To ensure that children make developmental progress, it's important that parents and their pediatrician keep a close eye on the child's growth and identify any problem areas as early as possible. There are benchmarks, of course, by which caregivers and physicians can measure a child's development. Yet how do parents know when their child is progressing normally and on pace with his or her peers? When should they voice concern about perceived development issues?
Theresa Hetzler, MD, General Pediatrician at Children's and Women's Physicians of Westchester,www.cwpw.org with an interest in children with special health care needs, and Associate Professor of Pediatrics at New York Medical College, points to recommendations from the American Academy of Pediatrics (AAP) for surveillance and screening in identifying children with developmental disorders.
The AAP recommends that overall surveillance be conducted at each visit to the pediatrician. Should any areas of concern be observed, subsequent screening tests should be administered. Additionally, standardized developmental screening tests ought to be given at 9- 18- and 30-month visits; the latter can be administered as early as 24 months of age. With this assessment strategy, the AAP notes, "... early identification of developmental problems should lead to further developmental and medical evaluation, diagnosis, and treatment, including early developmental intervention."
"If parents are concerned, they need to consult with their pediatrician when their child is not following the norm, especially with language development," Dr. Hetzler says. Screening assesses progress in physical growth and motor development to language skills. Pediatricians also watch for progress areas such as whether a child is babbling, pointing to objects, smiling and generally interacting with parents at the right stages of development.
Dr. Hetzler explains that she and her colleagues use the Ages & Stages Questionnaires developed by Brookes Publishing on a regular basis as an important tool in assessing child development. Touted by its publisher as "the most accurate, reliable and parent-friendly way to screen young children," the A&SQ is used to help spot developmental delays at early as possible. The tool is used by everyone from pediatricians and parents to Early Head Start educators and public preschool teachers.
ASQ-3, the most up-to-date edition of the diagnostic tool, is designed for children one month to six-and-a-half years old. Using 21 questionnaires and scoring sheets, children are screened in five specific areas: communication; gross motor; fine motor; problem solving; and personal-social.
"We obtain a good insight of the child's progress, whether additional evaluation is needed, and, if so, make referrals" to appropriate specialists, Dr. Hetzler says. Therapy, if deemed appropriate through the Early Intervention Program, is provided free and often in the home, as mandated by federal law.
First-time parents can be confused about their child's progress, so these guidelines give them a good idea of where the child stands. "At one month, the child coos, and within six months they babble," Dr. Hetzler says. Failure to do so does not necessarily mean a developmental disorder. Other factors may come into play. "Evaluation is key is getting to the root of the issue.
"The whole purpose of intervention is to get children on track with their peers for kindergarten," Dr. Hetzler explains. The Department of Health provides early intervention programs for children up to three years of age. After that, children fall under the Committee for Preschool Education within their school district.
Dr. Hetzler makes needed referrals to specialists in CWPW's Department of Developmental Pediatrics for older children with developmental or school-related concerns. They are evaluated for ADD, learning disabilities, and a range of other developmental issues.
Parents with children of any age who feel their child might have a developmental issue should always consult their pediatrician first. "The first person a parent should talk to is their pediatrician," Dr. Hetzler stresses. "Children normally have over 10 checkups in their first two years, so they see their pediatrician often. The doctor knows the child and has an idea of the child's development. He or she is the best one to call - and the one who can help with the next course of action."
About Children's & Women's Physicians of Westchester, LLP
Children's & Women's Physicians of Westchester is one of the largest medical practices in the nation comprised of dedicated doctors and health professionals committed to providing comprehensive inpatient and outpatient care to women, infants, children, adolescents and selected adults. The medical practice comprised of more than 240 physicians operates 39 medical offices throughout the greater New York Metropolitan area, extending from New York City, throughout the Hudson Valley, including Westchester, Rockland, Dutchess, Putnam and Orange Counties as well as in Southern Connecticut. For information on our medical specialties and office locations visit our website at www.cwpw.org, or download the CWPW app - free for iPhone and iPad.
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