As a Doctor of Physical Therapy (DPT), I have had many parents come to me after expressing concerns to their pediatricians, only to be told, "Just wait and see, they’ll be fine." Unfortunately, not every child ends up being “fine.” While pediatricians play a critical role in the overall health of children, the “wait-and-see” method can sometimes lead to missed opportunities for early intervention. When it comes to developmental delays, time is crucial. Waiting too long can lead to more significant delays and challenges in the future.
In this blog post, I want to explain why we shouldn’t always trust the “wait-and-see” method when it comes to pediatric therapy. I'll also discuss the benefits of early intervention and why it’s important for families to consult with specialists like pediatric physical therapists, occupational therapists, or speech therapists if they have concerns about their child's development.
Understanding Developmental Milestones: Guidelines, Not Absolutes
The CDC provides developmental milestones as guidelines. For example, the guideline for walking is around 12 months, but the range is actually from 12 to 15 months. That means a child may not take their first steps until they’re closer to 15 months, and this could still be considered within the "normal" range. However, after 15 months, if a child still isn’t walking independently or taking steps, it’s time to raise some red flags.
I have had clients come to me as late as 18 to 22 months old who still weren’t walking. In many of these cases, their pediatricians had advised them to “wait and see,” reassuring them that their child would eventually catch up. While waiting may be appropriate in some cases, the danger comes when we wait too long. If a child still isn’t walking at 18 months, or worse, approaching 22 months, without having taken independent steps, the situation becomes more concerning. It’s at this point that I advise families to trust their gut instincts, especially if they feel something is off.
Trust Your Gut: You Know Your Child Best
As a parent, you know your child better than anyone. You spend the most time with them, observe their behaviors, and notice when something isn’t quite right. If your instincts are telling you that something is wrong, it’s essential to trust that feeling. Waiting too long to act on developmental delays can lead to more delays in the future, making it harder for your child to catch up. The longer we wait, the more complicated the situation can become.
It’s important to remember that early intervention is key. Research has shown that the earlier we intervene in developmental delays, the better the outcomes for the child. Children’s brains are incredibly plastic, meaning they are still highly adaptable and can learn and grow more quickly when intervention happens early. This means we can help correct poor movement mechanics, build strength, and prevent muscle imbalances that may arise from delayed development.
The Benefits of Early Intervention
Early intervention offers many benefits, particularly when it comes to physical, occupational, and speech therapy. When delays are addressed early, children can make significant progress in a relatively short amount of time. Here are some of the key reasons why early intervention is so critical:
Maximizing Brain Plasticity: Young children’s brains are still highly adaptable and respond quickly to therapeutic interventions. The younger a child is, the faster they can learn and correct any motor, cognitive, or speech issues.
Preventing Secondary Issues: When a delay is caught early, we can prevent secondary issues from arising. For example, a child who isn’t walking by 18 months may develop muscle imbalances or compensatory movement patterns that could affect their future mobility. Early therapy can address these issues before they become more severe.
Improving Long-Term Outcomes: The earlier we address developmental delays, the more likely the child will catch up to their peers and meet future developmental milestones on time. This can improve their confidence, social interactions, and overall quality of life.
Minimizing Parental Stress: Early intervention can also ease parental stress. When families have concerns about their child’s development, waiting and hoping things will resolve on their own can be stressful. By seeking the help of specialists early on, parents can feel empowered knowing they are taking steps to help their child thrive.
Collaboration Is Key: Consulting with Specialists
It’s important to emphasize that pediatricians play a critical role in the overall health of a child. However, pediatricians focus on a broad spectrum of issues related to children’s health, which means they may not always have the specialized knowledge that a pediatric physical therapist, occupational therapist, or speech therapist possesses. These therapists specialize in their respective fields, making them highly skilled in evaluating and addressing developmental concerns that may not always be apparent to a general practitioner.
This is not the fault of many pediatricians; after all, their expertise covers the entire range of a child’s physical and medical health. Pediatric therapists, on the other hand, have focused, specialized training in specific areas like movement, sensory processing, speech, and feeding. When parents have concerns about their child’s development, it’s essential to consult with a specialist in addition to their pediatrician. Collaboration between pediatricians and therapists ensures that a child receives the best possible care, and all developmental concerns are addressed early and thoroughly.
When Should You Seek Help?
While developmental milestones can have some flexibility, there are certain signs and delays that should prompt parents to seek help sooner rather than later. For example:
If your child isn’t walking by 15 months, it’s a good idea to consult with a pediatric therapist.
If your child isn’t using age-appropriate sounds or words by the time they’re expected to, consider reaching out to a speech therapist.
If your child has trouble with fine motor skills like grasping objects, a pediatric occupational therapist can evaluate and work on these skills.
If your child struggles with balance, coordination, or strength, physical therapy can be a great resource to help them meet these physical milestones.
The Bottom Line: Don’t Wait Too Long
While the “wait-and-see” approach may feel like a safe option at times, when it comes to your child’s development, trusting your gut and seeking help early can make all the difference. The sooner we intervene, the more effective therapy can be in helping your child catch up and thrive. It’s not about panicking or jumping to conclusions over every small delay, but rather about staying vigilant and proactive when you notice something might be off.
If you have any concerns about your child’s development, don’t hesitate to reach out to a pediatric physical therapist, occupational therapist, or speech therapist. These specialists can work together with your pediatrician to ensure your child receives the best care possible, helping them build the strength, skills, and confidence they need to succeed.
In the end, the goal of early intervention is simple: to give your child the best possible chance to grow, learn, and experience all the joys of childhood without unnecessary struggles or delays. So trust your instincts, and don’t wait too long to act when it comes to your child’s development.
Until next time, Dr. Brittany Nardone, DPT
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