On a Monday morning twenty months ago, I rushed around to tidy my house before an afternoon appointment with an Early Intervention coordinator. At the time, I had no idea what Early Intervention entailed. I just knew that in the brief month that we had known our youngest son, we identified several areas where he was behind… what our doctors called “global delays.”
At the time, we didn’t know whether the delays were related to inadequate care and interaction during his time in China or something bigger. No matter the cause, we needed some assistance in order to guide him in the right direction.
If you haven’t adopted yet, please expect that your newly adopted child will be delayed. Experts say that a child may be delayed one month for every three months he is in an institutional environment. Some children will experience even greater delays.
If you are already home with your newly adopted child, you may be noticing that your child is lagging behind in developmental milestones such as crawling, walking, talking, or even eating. She may have sensory issues that baffle you. He may have self-soothing techniques such as head banging or rocking, swaying, picking at his skin or hair, or “checking out” and staring off into space. She may be very clumsy, falling often or bumping into furniture or walls.
To add to the confusion, internationally adopted children may exhibit what look like delays, but some behaviors (or lack thereof) can be attributed to adjusting to a new home environment or learning a new language. If you’re unsure if what your child is achieving is considered typical, you can reference this great checklist of developmental milestones. Early Intervention therapists can assist you in identifying what specialists your child may need to see, in addition to providing in home therapies or in community therapies.
What is Early Intervention?
According to pathways.org, “Early Intervention is a federally mandated program of coordinated services, through Individuals with Disabilities Education Act (IDEA) Part C, that provides support and education to children with developmental delays and their families. Children ages 0-3 exhibiting delays in physical, cognitive, communication, and social/emotional development are eligible for services. The goal of Early Intervention is to help children with developmental delays as soon as possible so they can reach their fullest potential.”
How do I get connected with Early Intervention?
You can ask your pediatrician or international adoption clinic for a referral for EI services, or you can contact your local EI program directly and request an evaluation. To determine your child’s eligibility for Early Intervention services, a health care professional will assess your child in a range of developmental areas.
Children who receive Early Intervention may have a diagnosis such as chromosomal abnormality, congenital or genetic condition, nervous system disorder, or sensory impairments. Children might also exhibit developmental delays with no known diagnosis.
What needs does Early Intervention address?
The website understood.org explains the following about services provided by Early Intervention.
Babies and toddlers may receive services at home or in the community to help with development in these areas:
• Physical skills (reaching, crawling, walking, drawing, building)
• Cognitive skills (thinking, learning, solving problems)
• Communication skills (talking, listening, understanding others)
• Self-help or adaptive skills (eating, dressing)
• Social or emotional skills (playing, interacting with others)
• Sensory processing skills (handling textures, tastes, sounds, smells)
A child who qualifies for an early intervention program may receive one or more of these services:
• Screening and assessment
• Speech and language therapy
• Physical or occupational therapy
• Psychological services
• Home visits
• Medical, nursing or nutrition services
• Hearing (audiology) or vision services
• Social work services
In our case, we had our son evaluated by Early Intervention only 4 weeks after returning home from China. Our EI coordinator immediately scheduled therapists to come to our home so that we could begin working with him in terms of physical therapy, occupational therapy, speech therapy, and feeding therapy.
What is the goal of Early Intervention programs?
The goal of Early Intervention is to work with parents and caregivers to formulate plans to help children meet their potential. This will look different from what you may see in private therapy. Our EI speech therapist observed our son and worked with me to explain what I could do best to encourage our son to attempt speech. It was a very parent/caregiver centered approach.
This is crucial because we, as parents, are with our kids the most, and we need to know how to help our children reach their potential. After each session, our EI therapists gave us advice, resources, and specific objectives to work on with our son.
For example, our son came to us with essentially no words, no language, and no means of communication other than crying. He wasn’t really even babbling like an infant in the language development stage. As a parent to four other children, I was accustomed to showing my kiddos a book, pointing out various items or characters, and simply asking, “What’s (or who’s) that?” After a few attempts, they nailed it, happily pointing to pictures and reproducing what I told them about the book.
This approach was a total fail with our son. I was operating at a level that was light years ahead of what he was capable of during that time. He couldn’t reproduce sounds, and he certainly couldn’t formulate sounds into words. Our EI speech therapists explained that I needed to dial my approach way back and start with easy, fun “environmental sounds” that would be entertaining and enticing for him to say, such as “moo,” “vroom, vroom,” and “meow”. That was absolutely the key to initiating speech for Caston.
What happens when a child “ages out” of Early Intervention?
Early Intervention is specifically for babies and children ages 0-3. Once Caston turned three, he was then moved into the school district’s program where he continues to see a speech therapist, a physical therapist, and an intervention specialist. Having already been involved in EI, our transition to the school district was relatively seamless. His previous therapists and coordinator gave input regarding his strengths and opportunities to the new team that now handles all his therapies.
They have been a phenomenal part of Team Caston since the beginning. They even attended Caston’s IEP meeting with my husband and me to help formulate the goals for Caston and help determine the best placement for preschool in the fall. I personally was not ready to send him to preschool when he turned three a couple of months ago. Our school district team supported our family in this decision. Although he’s not enrolled in preschool this semester, Caston is still receiving itinerant services through the school district free of charge.
I am so grateful that we have had such a caring team of people supporting Caston for the past 20 months. I can’t imagine waiting years until kindergarten, in hopes that he would simply “catch up” on his own, to begin navigating his delays and jumping into a world of IEPs.
If you have adopted a little one with delays, do not hesitate to contact your local Early Intervention program for an evaluation. And if your child is over three, contact your school district for an evaluation. While some children may catch up after some time, it is best to have a team in place that can work with you to help your child achieve his or her potential. You will never regret taking that first step for you child as early as possible.
Milestones: Center for Disease Control and Prevention
Early Intervention Offices by State
Early Developmental Evaluations and Therapeutic Services for Adopted Children
Early Intervention Success Story: Croston Family
Early Intervention Success Story: Crider Family
This is such an important post for new-to-adoption parents.