Importance of Early Intervention
It happens to many parents – you’re concerned that your child isn’t hitting a developmental milestone so you talk to your pediatrician who gives you the “let’s wait and see what happens” answer. Or others saying “they crawl when they crawl.” While sometimes parents can be worried over nothing, there are times when kids do need intervention in order to develop as they should. In fact, early intervention can be key to helping your child thrive.
If you’re concerned that your child is missing developmental milestones, early intervention therapy could help. Children’s brains develop quickly between toddler and preschool age and it’s when the brain is considered the most “plastic” or malleable. If children receive treatment during this period of rapid brain growth, the therapy can be more effective and prevent more serious problems down the road.
How do I know if my child needs early intervention?
Healthy development isn’t always a clear path for infants and toddlers. Early identification and intervention for children with developmental delays or disabilities can improve cognitive and social skills, lead to higher achievement and greater independence and promote family competence and well-being. It’s important to remember that each child is different and that no one child will hit the same milestone at the exact same time. However, you should look for certain skills to develop within a range, or window, of time.
Speech and language developmental milestones:
1-2 Years
Points to body parts when asked
Follows simple directions
Understands simple questions
Says more words every month
Points to pictures in a book when named
Uses 1 and 2-word questions (“What’s that?”)
Puts two words together (“More cookie”, “no juice”)
Uses many different consonant sounds
2-3 Years
Understands simple opposites (up/down, stop/go, etc)
Follows 2-step directions
Listens to stories
Has a word for almost everything
Uses k, g, f, t, d, and n sounds
Uses 2-3 word phrases
Speech is usually understood by familiar listeners
Names objects
Asks “Why?”
May stutter on words and sounds
3-4 Years
Uses a lot of 4+ word sentences
Understands family words (e.g. brother, aunt)
Talks about events/activities that happened away from home
Speech is mostly understandable
Answers simple “wh” questions
Asks “when” and “how” questions
Understands basic shapes and colors
Uses pronouns and some plurals
Speaks without stuttering
4-5 Years
Understands sequencing and time words
Follows complex instructions
Hears and understands most of what is said to and around them
Produces all speech sounds but may make intermittent errors on l, s, r, v, z, ch, sh, and/or th
Names letters and numbers
Tells short stories and maintains conversations
Can adapt speech to listener or place (peers/adults, inside/outside)
Gross motor skills developmental milestones:
2 Months:
Hold head up briefly when placed on tummy
Turns head from side to side during tummy time
Opens and closes hands
Brings hands to mouth
Turns head towards sound
Visually tracks an object (8-10 inches away) side to side
Moves both arms and legs
Improved head and trunk control
4-6 Months:
Holds head up and rests on elbows when placed on tummy
Brings both hands to midline to hold a toy
Weight bears/bounces when placed in standing position
Kicks when placed on their back
Rolling tummy to back (accidentally)
Pushes up on hands with extended arms when placed on tummy
Propped sitting independently
Rolling tummy to back (purposefully), may begin rolling back to tummy
Purposeful play-picks up toys, moves toys, passes toys between hands, oral exploration of toys
May start belly crawling
7-9 Months:
Transitions in and out of sitting independently
Sits unsupported
May start creeping (hands and knees)
Uses raking movement to grasp an object
May pull to stand when placed next to an object
10-14 Months:
Pulls to stand when placed next to an object
Squat to pick up toy and return to stand without falling
Stand without support for few seconds
Cruising furniture or walking with a push toy
May be walking or attempting steps on their own (hands in high guard position)
12-18 Months:
Walking without support (hands down at side with natural reciprocal swing)
Climbing on/off furniture
Creeps up and down stairs (hands and knees/feet)
18 months-2 Years:
Starts to run (hands in high guard position)
Kicks a ball
Walks up and down stairs (holding on to hand or wall), step-to pattern
Walks up and down an incline
May start to jump
3 Years:
Walks up and down stairs without assistance, reciprocal pattern
Running (hands down at side with natural reciprocal swing)
Catch and throw a ball
Jump with two feet
Balance on one foot
Ride a tricycle
4 Years:
Hop on one foot
Gallop
Skip
Hopscotch
Improved ball skills-use a bat and swing at moving ball
Improved balance
5 Years:
Ride a bike
Balance on one foot with eyes closed
Can dribble a ball
Fine motor skills developmental milestones:
0-6 months
Reflexive grasp (at birth)
Global ineffective reach for objects (3 months)
Voluntary grasp (3 months)
2 handed palmar grasp (3 months)
1 handed palmar grasp (5 months)
Controlled reach (6 months)
6-12 months
Reaches, grasps, puts object in mouth
Controlled release of objects
Static Pincer grasp (thumb and one finger)
Picks things up with pincer grasp (thumb and one finger)
Transfers objects from one hand to another
Drops and picks up toys
1-2 years
Builds tower of three small blocks
Puts four rings on stick
Places five pegs in pegboard
Turns pages two or three of a book at a time
Scribbles
Turns knobs
Paints with whole arm movement, shifts hands, makes strokes
Self-feeds with minimal assistance
Able to use signing to communicate
Brings spoon to mouth
Holds and drinks from cup independently
2-3 years
Strings four large beads
Turns single pages of a book
Snips with scissors
Holds crayon with thumb and fingers (not fist)
Uses one hand consistently in most activities
Imitates circular, vertical, and horizontal strokes
Paints with some wrist action, makes dots, lines, circular strokes
Rolls, pounds, squeezes, and pulls playdough
Eats without assistance
3-4 years
Builds tower of nine small blocks
Copies circle
Imitates cross
Manipulates clay material (rolls balls, makes snakes, cookies)
Uses non-dominant hand to assist and stabilize the use of objects
Snips paper using scissors
4-5 years
Cuts on line continuously
Copies cross
Copies square
Writes name
Writes numbers 1-5
Copies letters
Handedness is well established
Dresses and undresses independently
5-6 years
Cuts out simple shapes
Copies triangle
Colours within lines
Uses a 3 fingered grasp of pencil and uses fingers to generate movement
Pastes and glues appropriately
Can draw basic pictures
6-7 years
Forms most letters and numbers correctly
Writes consistently on the lines
Demonstrates controlled pencil movement
Good endurance for writing
Can build Lego, K’nex and other blocks independently
Ties shoelaces independently
7+ years
Maintains legibility of handwriting for entirety of a story
If you notice that your child is not hitting these markers or is displaying any of the following signs, contact your pediatrician right away or request an evaluation with us today:
· Physical delays- including fine and gross motor skill delays
· Cognitive delays- difficulty learning, communicating and even trouble being aware of their surroundings.
· Social, emotional and behavioral delays- this includes trouble communicating or interacting with others and difficulty understanding information or their environments. Usually, disorders like autism and attention deficit hyperactivity disorder (ADHD) fall under this category.
If your child doesn’t develop a skill on time don’t worry, it doesn’t necessarily mean they have a serious issue and often therapy can help your child catch up and continue to thrive.
Early Intervention: Why it Works
Earlier identification and intervention is more effective and less costly. Approximately 16% to 18% of children have disabilities or developmental delays. Only 32 percent of babies receive developmental screenings to identify delays or areas of concern. 1 in 3 infants and toddlers who received early intervention services did not later present with a disability or require special education in preschool.
Research has shown that early intervention is very beneficial especially with disorders like Cerebral Palsy (CP). In fact, an early diagnosis of CP (before the age of one) has shown major benefits for motor and cognitive skills and very few disadvantages. Even if a child is misdiagnosed, while it can cause some distress for the parents, it is still overall beneficial for the child.
More research on early intervention has shown that parents play a vital role in advocating for their children to receive therapy earlier. In the article “Early Identification of children with at-risk of development coordination disorder: a scoping review” the authors note that when parents advocate for their children to get the treatment they need sooner, the early intervention for developmental coordination disorder can prevent secondary, or even worse consequences of the disorder.
Researchers also came to the same conclusion with Autism, and noted that “Early detection and intervention for Autism Spectrum Disorder (ASD) provide an opportunity to foster development, ultimately improving the quality of life and decreasing the lifetime financial and mental health costs associated with ASD.”
Overall, screening and diagnosing disorders earlier (even if the diagnosis may be initially wrong) has many advantages that can help kids have a better quality of life and prevent them from developing more serious complications from certain disorders.
What early intervention therapy is available?
At Sprouting Up Therapy, we offer physical therapy early intervention therapy as early as newborn. Please note: we are not a therapy clinic associated with the Texas Health and Human Services statewide program, but we will refer to this program if your child is between the age of birth to 36 months. Depending on your child’s diagnosis, we will work with you to develop a plan to help your child get the treatment they need. We recognize that each child is unique and our trained therapists will strive to ensure that your child gets the right services to help them thrive.
References
te Velde A, Morgan C, Novak I, Tantsis E, Badawi N. Early Diagnosis and Classification of Cerebral Palsy: An Historical Perspective and Barriers to an Early Diagnosis. J Clin Med. 2019 Oct 3;8(10):1599. doi: 10.3390/jcm8101599. PMID: 31623303; PMCID: PMC6832653.
Lee EJ, Zwicker JG. Early identification of children with/at risk of developmental coordination disorder: a scoping review. Dev Med Child Neurol. 2021 Jun;63(6):649-658. doi: 10.1111/dmcn.14803. Epub 2021 Jan 19. PMID: 33469912.
Grzadzinski R, Amso D, Landa R, Watson L, Guralnick M, Zwaigenbaum L, Deák G, Estes A, Brian J, Bath K, Elison J, Abbeduto L, Wolff J, Piven J. Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda. J Neurodev Disord. 2021 Oct 15;13(1):49. doi: 10.1186/s11689-021-09393-y. PMID: 34654371; PMCID: PMC8520312.
ZERO TO THREE (2010, February 8). Making hope a reality: Early Intervention for infants and toddlers with disabilities.
Texas Health and Human Services. 2024. Early Childhood Intervention Services.
