The early childhood years (between two and five years of age) are an ideal time to identify developmental differences and needs in children. Unfortunately, many children who would benefit from early intervention are undiagnosed. Primarily, this is because:

• While the first 18 months have clear developmental milestones and regular check-ups, after two years of age, developmental supervision and tracking wane until early elementary.

• Many early childhood educators are neither credentialed nor trained to identify these needs in children they work with and may struggle with what information to present to parents.

• Children can easily avoid activities they struggle with, masking or hiding challenges unless a teacher, parent, or caregiver pays close attention.

• A more conservative approach to a child’s developing skills and maturity is often employed. As a result, many parental concerns are dismissed as typical of the age and stage of development (e.g., “they’ll grow out of it soon”) or attributed to over-anxiety, poor boundary settings, or inconsistencies by the parents (sometimes true).

• Most parents and caregivers are unaware of early warning signs.

Parental Intuition Is Relatively Accurate

At Prism Advocacy, my experience is that parental intuition is relatively accurate, so parents should trust their judgment and seek answers should they notice any of the following patterns in their children:

• a consistent level of intensity and discomfort across settings (home, school, and community)

• challenges in adjusting to different social situations

• overresponsiveness to transitions and/or slight changes in routines or the environment

• a more challenging time adjusting to preschool over a prolonged period, i.e., requiring more one-on-one guidance than a teacher may have the opportunity for as well as other unresolved issues at school

• a delay in self-help or adaptive skills, motor coordination, and other sensory-related challenges

Where a Pediatrician Fits In

Parents should use their general pediatrician as a resource to help make sure their child is developing appropriately. Ideally, pediatricians use standardized tools to assess developmental concerns, as clinical judgment alone is less accurate. Screening questionnaires can be an appropriate way to look for specific delays and other developmental issues.  

Pediatricians may be conservative with referring children, as developmental maturity and milestones can vary considerably within the first two to five years. Further, most children exhibit a certain level of anxiety when visiting pediatricians. Naturally, pediatricians need more time with their patients to notice the more subtle issues that may be present. Parents should always feel empowered to pose questions and ask for second opinions or referrals should they feel the need. Many families I have worked with were initially dissuaded from seeking additional support during visits to their pediatrician. Pediatricians are underexposed to neurodivergent traits in very young children, so they may not recognize them. Trust your intuition, that niggly voice, and ask for a referral. It’s better to have no doubts or regrets.

Specialized Resources Are Available

To help diagnose a developmental difference or delay, it is best to seek a qualified specialist, such as a developmental-behavioral pediatrician or a pediatric neuropsychologist. Another resource for sensory and motor delays is a Pediatric Occupational Therapist (OTR/L). These professionals work collaboratively with other practitioners and therapists and can diagnose, refer for treatment, and help parents prioritize and coordinate care at home and school.

The Regional Center (birth to three years old) and public school districts (three to 21 years old) are also resources available to parents with concerns. Elementary school-aged children with needs may be eligible for Individual Education Plans (IEPs) and 504 accommodations, which can be assessed through the Special Education section of your local school district.  These services are federally mandated through the Individuals with Disabilities Education Improvement Act (IDEA).