How long should I “wait & see”?

It is still common practice for pediatricians to tell parents to wait and see before seeking a speech and language, occupational, or physical therapy evaluation.  After all, there is a wide-range of normal, and many children just need a little more time.  Pediatricians don’t want to alarm parents by unnecessary referrals to therapists, ENTs, and audiologists.  However, there are many children that slip through the cracks with a wait and see approach and many lose valuable time, further widening the gap.  Specific groups of children that often miss out on early referrals for evaluation include children with persistent, non-infected, middle ear fluid, girls on the autism spectrum, and children with sensory processing disorder, but there are many more.  The later children receive services, the further the gap may become.

 

The Center on the Developing Child at Harvard University has found, through decades of research, that 1, 2, 3:

  • The neural circuits in a child’s brain are most flexible or “plastic” during the first three years of life.  After this period these circuits become more difficult to change.
  • Early intervention services, those received between the ages of 0-3 years, that are high-quality and evidence-based can alter a child’s developmental trajectory and improve outcomes for children, families, and communities.
  • Intervention is likely to be more effective and less costly when it is provided earlier in life rather than later.

 

If you are concerned about your child’s development of speech, language, feeding, sensory, fine motor or gross motors skills, please see the following checklists.  We recommend printing and completing these checklists and bringing them to your pediatrician to discuss your child’s development.  You and your pediatrician can work together to find services or to set a timeline to “wait and see” that you both feel comfortable with.


Checklists:

CDC Milestones from 2mo to 5 years

Infant Toddler Connection of Virginia’s Developmental Checklist

MCHAT- If your child is between 16-30 months and you are concerned that your child may have Autism, take the MCHAT screener online or print and bring to your pediatrician. It is available in many languages.

More resources can be found on our website.


References

  1. Goode, Diefendorf, & Colga. The National Early Childhood Technical Assistance Center.
  2. Center on the Developing Child at Harvard University (2008). In BriefThe science of early childhood development.
  3. Center on the Developing Child at Harvard University. (2010). The foundations of lifelong health are built in early childhood.