Making a Difference for the Very Young
by Kerri Scwab
The same brochure greets you at every visit to your child's pediatrician: a colorful pamphlet with a smiling baby on the front and a developmental milestones questionnaire inside. And at every visit, you dutifully glance through and note the things your child can do.
To some milestones, you give an emphatic "Yes! My child walks, runs and climbs!" For others, you answer "No, she's not sitting alone," but tell yourself she's just not ready, or hasn't needed to - but you are sure she'll start soon.
The questions parents hesitate to answer - because their child hasn't met the skill - can be red flags in a child's development. If your child hasn't met a milestone, it could be he or she isn't ready, like you thought. Or, it could be something more.
Gaye and Doug Watkins noticed their son Joseph lost words and skills when he was about 18-months old.
"We didn't know what was wrong," Gaye said. "We knew he was having some loss of skills and regressing other ways and we were very anxious to find out why."
Just before moving from New York to Virginia, their pediatrician referred Joseph for developmental evaluations that showed speech and social-emotional delays. Once in Virginia, Gaye and Doug wanted speech therapy for Joseph, but thought they had to wait for a pediatrician's referral. They waited almost four months before getting help.
"We didn't know all we had to do was contact your office," Gaye said.
Many pediatricians and parents aren't aware of the free developmental screenings offered by The Infant and Toddler Connection of the Blue Ridge, the local early intervention agency.
Anyone with concerns about a newborn or toddler's development, including intelligibility of speech, quality of large muscle movements, or ability to use small muscles, can refer the child to early intervention.
"We didn't really realize how important time is when your child has ... any kind of delay," Gaye said. "We didn't realize the significance of early intervention and what it is and what it does."
The Infant and Toddler Connection of the Blue Ridge serves Charlottesville, Albemarle, Louisa, Greene, Fluvanna and Nelson counties. Early intervention programs exist in every state, and are federally mandated under the Individuals with Disabilities Education Act.
After a receiving a referral, Karen Taylor, the central point of entry, completes an in-home screening and explains early intervention to the family. Karen plays with the child to compare his or her abilities to an established standard of typical child development.
If the screening shows the child might have a delay in one of seven developmental areas, Karen refers him or her for more detailed evaluations in two of the areas. The developmental areas include expressive or receptive communication, gross or fine motor skills, self-help, social-emotional or cognitive skills. The in-depth evaluations help determine if the child has a 25 percent delay in a developmental area, making him or her eligible for early intervention.
For example, if a child is 20 months old but has communication skills typical of a 16-month old child, that is a 25 percent delay and the child is eligible for early intervention. If the child has a diagnosed condition such as Down's Syndrome or autism, they are automatically eligible.
Next, the family meets with their early intervention team to write an Individualized Family Service Plan. The plan outlines a typical day for the family, what the child's delay is, and what therapies and therapy goals are needed to address the delay. Therapies can include speech, occupational, physical, vision or hearing, as well as special instruction, which addresses cognitive delays. Therapy sessions can be billed to some insurance companies, or paid for using Virginia's early intervention sliding fee scale.
Once therapy starts, Step By Step, a program under the Infant and Toddler Connection, takes over as the monitoring agency for the family, child and therapist. Therapy happens in the family's home, or any place the family might typically go, such as the park, library or pool. Therapy is play-centered and therapists use toys already in the child's home. During each session, parents learn to encourage their child's development by putting the therapists' suggestions and activities into their daily routine.
Gaye discovered letting Joseph play with shaving cream, beans, pudding and gravy was therapeutic.
"It's for sensory depravation because he doesn't like doing a lot of things with his hands," she said. "You don't really stop to think about the importance of very small but very significant pieces of information you get from people who are more trained."
Step By Step also provides families with service coordination, which gives them one person for all their early intervention or typical child development questions, and access to a lending book and toy library.
Service coordinators also help parents link up with other children's programs such as specialists at The Kluge Children's Rehab Center (KCRC), workshops with Children Youth and Family Services, or other community resources such as The Parent Center.
KCRC is part of the Children's Medical Center at the University of Virginia. It offers in and outpatient services to children from birth to 21 years old with a range of disabilities. Many Charlottesville families see the specialists and outpatient clinics at KCRC for more information on working with a child with cerebral palsy, autism, a genetic syndrome, feeding and swallowing problems or hearing concerns.
KCRC also offers parent education, information and a support group for parents whose children have similar disabilities.
Children Youth and Family Services offers a range of programs including parenting classes, workshops, and support groups. Previous workshops included how to look for quality childcare and positive discipline techniques. CYFS also offers a transparenting course for divorced parents. The fee for each workshop varies, and sessions are usually held in the evening.
For parents who want to find information on their own, The Parent Center opened last year in the glass building off Water Street. The center includes a living room and library with computer kiosks offering parents resources for strengthening families, child development and links to schools, businesses and family organizations.
To refer a child for a free developmental screening with the Infant and Toddler Connection, call Karen Taylor at 924-5357.
To contact KCRC, call 924-5272.
To contact The Parent Center, call Miriam Rushfin at 817-1234.
To contact Children, Youth and Family Serivces, call 296-4118.
Keri Schwab is a Service Coordinator with the Step-by-Step program and provides early intervention services for local families.