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Early Identification & Referral

Dear Debi,
My 3-year-old doesn't seem to be talking as much as I think he should. How can I find out if he's developing at a typical rate?
Maricruz Sanchez
Debi's Tips
Debi Gutierrez
Debi Gutierrez
  • Contact your local early intervention program
  • Schedule a developmental screening
  • Be persistent in seeking an evaluation
  • Get a second opinion
  • Follow through with recommended treatments
Expert Advice
Carmen Vasquez
Carmen Vasquez
Early Intervention Specialist
As we know, each child develops at his or her own pace and is different and unique. However there is a range within which children should be developing, milestones they should be hitting. A developmental delay is when a child isn't hitting those milestones or accomplishing the things that are typical for his age. For example, if by four months, a child isn't cooing, making eye contact with his parents, and holding his head up, those could be signs of a delay.

A developmental delay can be detected as early as infancy. Again, it goes back to those developmental milestones and observing your child to make sure he's doing the developmental things he should be within the appropriate time frame.

Early identification is very, very important. If we're able to identify a delay from early on, we can immediately go into action to provide the best services to enhance that child's development and help improve his chance of success.

I suggest first discussing your concerns with your pediatrician. Your pediatrician can then refer you to the appropriate early intervention services. However, you don't have to go through a pediatrician. You can contact the state's Early Intervention Program for resources. You can also go to the local education agency, such as your school district. In fact, there are some delays that are required to be served by the school district.

Sometimes a child's development may not be accurately reflected during a regular doctor's visit. If the pediatrician doesn't think there's reason to be concerned, but parents still have concerns, they should certainly seek a second opinion. Parents know their children better than anyone and shouldn't second-guess themselves. Again, parents can go to their state's Early Intervention Program. You don't need a referral from a pediatrician in order to receive an evaluation. Anyone can make a "referral." The primary referral sources include parents!

Once it's determined that there is a delay, an individualized family service plan (IFSP) is then issued and children are assigned a service coordinator. The family then works closely with their coordinator for treatment, and parents can choose the people they want to be involved in implementing treatment, such as child care providers.
Child Care Provider Comments
Aimee Gutierrez
Aimee Gutierrez
Mother of three
Diego was close to two years of age when I began to really notice his speech. He didn't have as many words as other two-year-olds. He wasn't making complete sentences, not even two-word sentences, so I was really concerned. I just had that gut feeling. I shared my suspicions with my husband and he suggested we get the pediatrician's opinion. Our pediatrician assured us our son was still on track, and that we should give it more time. My gut instinct was that I should have gotten a second opinion and had him evaluated right away, but my husband was relieved to hear the pediatrician's advice. When a family friend, who is a speech/ language therapist, confirmed my suspicions, we sought help right away.
Janis Sanders
Janis Sanders
Grandmother of four
We noticed that from an early age my grandson seemed to not respond to commands and trying to get his attention was very hard. We thought that he was just being stubborn. Then we began to realize that maybe he's not really hearing us.

The doctors confirmed that indeed he had hearing loss. Early diagnosis has really helped my grandson. He receives affection much more now. Before he didn't want anyone to touch him. He was constantly startled. Now he is very social and talkative. We don't always understand him, but he's come a long way. He is about two years behind in his speech, but should eventually catch up.
Alma Martinez
Alma Martinez
Child care provider for 10 years
As a child care provider, if you suspect that a child might have a delay, you should be very sensitive. Often parents may suspect that there could be something not quite on track, but it's hard for them to admit it. You have to empathize with people. It's important the parents know that if they stick with me, I'll be with them every step of the way. One of the things I have noticed is that new parents don't know what to do in situations like this. They depend on more experienced people such as providers to help them along the way.

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