Early Intervention/ Developmental Delay Information & Resources

Part of being a parent seems to be worrying about your child. Most parents at some point feel concern about their child's use of language, social interaction, or other developmental milestones. But how do you know if you are worrying too much or needlessly? This can be especially mysterious if your twins are your first children and you have no basis for comparison.

Having occasional concerns is natural, but when those concerns persist, it is time to take action. Don't wait. If your child does have developmental delays, waiting will only allow them to fall further behind. The sooner you can identify a developmental delay the sooner your child can receive the appropriate intervention to improve his/her prognosis.

Trust your instincts. You know your child better than anyone, and you are your child's best advocate. It's up to you to describe your worries to your child's doctor. Be specific; tell him exactly what is causing you concern. And by expressing your concerns you are taking that all important first step toward ruling out or identifying a developmental delay or disability.

Early Intervention is a national program to identify and begin treating developmental delays and disabilities in children under 3. In most cases, it's free, or very low cost, and requires only that your child undergo a free evaluation in order to qualify. And experts agree that the earlier a child with developmental delays gets treatment, the greater chance there is for a bright future for that child. Waiting only allows behaviors and blocks to become more entrenched and harder to overcome.

The following is a checklist from FirstSigns.org. The presence of any of these red flags may indicate a child is at risk for atypical development, and is in need of an immediate evaluation or screening to ensure that he/she is on the right developmental path.

Social/Communication Red Flags:

If your baby shows any of these signs, please ask your pediatrician or family practitioner for an immediate evaluation:

At 6 Months:
* No big smiles or other warm, joyful expressions
* No cooing or babbling when happy

At 9 Months:
* No back-and-forth sharing of sounds, smiles, or other facial expressions

At 12 Months:
* No babbling or speech sounds such as ma, ba, na, da, and ga
* No back-and-forth gestures, such as pointing, showing, reaching, or waving
* No imitation of speech sounds
* Does not turn toward speaker when name is called; appears deaf
* Does not engage in social games such as patty cake or peek-a-boo

At 16 Months:
* No words
* extreme aversion to food tastes and textures (this can be a normal toddler behavior, but when seen in conjunction with other behaviors can indicate a problem)

At 24 Months:
* No two-word meaningful phrases (without imitating or repeating)
* Does not look for familiar objects out of sight when asked
* Does not show interest in other children

* Any loss of speech or babbling or social skills at any age

General:
* Toe Walking
* Hand flapping or preoccupation with hand movements
* Does not seem to understand simple commands or requests
* Does not seem to know the use of common household items
* Does not engage in imaginative or pretend play

Most parents want what is best for the kids so it's only natural to be concerned about lack of communication or general mobility problems, but if your concerns do not seem to dwindle over time, early action is important. The sooner your child's delays are identified and addressed the sooner you can get them the assistance they need to improve and remedy the delay.

Red Flags were compiled from the following sources: Greenspan, S.I. (1999) Building Healthy Minds, Perseus Books; Filipek, P.A. et al. Practice parameter: Screening and Diagnosis of autism. Neurology 2000, 55: 468-79.

Below are some helpful links:
Early Intervention Contacts, State by State: The National Early Childhood Technical Assistance Center
First Signs
Bright Tots

 

Thank you for posting this important information! I have seen first hand how early identification and treatment can make such a difference in children's accomplishments (I am an SLP who works with children). The help is out there....parents only need to ask for it.

 

I have 19 month old twin girls. Born at 37 weeks 6 days:}. Kaitlin says 10-15 words. Sidnee has only said mom/dad and then only rarely. Most information I've found on twins is related to preamature twins not full term full size twins. My doctor was worried about sidnees hearing-she understands and follows simple directions but I wonder when I should or if I should already be worrying. I have an appt in 2 months for a follow up. But that seems a long time towait. Any info would be appreciated.

 

First off, welcome!
It sounds like you and your doctor have some concerns about Sidnee. I would recommend contacting Early Intervention. Here is a link to a site that list the contact person for each state. They should come out and give your girl/girls an evaluation to see if they qualify for the program. The evaluation should give you a much better idea of how your daughter is doing developmentally. She may well just be waiting until she's good and ready to talk, or she may have some delays that the therapists can help with. In either case, knowing one way or the other will give you some peace of mind.

I hope this helps, that some other members will also chime in with information, and that you will post again if you have other questions.

 

I can't stress the importance of following your instincts as a mom and keep track of each child's developmental milestones; and if you have any questions or concerns don't wait, address them with your pediatrician immediately. When my b/g twins were infants I kept track of when they achieved each developmental milestone and tracked each milestone based on their gestational age (they were born at 30 weeks). When they were 19 months old, my husband and I were highly concerned about how minimal our boy twin's speech was developing and how he was generally non-verbal while our girl twin said a list of different words and was already combining two words. Before the twins' 2nd birthday we had our boy twin's hearing re-evaluated as well as a full speech evaluation through our local children's hospital. We then proceeded to have another evaluation through our county's early intervention program for infants and toddlers and our son began receiving in home speech and developmental therapy twice a week. As the next six months passed we began to notice atypical behaviors and grew even more concern about the limited progress with his speech development. At 2 1/2 years old we had him evaluated by a developmental psychologist and developmental pediatrician through our local children's hospital child development unit and he was subsequently diagnosed with an autism spectrum disorder and has been receiving a regimen of both in home and outpatient therapy ever since in addition to attending morning preschool 3x a week with both "typical" and other "special needs" children. To make a long story short, the sooner you address your concerns the better, in terms of ensuring that your child receives services as soon as possible. I don't mean to alarm any other parents who may have a two year old that isn't talking yet. There are multiple factors that may play a part in why certain children aren't reaching developmental milestones on "target" or aren't speaking yet and that doesn't mean there is a diagnosis such as autism at hand, but in the case that there is that possibility, again waiting to address your concerns will prevent your child from getting services early on that will benefit them.

 

Thank you! I've been concerned about one of my twins with his speech development. My ped hasn't been. This son has been slow in about everything. He didn't crawl until 12 months, walk until 16 months. He WILL say ma, du-de (suzie, our dog) ni-ni (For bye bye) and for the most part, screams anything else. My ped states that he'll be 'concerned' if he doesn't say 6 words by the age of 2. I don't believe he has autism, but it was in my mind before we got our dog, he just didn't act like anything was taking place around him.

Anyway, I'll be checking into the site you mentioned.

Again, Thank you!

 

Thank you for the information on Early Intervention. My twins (2 boys)just turned 2 in November and my one son is says basically mama, dada, hi, and lots of vowels sounds. I always figured that he 3 strikes against him...he was a boy, a climber, and a twin. We've just been waiting fo him to break through. Well, he hasn't. When I read this information, it really put the wheels in motion. I called Early Intervention yesterday and they will be assigning someone to our son in the next week. What can I expect as far as an evaluation? They will be coming to my home, which I am happy about. I would like to be as prepared as possible. I have looked into the autism spectrum disorders as well...my head is spinning! Any words of experience would help greatly!!

 

quote:
. What can I expect as far as an evaluation? They will be coming to my home, which I am happy about. I would like to be as prepared as possible. I have looked into the autism spectrum disorders as well...my head is spinning! Any words of experience would help greatly!!


Pam,

My son has been receiving therapies ever since leaving the NICU. Usually when they come for testing at your house it is a combination of questions for you and playing(testing) with your son. They will ask questions not just about expressive speech(what he says)but receptive speech(what he understands)When my son was first tested at age two he had a large gap. His receptive language was on target and his expressive was delayed six months so he qualified for speech therapy. He too didn't say much at two, but shortly after that had a huge language explosion and by next testing had not only caught up, but was testing above age level. I have a friend with twin boys who had zero words at two and hardly any at their third birthday now she says they never stop talking.

 

Pam, I just had my first interview. The lady came out and just interviewed me.(she came when teh boys were nappying) This coming Thursday, she's coming again to "interview" Brody.

He qualifies for speech therapy and possibly for a physical therapist. She wasn't sure on that one, (he must be borderline, or she's waiting to see him personally)

He's waaaaaay behind on his speech, and behind on his gross motor skills, and I think he was borderline on another, but I don't remember what it was. There were more, but she wasn't able to make a decision without doing some of the tests on him.

 

Thanks for the sharing your experiences. EArly Intervention is sending out a speech/language pathologist and a child development specialist the first week of Feb. So anxious to get this process started. I keep waiting for that language explosion-that was a perfect description. This is very hard because you don't want to compare your kids, because you know they are two different individuals...with different personalities etc. Plus, you don't want to self-diagnose either. Would love to hear how the evaluation goes for Brody as well as anything other information. Thanks

 

Something to also take into consideration when dealing with speech patterns is whether they are learning one language, or more.

I live in Southern Texas, and I am Caucasion and my husband is Hispanic. Our children, as a result, are learning two languages, rather than one. We were told before, and are still reassured now by doctors and others who have done it, that children put in such a situation develop their speech patterns a bit slower than those learning only one language.

 

I have b/g twins that are 2 and a half. My daughter speaks in complete sentenses and is able to articulate very well. On the other hand my son was having problems with prnouncing his words and expressing his needs and wants. He's been receiving early intervention for the last 5 months and is doing much better. What I've found to be most important for my son is reinforcing what his thearapist does with him. He is now receiving a speech thearapist starting next week. SI and Speech will be working together. I'm looking forward to seeing his progress before his transition when he turns 3.

 

I have identical boys who are almost 16 months old. They are not walking yet without support and have not said anything that I recognize as words.

My DH and myself have been worrying so much over the past month or so, that we decided to go ahead and call Early Intervention. They should be calling back in the next week or two to set up an appointment.

So I guess they will see if these kids need ST and Physical therapy for walking.

Oh, I am so anxious. Its also frustrating and scary to see a friend's kid who is 8 months younger, but so verbal at this stage.

I absolutely know that I should not compare and I know my kids are generally more quiet than other kids, but I just cannot stop worrying about things like Autism.

I hope that Early Intervention will be helpful.

Diya

 

quote:
Originally posted by Diya:

I hope that Early Intervention will be helpful.

Diya


Diya I am sure they will be great with your boys!! One of my twins Nathan gets OT/PT and has since he came home from the hospital he also had ST from 18m-3yrs and made great progress with all his therapies through EI.

It is hard when you see other peoples children around you that are more verbal or more physically advanced, but like you said all children develop at different rates. Also, in addition to EI, you could start now writing a list of questions for your pedi for their upcoming 18month well child visit as you think of them.

Good luck with early intervention, keep us posted.

 

Thanks for this post. DH and I are concerned about 1 of our boys. At 12 months, he is finally crawling but seems to have trouble holding small items like Cheerios. Maybe he just doesn't want to, I don't know as he doesn't want to hold his bottle or sippy either. He doesn't try to pull himself up and when I hold him up after just a little bit (sometimes 30 seconds, sometimes less) he's had enough.

The ped said it's important to not compare but my gut is telling me to have him evaluated. I printed the EI Parent's Guide found in one of the links and will show it to DH.

Thanks again.

 

Hi,

EI did come in to see our boys about a month and a half ago. Now, they did come up delayed on most issues, but not that far off that they needed therapy. Their receptive speech is good (where they understand what I am saying), but expressive speech is delayed.

Also with walking, they thought that the kids are not confident about walking on their own and they really did think that the kids should be walking soon. Now its a month down the road and Roshan is taking some steps on his own, but only a couple of times in a day. Samay does not seem to do even that.

At this point I really don't know what more to do. I try my best to walk them around the house, they love using the walker, climb everything they see. We have the 18th month appointment coming up in October, hopefully they will be walking by then, but thats just about 3 weeks away, and it seems so unlikely at this point.

EI said they would come back to evaluate them only 3 months later and not sooner than that.

It is so frustrating to see them not want to walk at all, whereas they were so eager with all other milestones .

Diya

 

We were evaluated by EI and they found Alexandru behind in both receptive and expressive language skills fine motor skills and cognitive skills.
All these are related. He is very affectionate, points, waves, very social. responds to his name and responds to verbal praise.

He does not follow commands consistently and does not do puzzles unless they have big trucks and he is in the mood, he is easily frustrated, points in the books but not when I ask him to point to something, use sign language and says around 10 words

One thing I was not clear on with the EI program was that only the eval is free at least in NJ and you pay for the therapy. How much you pay is determined on how much you make; in our case we would pay in full and it comes to over $100/hour for us. They dont work with insurance companies at all and I decided to shop for a SLP myself since my insurance is covering 60 visits. I'll report on the progress/status in couple of months.

these are some great sites with more details on speech disorders and late talkers:

http://www.speechville.com
www.cherab.org
www.asha.org
www.kidspeech.com
www.speechbin.com

I found the boards on http://www.speech-express.com/boards/ really good

and since there was a question on fish oil some time back:
http://www.speech-express.com/boards/viewtopic.php?t=618

 

Hi,

I wanted to share with you all, that Samay and Roshan are finally walking on their own at 17 1/2 months. Last week, Roshan just started walking between the couches and that just continued. Samay watched him and followed.

So one huge milestone is crossed, PHEW!!!

I was so worried.

To the pp, I think in NY State EI is completely free and does not depend on income, if you qualify for services.

Diya

 

Yay Roshan! Yay Samay! You better get your running shoes on Diya!

Congrats on the milestone.

-Kimberly

 

Hello everyone! I am new to the chat and felt I needed to share my twin’s story. I am hopping it might save another Childs life. My pregnancy with my twins was completely natural and besides carrying a low placenta (and being on bed rest) it was a healthy pregnancy. My son Brandon was born with a cleft lip and pallet. My son Nico was born perfectly healthy. Brandon was delayed in all motor areas and was always behind Nicolas. Nicolas met all of his gross and fine motor skills early. At the age of two Nico could only say Mama, Dada and Indy (dog). I spoke to Brandon's speech therapist about my concerns with Nicolas. (Cleft children receive speech therapy) She stated she would need to see him but not without the referral. I took him to my PEDS doctor he assured me nothing was wrong. I assisted on a referral to speech and language. Nicolas and Brandon both saw the same speech therapist. Brandon received speech and language threw are HMO and then at the age of four started services at our local school.
At the same time my friend son was struggling with speech issues and she took him to the doctor and it turned out he was having silent seizures while he slept. This was why he was struggling with speech and language. When she told me this I was worried about my son and I took him to my PEDS doctor and told him of my concerns. He sent me to neurologist and they ran an EEG and it came out negative. The next step was the MRI. They found an AVM (artevenious malformation) in my son’s brain. It was so bad it had blocked off a major artery to the left side of the brain. The language center of the brain was receiving minimal blood supply which explained the problems with speech and language. Nicolas's has had four surgeries. The doctors were amazed his speech had progressed as much as it had. If we had never had the MRI my son would have had a massive stroke or would have died. Nicolas's was a good candidate for the gamma ray surgery so we are waiting to see if has been successful to reduce the aneurism.
I am passing on the information I hope it helps someone else.

God bless!

 

MickeyM, you are a God send...

I have 2 year old twins (a boy and a girl). Just yesterday, my son was evaluated by a speech, developmental, occupational and physical therapist. They determined that he is exhibiting an eligible level of delay based on their evaluation. They also suggested that he have a medical evaluation. I wondered what that would entail. They said he would be seen by a team of doctors- one being a nuerologist. I know it is too soon for me to panic, but I can't help it. He was on track and one day he just slowed down. He stopped saying things like "bye" and "one". All he says know is "ma", "dada" and "nana". His sister is the mouth of the south.

I am so glad your son is doing better, but I thank you again for sharing your story.

 

Wow, I just wanted to tell you all how helpful and comforting this discussion is for me. I just found this site and this discussion is exactly what I was looking for and it is good to know that I'm not the only one having speech problems with my twins. I have 19 1/2 month old twin non-identical boys. Evan can say "Mom", "Dad", "What's That" only it sounds like "Sat", he tries to say his brothers name Darrus and Levi and that's about it. Darrus on the other hand can say "Mom", "Huh" and "Hum" and that's it unless you count whining, screaming and crying. They both understand and comprehend when I talk to them, give commands and ask questions. Evan will answer you with hand gestures, different tones of voice and ranges of emotion only speaking jargon. I've even began potty training which I think they'll learn to do before speaking. My concern is Darrus because he won't even try to communicate in any way, he just whines and sucks his thumb. The funny part is, Darrus who can be annoying by the end of the day with all his whining, has photographic memory. If he lost a sippy cup in the bottom of the toy box in the morning, he knows where to find it later in the day if I ask him, and he finds it within minutes. That I love about him, anyway the twins will be getting a speech assessment next week, so we'll see what they say. Thanks alot mom's, reading your story's was comforting for me. It's good knowing your not alone.

 

Just wanted to add that I had two boys prior to my twin boys. With my first late talker I went through all the hearing tests, speech therapy, and he didn't really bloom into talking until 31/2 years old at play school. The same occured with my next boy being a late talker and currently my twin boys at age two are not talking yet- just alot of meaningless chatter. I don't overly concerned now with the twins, when all the signs of their development are on point.

 

hello, i have 2 year old twin boys. Im worried about them. There not saying anything but ma and da barely. im a single mom and i dont know what to do. Ive taken them to doctors and they just told me to wait. they didnt crawl till 16 month and didnt walk till 20 months. i dont know what else to do!!

 

Hi mizflaca!

I have boy/girl twins 2.5y.o.
At 2y.o. their vocabulary was under 15 words. We went to our ped and he wasn't concerned about it at all. But I was concerned.. So I switched the ped and the other one recommended to do hearing test and speech evaluation. Hearing was fine but with speech we were behind and needed speech therapy. The evaluator recommended contacting county free toddler services to start speech therapy. I think it took about couple weeks or so for services to come, evaluate our kids and set up the therapy.

The speech therapist comes once per week to our home after work hours and has 45 min session with each twin. They provide this services untill our kids will be 3y.o. and then kids will be evaluated and passed from county services to school district.

I understood we could just directly contact our toddler county services to evaluate our kids and start the services.

I would strongly recommend you to find out what kind of free services you could get through your county and try to get your boys (they're gorgeous BTW) evaluated as soon as possible.

Hugs,
kalinka

 

i will do that thank you!

 

I have 16 month old b/g twins. They babble up a storm but barely say any legible words, they have and can say mama, dada, and cat. They are stringing sounds together but it sounds like a foreign language. Everything else seems to be right on target, they are both walking, running, pointing, smiling, laughing and make eye contact. They seem to understand commands, such as when I ask "where do we brush our teeth?" they both run to the bathroom. Should I be really super worried about this? I am a first time Mom and super concerned about this delay in speech. Oh and they were born at 39 weeks, so not premature. Anything anyone can add would be greatly appreciated!!!

Thanks

Karen

 

Karen,

I have 18 month old boy/girl twins. They have that weird language also. They talk nonstop all day but it sounds like Chinese. They say some words, like "no" is my daughter's favorite. But for the most part all they do is babble. They seem to know what they are talking about to each other and have full conversations with each other. Its pretty funny to watch. I was a little concerned that they weren't talking, but I guess it is normal. They do everything else, they starting walking at 12 months, they eat with utensils, they share, play well with each other and other kids. They have mastered the playground. The only thing they are slow on is saying English words. I'm glad to know mine are not the only ones.

~Marie

 

Hi... My girls will be 13 months on Tuesday (June 26) and I was wondering if I have anything to worry about?? When it comes to physical milestones, my girls have always been right on or even a little ahead (they were born at 35 wks 4 days, and we've never used adjusted age), but when it comes to speech and indicating wants and needs, they seem to be a little slow, at least to me... They'll play peek-a-boo, but they don't wave, and they don't point to things that they want... Also, pretty much the only word they'll say on a regular basis is dada or daddy. They call me dada, not mama (although I know they can say it and know that's who I am), but other than that they just babble constantly... Oh, and Lily can say Baby but I'm not sure if she understands what it means... I'm just wondering if I should wait awhile before I start worrying??

Thanks

 

Well I am a mother of 2 yr old twins one of them who is developmentally delayed. She sees 3 therapists. Occupational,Speech and Phyiscal. It is very challenging but she is gaining skills. She is still not walking yet but she is almost there.

 

Hi

I have twin boys (Arjun and Ishaan - 25 months) and am a bit concerned about my son Ishaan. Ishaan knows his alphabet and numbers but won't say many words or two words etc... I have someone from early intervention come out for the past two months and I have seen big progress in his motor skills and very little progress in his speech.. Should be concerned?

Rupal

 

We have 2 sets of twins, 1 year apart. Of the four total, 3 are receiving some sort of early intervention. One of the older twins is getting OT for Sensory Processing Disorder, with focus on attention and fine motor. The younger twins are 19 months. They are not walking or talking yet. They only say "mama" and sometimes " go go go". They have always been really behind. One didn't crawl until 13 months and the other just started crawling 2 months ago. These children were not preemies and weighed over 7 lbs. each.

They have started PT and OT with focus on fine motor, feeding and movement (speech is to begin in Dec.). One of them recently began pulling up and cruising along the couch and has been crawling up the steps since Halloween. The other one doesn't like to bear weight on on his feet. We have been through MRI's, had x-rays and had visits to the neurologists and still no concrete answers. They have ruled out Autism and Asperger's. They are sure some may be Sensory Processing as well (The OUT-OF-SYNC Child is a good resource online for more info. on this). What is really frustrating is I taught 1st and 2nd grade for 9 years and can't seem to pinpoint my own children's problems concerning this matter (nor can the doctors).

Some words from recent experience:

For anyone going through the process of getting early intervention services for a child, the process can be scary. However it is so necessary to get things started, especially before they reach school age.

One very important thing to remember is that not all signs of Autism means your child has Autism. There are many other reasons why your child may flap his arms, not be speaking yet and so forth.

Finally, if anyone else has a child (children) with Sensory Processing Disorder, I would love to hear from you!

 

I can not say enough about how great the early intervention program is. The education they provide is wonderful. It is SO EASY too. If you are in doubt it is a simple meeting that can put your mind at ease or get you are the right path to helping your child. My oldest son had a speech delay and started therapy at age 2. A couple months after his 5th b-day his speech improved to a "normal" level. It was a long 3 years. I am not sure if his speech would have just "clicked" at age 5 with or without the early intervention but I wouldn't want to find out. I feel good I did all I could to help his speech. Now my 2 1/2 yr old is also in the program for a speech delay.

 

Here is the contact for CO: http://www.nectac.org/contact/ptccoord.asp#CO

They will know where to direct you next. Good luck!

 

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