By Dr. Yvonne Becher, Chief Executive / Director, Programme Development and Learning
PhD (HKU), MClin Psych (Macquarie U., Austrl.), BA(Hons.), The Child Development Centre

Parents often enter unknown territory when they are told or suspect that their child has a delay or disability. The following ideas may help parents to get some clarifications.

When should parents be concerned and what should they look out for?
Regression or losing skills, skill delays, or atypical behaviours for your child’s age or character may send you “red flags” or reason for concern which warrant further investigation by a professional.

Avoid focusing on just one particular behaviour and coming to a firm conclusion since any one behaviour may have a variety of explanations. Just like a headache can have a range of causes, not looking at someone when greeting them may not be the infamous “lack of eye contact” indicating autism, but rather a very nervous or shy child. Have your concerns checked out by a professional by all means and approach the situation with an open mind rather than a set mind or denial.

Instead of a single focus, observe and visually record or write down all of your child’s behaviours over a two-week period. Include all behaviours to get a comprehensive overall developmental picture — those which concern you as well as those that seem okay. Make sure to include physical skills (jumping, balancing on one leg, kicking/ throwing a ball), self-help skills like the ability to independently dress (or undress), feeding, using the toilet, and even their temperament – do they cry easily or a lot, are they curious, etc.

Be specific on how much language your child understands and speaks, as language delay is quite common but can also be one of the earliest and vital indicators of more complex delays or disabilities.

In addition, does your child pay reasonable attention and show imagination? What toys and activities do they prefer or dislike, and how do they play with other children? Do not worry if you are unsure if their skills are age-appropriate or not, as these will be questions asked during an assessment by a professional who will be able to tell you the age expectations in relation to your child’s abilities.

What assessment and where?
The one purpose underlying all assessment is to determine if your child has any gaps in any of the developmental areas and if and what type of intervention could address these gaps.

Speech-and-language therapists, occupational therapists and/or physiotherapists trained in or having experience in paediatrics can determine developmental levels and gaps in addition to the intervention needed.

An additional step is to establish a diagnosis, if desirable. Some parents shy away from this step, often out of fear of labelling, but many parents are seeking proper diagnoses as this can open doors to intervention programmes. For example, some programmes are specifically designed for children with autism; without a diagnosis, a child would not be eligible to join a programme even if it offers the intervention that fits with his/her developmental needs. An educational or clinical psychologist experienced in early childhood, or a developmental paediatrician, can provide such a diagnosis.

Regardless of circumstances, parents should apply three key criteria to address developmental concerns about their child:

1. Act now; seek an assessment as soon as you have doubts or concerns rather than extending the time of agonising and wondering, but never coming to a conclusion (the wait-and-see approach). Children develop at a rapid rate in their first eight years of life and this is a crucial time in their development. Each day is valuable at a child’s young age for developmental gains; we are talking about all-round development, rather than academic gains.

2. Optimal intervention does not always mean finding the most expensive therapy or signing up for every therapy session that is available. It is about getting sound professional advice. Therapy or a mix of therapies might be the best option for the child’s individual needs at any one point in time, but it is important to work in partnership with the family with acknowledgement of the child’s own circumstances.

3. Miracles do not happen in early childhood intervention but everyone’s input can contribute to positive outcomes. Rather than entirely relying on professionals to achieve results, talk to your child’s therapist and get hints of what to practice daily with your child at home — ideally in a natural way, e.g. during mealtime, playtime, etc., and intertwined in the daily routine to optimise the intervention effect.