A Look at Early Child Development

Crawling, walking and talking are just a few of a child’s developmental milestones. With the information overload all around us, it’s easy for parents to become anxious about their own child’s progress. So when should you be concerned?

Brian Tang, M.D., a specialist in behavioral and developmental pediatrics at the Palo Alto Medical Foundation, understands parents’ anxieties about their children’s development.

“Think of developmental milestones as guideposts rather than definite targets your child should reach,” Dr. Tang says. “Much as each child has his or her own unique personality, each child has a unique pace for reaching developmental stages. In fact, there is a wide range in what’s perfectly normal.”

Dr. Tang explains that the way a child develops is not a linear process. Instead, there are plateaus when nothing much seems to happen and spikes when a child may suddenly learn to do several things at once.

Regular well-child examinations with your child’s doctor are an important way to make sure your child is on track. At each visit, your child’s doctor will ask you questions about your child’s development and screen your child’s physical and behavioral abilities. Your doctor is not looking for your child to have achieved every milestone by a certain age. Rather, doctors look for patterns that may indicate a developmental issue that needs further evaluation and possibly treatment.

“Early detection of any developmental delays, especially in children under three, can make a tremendous difference in your child being able to catch up,” Dr. Tang says. “Most importantly, trust your instincts when it comes to your child’s development – you know your child best.”

Parents can get a lot of information from simple informal observations of a child, especially when the child is around other children. Dr. Tang says extremely disruptive behavior can also be a red flag for an underlying developmental issue.

When to Be Concerned

If your child seems to be behind other children in mastering skills and you are worried, the first step is to speak to your child’s doctor. A pediatrician can evaluate your child and, if necessary, refer you to a pediatric specialist in developmental issues.

Kids younger than 3 years old with suspected developmental delays also are eligible for evaluation and treatment through the California Department of Developmental Services’ Early Start program. This early intervention program brings together teams of service coordinators, healthcare providers, therapists and parent resource guides to provide early intervention and support services for young children from birth to three years of age. Parents can either self-refer themselves into the program or be referred by their child’s doctor.

Speech Delays and Autism

There are many reasons for delayed speech and language development. Autism is one reason, but it is not the only one.

“If your child is doing well in other respects, it’s unlikely that your child is autistic,” Dr. Tang says. “Autism is a very complex disorder, and a child with autism will demonstrate many other symptoms in addition to delayed speech.”

Early signs of autism include:

• Problems with social interaction, including difficulty using non-verbal gestures such as pointing and eye contact.
• Difficulty sharing enjoyment with others.
• Inability to engage in conversations or activities with others.
• Difficulty with pretend play or imitation.
• Behaviors and interests are restrictive and repetitive.
• Parents find it hard to engage the child.

“Unlike a child who is autistic, young children with speech and language delays due to other causes are often excellent non-verbal communicators,” Dr. Tang says. “For example, by pointing, gesturing and using facial expressions they can hold ‘conversations’ with their parents and peers without using a single word.”

Encouraging Healthy Development

According to Dr. Tang, one of the very best things parents can do to support a child’s healthy development is to limit screen time. According to the American Academy of Pediatrics: “Neuroscience research shows that very young children learn best via two-way communication. Talk time between caregiver and child is critical for language development. Passive video presentations do not lead to language learning in infants and young toddlers."

Dr. Tang says for both parents and kids, being absorbed in electronic entertainment comes at the expense of time spent interacting with each other in a way that furthers kids’ healthy development.

Some alternatives to screen time for both parent and child:

• Reading. Read to your child regularly, using intonation and adding gestures so she hears a wide range of ways words and speech are used. Singing and saying rhymes are also good stimulation.
• Talking. This will not be a two-way conversation at first, but it is still very important. “Think of yourself as a play-by-play announcer for your child,” Dr. Tang says. “Whether at the park or the grocery store, point out colors, shapes and names; describe what you are seeing out loud. Be expressive and use body language to make it interesting and fun.”
• Exercising. Be active. Take your child for a walk around the neighborhood, go to the park and let your child explore different terrains in a safe environment.
• Socializing. Give your child plenty of opportunities to spend time with other children so he can learn how to interact appropriately and make friends.