Unbabbled
Unbabbled
Wait and See? The Importance of Early Intervention with Anne Powers | Episode 14
My 18-month-old isn’t walking... My 2-year-old only says a few words... My gut tells me something’s wrong, but my pediatrician says we can wait and see. My Mom told me, “your cousin didn’t talk until 3 and she’s fine.” My friend says, “he’ll talk when he’s ready.”
Who do I listen to and where do I go for help?? If any of this sounds familiar, this episode is for you!
In this episode, Anne Powers, a speech-language pathologist and Director of Early Childhood at The Parish School discusses the importance of early intervention. During our chat, Anne touches on the importance of receiving services early, what age range is considered early intervention, and how parents can get an evaluation and find services. Additionally, she gives parents and educators a few simple methods for supporting their child’s early language development. We also asked our listeners on social media to submit their questions for Anne and received several fantastic responses that added to the conversation.
Anne Powers, MA, CCC-SLP, Director of Early Childhood at The Parish School, is passionate about helping children find their voices and believes that all children have the right to learn to communicate. Anne is a Hanen-certified trainer for Learning Language and Loving It™, a program designed to provide early childhood educators with practical strategies for helping children in the classroom to build language, literacy and social skills. She also has experience partnering with public and private schools, daycares and community centers in Pennsylvania and Texas to detect early signs of communication disorders and provide treatment for young children who have language delays.
Resources
- How to Spot a Language/Learning Disorder Early
- American Speech-Language-Hearing Association:
- Early Intervention Services in Texas:
Hello and welcome to Unbabbled, a podcast that navigates the world of special education, communication delays and learning differences. We are your hosts, Stephanie Landis and Meredith Krimmel and we're certified speech language pathologist who spend our days at The Parish School in Houston helping children find their voices and connect with the world around them. In this episode we speak with certified speech language pathologist Anne Powers about early intervention and as the director of early childhood at The Parish School and has experienced working with public and private schools, daycares in community centers to detect early signs of communication disorders and provide treatment for young children with language delays. Prior to recording, we reached out to our listeners via social media for their questions and received several fantastic responses that added to our conversation during our chat and touches on the importance of receiving services early. What age ranges are classified as early intervention and how parents can get an evaluation and find intervention services additionally and gives parents and educators if you simple ways they can support their child's early language development. Be sure to check out our episode description for links to resources. Hi Ann, welcome to the podcast. We're really excited to talk to you today about early intervention.
Anne:Yeah, I'm glad to be here.
Stephanie:Thanks. We had asked a few of the listeners on Instagram and Facebook to give us some of their questions and they had amazing questions so we'll jump in with theirs. And the first one they ask is what is early intervention?
Anne:Yeah, it's important to define right from the start, I suppose. Early intervention is a term used to describe services for children who are babies or young children to help meet some of their developmental needs that are lagging. So it could be things like speech therapy or physical therapy, occupational therapy, mental health services, whatever, a child who's at risk, maybe needing, so those services are provided through professionals. Some of those services are available for free. Each state has a child find that you can help get connected to those resources. Or sometimes families choose to privately pay with insurance or go to clinics and those types of things.
Stephanie:What ages fall under the early intervention category?
Anne:It depends on how you define it. Some States define it as zero to three years of age, others zero to five, but you're really talking about kind of babies, toddlers and through the preschool years.
Stephanie:Great. One of our other great questions was when should I be concerned about my child's language development?
Anne:When, um, I guess anytime you're feeling nervous, it's a good time to explore that question with your pediatrician or with your therapy team if you have one. Um, there are certain developmental markers that we're looking for if we're talking specifically about speech and language and we really want to see that children around the first year of age are beginning to use words. Um, and that can be tricky because child development is different for every child. They progress at different rates. And so I think that's where it gets confusing for families and for teachers. I work with a lot of teachers as well. That's often a question that they have is how do we know what's just the normal span of child development and what, what is problematic? So I think that's a, that's a good question. So when to be concerned if your child is having a hard time understanding that language that they're hearing, if they're having a hard time communicating their thoughts or their ideas, then those are always really big red flags. If you notice that their social development is a little bit different, that they're not connecting with their siblings or with you or playing in those types of way. Those are all red flags. But if we're talking specifically about words and when kids are using words we want to look for by 18 months they should have about 20 different types of words and they should be using a variety of words. So not, not just nouns like mom, cup, dog, those types of things, but also action words and verbs and prepositions and on under things like that.
Meredith:A really great question we got as well as if I am concerned, where do I start?
Anne:Yeah, I with a speech language pathologist is a great place to start. If you're worried about communication specifically. Sometimes parents or teachers will say something just doesn't feel right and I don't know what that is, whether it's language or something else. And I think in those cases it can be really helpful to have somebody look at the whole child with you look at child development as a whole and look at how is their language developing, how is their physical gross and fine motor skills developing? How are their social skills developing and developmental pediatrician or a neuropsychologist can help you with that.
Stephanie:Oftentimes people start with their pediatrician and it can get tricky because some pediatricians more than others will have kind of the wait and see approach. At what point in time should a parent or do you suggest a parent stops doing the wait and see and goes ahead and goes for an evaluation. Many parents are told, wait and see, but in their gut they still feel like something might be wrong.
Anne:Yeah, I hear that all the time. The the wait and see or from well-meaning friends or relatives who say oh so and so didn't talk till he was five. You know, it's totally fine. As a parent, you have an instinct about your kids and there's a lot of anxiety and stress when you feel like I know something's not quite right here and, but you're being told it's all right. It's all right. The hard thing is we don't have a crystal ball into the future. And when we're talking about late talkers, there are some children that develop language later and so late talkers technically is defined as 18 to 30 months where the rest of their development is going well. Like they're understanding the language that they're hearing. They're playing as expected, their motor skills are as expected, but what they're able to put out, what they're able to express with their vocabulary and other types of things is not, it's still very little. There is that group of children and some of those children grow out of that, but many children don't. And we also know that some of the children that appear to catch up later in the school years, they're language really still has some differences in it. So the best thing to do is go ahead and seek help. Go ahead and seek an evaluation because we know that the earlier that you get intervention, the better it actually is for the child.
Stephanie:Yeah, I found it very interesting going through and reading some of the research that shows that some of the late talkers, yes, might catch up, but the majority of them, because they were having difficulties with vocabulary or oral language expression, once they get later into the school years, they're finding that not all of those difficulties were resolved. And now that language gets more and more complex, they really were having difficulties. It just wasn't being caught when they were younger.
Anne:Yeah. And we know that children that fall into that late talkers category, some of them are more at risk for ongoing issues. Right. And, and some of those risks include a family history. If you have a family history of any kind of language difference or learning difference, your child is at greater risk. Um, gestures, a child's ability to use gestures. There's a lot of research around that and we really are wanting children to use at least 16 gestures by the age of 16 months. So things like waving, you know, that's really communicating through a gesture, a meaningful message. Like I know when I wave goodbye, even though I can't say that that one of us is leaving, you know, so lots of pointing and showing and giving, we would expect to see, start seeing a lot more of that right before a big, you know, vocabulary burst at 18 months. But so if you're not seeing those gestures, that's a big red flag. And just in general, I think it's important to remember that communication is more than just words. So if you're seeing any other types of red flags or any other types of difficulties that aren't going quite the way that you're wanting it to, or even if your child does have a lot of language but you're still having to do a lot of interpreting for them and giving context for them to other listeners, those are all red flags of continuing language needs that need to be addressed through therapy.
Meredith:And if a child is a late talker, would it hurt them to get evaluated?
Anne:No. I mean of course not. That's the, to me, that's the great power of therapy is that it's not detrimental. Unlike other types of medical interventions that could actually harm development or harm health if it's not absolutely necessary. It can only help. And we know that children experience all kinds of frustrations when they can't communicate. I mean just imagine when you're trying to say something and you can't find the words that you want to use. We have that experience all the time, but these children really don't and so they end up having more meltdowns and are communicating in more of the undesirable ways that that parents want to reshape. And so any type of language delay or any type of learning difference really ends up impacting the whole family. And so getting help for those things earlier, even if these issues do resolve can only help that child and help the family through that season of time.
Stephanie:Yeah, that kind of leads us into one of the questions that we got online was does it really intervention really help?
Anne:Yes, it does. What research has showed over and over again is that the earlier you get intervention, the better. The more impactful that it is, both from an efficiency standpoint and from a financial standpoint, it's much less costly to intervene early. And that's because children in the in these age range from zero to three, their brains are in the most rapid time of growth. They're 80% of their brain is developed by the age of three. So their brains are just like primed and ready to grow. They're building that foundation in their brain, all those connections for language and learning and behavior. And so when we have an opportunity with early intervention to directly teach the skills that are lagging, we can strengthen the connections in the brain that we want to strengthen. We can build new ones that we want to make. So really during these, these years, the brain is much more adaptable and it's a much more fluid system. So we can have a greater impact early. But it's also important to know that it's never too late. So if you feel like, Oh no, I've, I've missed my time. it's too late to help my child. It's never too late. We always know that no matter your age and even into adulthood, a person continues to make progress as compared to themselves. So always get help.
Stephanie:Yeah. I saw a infographic that really kind of hit home that point, and it showed a child at, I think it was a toddler, and it had how many words that they had. If they had like 10 words, but some of their peers had 50 words, they were only about 40 words behind, and then fast forward, even just a year's worth of growth. If the toddler that had only 10 words doubled it, they had 20 so they made this, but the other toddler doubling it had exponentially more. So even though they made the same, you know, doubled what they had, they were now further behind. And so that kind of hit home that like, yes, as their growth keeps going rapidly when their children, children who are already behind need to make even more growth to catch back up. And the best way to do that is through targeted intervention.
Meredith:I think the, the term catch up can be a little misleading because everybody does learn on their own path and especially if there is a language delay. I know a lot of parents come to speech language pathologists and say, I want them to catch up. We know that sometimes kids learn at a different rate and as long as they're making progress against themselves and successful in whatever environment they're in, that's good.
Anne:Yeah. I think that that's what we desire for all of our kids. Right? It's so hard to think, Oh there's something wrong with my child. I want that fixed. I want that to go away. It's such a hard emotional journey I think as parents to to face that and walk through that and seek help for those skills that you, you nailed it. That's exactly it. Children develop in their own time. We know that therapy can help with those things and we know that if we get therapy early, we can change the life trajectory of a child. So it's really not about trying to fix someone or you know, change them to be other people or we're wanting to meet children where they're at and um, help them grow in the ways that they need to really thrive and be effective communicators. And that timeline might look different or they might continue to need strategies later in life to help the things that are feeling hard. But that's not unlike us. All right. I, I can't spell, I have to use spell check. I can't do math. These are things that are really hard for me. I have to use a calculator, even basic math or count on my fingers. We all use strategies. These things are tools to help us succeed and grow. So it's not about trying to make children fit into a cookie cutter definition of what normal is. It's just celebrating, celebrating them for their uniqueness and helping them just be effective communicators and, and live up to their, their potential living up to their potential. Yeah.
Meredith:And to Stephanie's point, the longer you wait, the bigger the gap. I imagine you see more frustration than the gap can maybe even grow more and more without intervention. So even if they're not quote unquote catching up, they're making progress. That's allowing them to be more successful and closer in range to their peers as a communicator.
Anne:Yeah. I mean that's the great risk and not getting help is that we know maturity alone doesn't resolve these issues and for young children it's not enough to also just be around other children who are developing typically that have these skills. Right. If it was enough for these children just to be around typically developing people, they would have already acquired the skills because they've, even if they're only children, they've been with their parents their whole lives and grandparents and cousins and classmates and so really what they need to, to change their skill level and to strengthen the things that are feeling hard for them is to have direct teaching from a skilled clinician that can also partner with the family, partner with parents and caregivers and the teachers so that this child is getting lots of direct teaching for the things that are feeling hard.
Stephanie:Yeah. I think that's an important point is that at this age range of the early intervention that some of the best therapy is partnering with the parents and the teachers that are around them often because in occupational therapy or speech language pathology or the physical therapy, if they're needing that at an early age, there's only so short time period that they have for direct intervention and parents can learn such great skills to be doing that at home and really targeted ways to help boost their kids language and other development at home.
Anne:Absolutely. Parents are the child's first teacher and you're forever teachers, right? You never grow out of that role.
Stephanie:Um, yeah I still call my mom and she just teaches me things. Right?
Anne:But the great thing is that parents don't have to navigate that alone. Like really to be most impactful. You need the help and guidance of someone that has in depth knowledge about social communication or language development or physical development so that you can be equipped with those same techniques to be a greater, more effective teacher.
Stephanie:And kind of an outside lens. Because sometimes when you're in it, you're wondering, is this something that all children go through? Is this something that's just my child? I've had parents that I've worked with and their child is suddenly throwing fits and using their words to express their ideas and really giving their point of view across and the child might not have done that at a younger age and they get a little frustrated or give me a weird look when I start getting excited and I said yes, you know, they're hitting this developmental milestone and they're starting to realize how powerful their communication was. Whereas before they might not have. And so while it seems like, and it is probably difficult for them at the time, it's also something to be really celebrated.
Meredith:And I think having the outsider view is really important as well because we're just so close to it as parents, you're in it every day, you're with your child every day. Maybe you understand a lot more of their communicative attempts because you know them so well. So I think anytime there's reason for concern, it's nice to bring in an outside person because you're just too close. Even as a professional myself, I'm, I just, I'm too close. I absolutely, yeah.
Anne:I hear it all the time from parents just like, I need somebody who's not mom to teach this or you know, how, how did you get them to do that? I ask him to do that all the time and he doesn't do that at home. And yeah, it definitely helps to have that outside person to just help continue to challenge. Right. And to bring awareness. You know, sometimes when we're around the people we love and our, and our kids, we're automatically making accommodations for them that were not even aware of cause they're such ingrained habits. So it really does help to have that outside lens just to help you refocus and yeah, we can challenge in this way. We always want to give our kids that just right challenge where they're, they're feeling like, Oh gosh, I'm having to stretch a little bit and work for this, but also not reaching that point of frustration and an and an outside professional can help you see that lens more clearly. Right? We want kids practicing skills, not just where they already have skills. We want them to be independently practicing them, right? But where they're there, they can do it with a little bit of help. That's where that professional can help bring some clarity to that without reaching that point of frustration. Sometimes. Also with parents, we're expecting our kids to be capable and competent really before they have the skills, so an outside professional can help give clarity to that. Like what can I expect without reaching frustration and what is really something I'm asking them to do that they don't really have the skills to do yet.
Meredith:Like you said, accommodating for our children without even realizing it. I remember a year ago I went to a friend who's an occupational therapist and said, I'm really worried. My son's not really dressing himself on his own. And she said, well, have you let him try it? And I thought, no, I really, I haven't, I have been making accommodations without even realizing it. So we do things as parents that we don't even realize that maybe it's pushing them too hard or maybe it's giving them too much support, not letting them be independent.
Stephanie:And how many moms do you hear out in public and their child is asking for something and the word sounds completely different and the mom's like, Oh yeah, they want this. Yeah. Or the dad's like, Oh, he's asking for that specific thing and everyone around is going, what? I did not get that at all. Parents are just so in tune with their kids naturally. And I find so many parents offers such great support and scripting and they, you know, guessed to what their kids needs are before they ask for it. That they don't even notice how much support they are giving.
Anne:Yeah. Or help provide context too. Right. Oh, he's really asking you this or he really is wondering about this. Right. Even if you can understand the words, cause sometimes it's not just about getting the words out, it's about understanding, Oh this person doesn't have the same contacts that I do. Some of those social communication skills. So yeah.
Stephanie:And I find that that's another way for parents to know if early intervention might be something their child needs is if they're finding themselves out in public a lot when their child's may be three or older and at an age where they could be or expected to be understood by other adults. And the parents are having to kind of like intervene and step in and provide context or clarity.
Anne:Yeah, we know that, you know, obviously early intervention helps all kinds of skills. And we've talked a lot about language specifically, but even with children on the autism spectrum disorder, there's all kinds of research that really says if we can intervene early before the age of six, we're talking about a quality of life change for them after that age. It's just that that time is so impactful. And sometimes our children on the spectrum have crazy vocabularies and spectacular memories and can tell us all kinds of things, but it's the other pieces of communication that are feeling a little bit harder or that they're feeling more challenged. And so yeah, early intervention can help with all kinds of things.
Meredith:We've talked a lot about how parents are an important part of intervention. Do you have advice or strategies parents could use at home to help with language development?
Anne:Yeah, for a young children and there's no replacement for being present and that is so hard, especially I think with our day and age where we always have phones with us or always have tablets with us, but there's no replacement for just being present, being to face with your child and having real authentic communication. So really just observing your child, seeing what their interest is in following their lead, imitating their play, looking for the things that they're interested in. I think parents, we are, we're so proud of our kids that a lot of times we say, Oh, sing the ABC's and show how you can count. And we're peppering them with a lot of questions, but when we're peppering with a lot of questions that can sometimes shut down that communicative exchange. So, or taking turn, taking in conversations. So really just being present with them, playing with them, joining in and playing, imitating, commenting on what kids are doing, you know, I, Oh, I see you building the blocks. And sometimes when adults enter play, there's this great fear that, Oh well they're not building blocks the right way, or they're not, you know, they're struggling with that puzzle piece, but just being okay with that and Oh yeah, that's really tricky. Or I see you're trying to build that even higher. Oh no, whats going to happen. Those types of things. Just trying to be playful, slow down and be playful and present.
Stephanie:You know, one of the things I often tell parents is that it feels really awkward, but instead of quizzing their kid as a way of interaction is to be more like a sports commentator. Yeah. And just comment on everything they do and then kind of narrate what the parent is doing themselves. And it just naturally kind of builds in conversation and,
Anne:Yeah, and using a lot of I wonder statements, Oh, I wonder what that was like or I wonder what it was like when you were, you know, running in school or whatever the example might be. Just those I wonder statements can prompt kids to just sit in the silence for a second and then they'll start talking about it and sharing ideas.
Stephanie:Are there certain things that teachers who may be in an early childhood setting and can do in their classrooms to help support these children who they may feel have some red flags or delays?
Anne:Yeah, um the same sort of thing. Finding time in a busy classroom just to be present, to get face to face, to provide that child with lots of rich language models. Sometimes we feel like because children aren't speaking as much as their peers, that we have to water things down with them and kind of use baby talk or incomplete sentences. And we still want to be providing kids really strong grammatically correct language models for them. Um, even if we have to simplify that sometimes. But yeah, reading books, the big thing is giving children enough time to respond. And then also when you notice that a child is just, I feel like children with, with communication delays kind of fall into one to one of two categories in the classroom. Either they're the child that's always on your radar, that you just are always thinking, Oh, Bobby, uh, no. I said this, you know, get in line here. Oh, why are you over there at their backpack? I said, it's time to go here. That child, you know, that's just always wiggling, always on your radar or the exact opposite. The child that tends to just, um, float along, right? They're never a big presence in your classroom. It's not that they're disruptive, but they're just not fully engaging. They're always on the perimeter. So when you see children in one of those two categories, it's time to pay closer attention and really look, are they, are, are there some red flags here? But then also to take the pressure off yourself to be the one to diagnose what those differences are. It can be really hard to talk to parents about the red flags that you're seeing. It takes a lot of courage and, and we can feel sort of nervous and take on too much responsibility for that. But our job, whether you're a teacher or a therapist, is to be honest with parents and equip them with the information that they need. And it's okay to say, Hey, I'm noticing these things. I'm concerned, you know, have you talked to your doctor about that? Or have you thought about seeking a speech and language evaluation? And if you're in a daycare setting or a school, talk to your principal, talk to your director and really partner with them so you can best equip families with the resources. Like you may be able to do some of the legwork on who are qualified providers in our areas and share that with families.
Meredith:And I know my child's daycare comes home, um, at the beginning of the year with a bunch of resources, including information for early intervention. So sometimes even if your teacher hasn't said anything to you, going to your teacher or your director of your daycare can help you with resources of where to go.
Anne:Yeah, and one thing I think that's really cool to know is that the early childhood curriculum in schools is so language based. So sometimes children that who are struggling to learn the content of kind of that preschool three year, that's a huge red flag that, you know, maybe what they're really struggling is with his language. So maybe it's not about giving them another year to mature. It's about making sure that we get the appropriate intervention in place so that they can acquire the skills that they need.
Stephanie:I think you made a really great point about, um, having it feel like a team that the teachers are on your team with the parents because they want what's best for the kids as much as the parents want what's best for the kids. And I think when people approach it that way, therapists, teachers, directors, family members, that it, it feels better when you're supportive as a team member. And instead of coming across with a list of like, Oh, your child's not doing X, Y, orZ, there was something wrong. Instead of, Hey, I'm noticing this, I want to give them support and you support it, let's look into this and see if that's an area where we can boost their skills.
Anne:Yeah, absolutely. I think that's, you know, why I love early intervention so much is because we're talking about quality life of, of life for kids and for their family, their whole family. And if we can get in early and make an impact early, that just, that makes such a difference to them. Um, to that child and to a family and things can be really hard when you have young kids. And so that would be just absolutely like it's a wonderful thing to have a team of people around you to help you and we all need that.
Meredith:And we know the child benefits the most when everybody's together working together.
Stephanie:Yeah. Sometimes I wish I had an even bigger team for my child.
Meredith:It takes a village.
Stephanie:It really does. This is backing up a little bit, but you discussed saying that they could go to a developmental pediatrician or a neuropsychologist or even that the government provides early intervention. Can you explain where parents might go to find those resources?
Anne:Yeah, we can probably share those resources too.
Stephanie:In our show notes, we'll share them.
Anne:Every state has as something called child find, so children, there's bylaw, there's some protections for children who are at risk for developmental delays or who have developmental delays and disabilities. So there are services birth to three. Those are usually provided in the home. Professionals come into your home and work with your child and then usually at three those transition into this school district. And if you're not sure how to find child find and you can always locate, you know your neighborhood school and tell them the age of your child and they should be able to direct you to the right agency. Whether they're going to take over that case or whether you need to go to the child find agency.
Stephanie:So, so they just can contact the school directly?
Anne:Yeah, they can contact the school directly. Just show your, your local neighborhood school or Google Child Find.
Stephanie:And how would somebody go about finding a developmental pediatrician or other evaluator?
Anne:Yeah, sometimes your insurance is a good starting point. Those evaluations can be costly. Sometimes you know, asking your pediatrician for a list of referrals, asking other friends or have you heard of anyone can help. If you do know that there's a special school in your area, like The Parish School, you can contact them for some information. Or if you already have a therapy team, like if you already have a speech pathologist but you're really wondering what your whole child, how your whole child is developing, asking them can also be a step in finding that, that right resource. As far as finding qualified speech pathologists, you want to look for somebody who has their, what's called their certificate of clinical competence and you'll know that a speech pathologist has that because after their name they'll have these three C's written, CCC-SLP and our national licensing agency, American Speech-Language and Hearing Association. They have a provider finder on their website. So you can always go in and put in your website and find qualified therapists that way.
Stephanie:We appreciate you giving us your time and your expertise. We do ask one hard hitting question at the end of every podcast.
Anne:Oh dear, okay.
Stephanie:If you had one piece of advice to give to our listeners, parents, educators, it can be specifically on early intervention or just general advice, one piece of advice. What would you give?
Anne:Besides getting intervention early, start the earlier the better. I would just say, give yourself grace as parents and give your kids grace as parents. You know, we all would if we could. Anytime your child has a difference. It's incredibly hard, not only on that child that the whole family on, on parents, on marriages, so just being, being graceful with each other and seeking help and knowing that you don't have to be alone in it and that it's okay that things are different. It doesn't mean that your child will not thrive. We can celebrate them and still see them achieve great things even though their path looks really different. Even though this was a journey that you didn't want to be on. And I think that although that's felt in unique ways, when they're special needs, I think that's true of all families. You know? Um, we never know what, what our life is gonna unfold and look like. So just be gracious and loving with each other and seek help.
Stephanie:Yeah. I like giving yourself grace. Oftentimes it's easy to blame yourself like I did something wrong as a parent or I'm not providing the right thing to help my child grow. And oftentimes it's nothing that the parent did. It's just, it's just how that child is wired and how they develop.
Meredith:Yeah. Well, thanks Anne. We appreciate it.
Anne:Yes, thank you.
Meredith:Thank you for listening to the Unbabbled podcast. For more information on today's episode, including links to resources mentioned, please see our episode description. For more information on the Parish School, visit parishschool.org and if you're not already, don't forget to subscribe to the Unbabbled podcast on your app of choice. And if you like what you're hearing, be sure to leave a rating and review. A special thank you to Stig Daniels, Amy Tanner and Amanda Arnold for all their hard work behind the scenes. Thanks again for listening.