner. Your pediatrician may reassure you, or they may recommend further evaluation.

2. Call Early Intervention (EI) If your pediatrician is concerned about your child, they should recommend an EI evaluation. EI is a program that provides free services to children ages 0 to 3. These services generally consist of one or more of the following: physical therapy, occupational therapy, speech and language therapy, applied behavior analysis, special education itinerant teachers, and parent training. To qualify for services, your child must be evaluated by EI and be deemed to qualify. EI is run by each state's Department of Health, so the process and services differ state to state.

If your pediatrician reassures you, but you still have a nagging feeling that something is wrong, you can contact EI yourself to request an evaluation. I will discuss all things EI in an upcoming post.

3. See a developmental-behavioral pediatrician

It is important to take the next step and see a specialist in childhood development and behavior, even if your child qualifies for services through EI.

Early Intervention will compare a child's skills in different areas to those of a typically developing child of the same age. If your child has significant delays, he or she will qualify for services to address those areas of weakness. EI will sometimes give diagnoses of autism spectrum disorder (ASD), but they do not give medical diagnoses. This is where a developmental-behavioral pediatrician comes in! A developmental-behavioral pediatrician will conduct a comprehensive evaluation of your child, taking into account their medical, developmental, and behavioral history and functioning, as well as a physical exam. The developmental-behavioral pediatrician will then conduct additional testing before coming up with a list of diagnoses and recommendations. There are often additional things a developmental-behavioral pediatrician will recommend that will help your child and your family. A developmental-behavioral pediatrician can also help diagnose genetic disorders that may be contributing to your child's delays.

Some children have mild delays and do not qualify for EI services. In this case, a developmental-behavioral pediatrician can recommend therapies paid for through insurance or privately to address the delays.

Developmental-behavioral pediatricians can also help advocate for your child to receive more or different services from EI if the current services are not adequate.

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