Developmental disabilities such as ADHD, autism, Asperger’s syndrome, and cerebral palsy affect approximately 13 percent of children in the US Many of these children are not diagnosed until they reach school age, where comparison with a large group of peers reveals deficiencies.
Children with cerebral palsy are often diagnosed around 18 months of age because they walk as they should. But if the symptoms are mild enough, the diagnosis may not come until years later, when the child has difficulty mastering more complicated and refined movements. Children who experience brain injury from events such as physical abuse, car accidents, near drowning, extreme suffocation may also not develop signs of cerebral palsy until later in life.
Because cerebral palsy affects the brain’s ability to communicate effectively with the muscles, symptoms are commonly related to movement. This includes the muscles of the mouth that affect speech. Speech problems can be difficult to assess before the age of three or four, whether or not the child has minor cognitive problems.
Preschool teachers and day care workers often identify developmental disorders in 3- and 4-year-olds because they can see them regularly performing tasks and participating socially in a group of same-age children. Informing parents of their child’s poor performance may trigger a visit to a health professional where a proper diagnosis can be made.
The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide” including this one is just that…a guide. If you suspect developmental abnormalities, seek guidance from the appropriate health professionals. Here are some specific warning signs for children between the ages of 3 and 4 who may be experiencing developmental delays:
A typical 3-year-old should be able to run, climb, crouch (without falling), kick a ball, hold a writing utensil, and scribble both up and down and side to side. They should be able to communicate in short sentences, talk and eat without drooling, stack 4 or more objects, copy a circle, play “pretend”, understand simple directions, show interest in other children, make eye contact, and show interest in toys
In addition to the above, a typical 4-year-old can throw a ball overhand and catch it most of the time, ride a tricycle, jump on the spot, remain calm when a parent leaves, show interest in games interactive, engage in fantasies. play, respond to people outside the family, exhibit self-control when angry, dress and undress (even with help), speak in sentences of more than 3 words.
Also, a child who loses a previously mastered skill may be a sign of developmental delay.
By law (IDEA – Individuals with Disabilities Education Act of 2004), special education services are available, free of charge, to families with children ages 3 and older for any type of diagnosed developmental delay or impairment.
Special education is available through each state’s Board of Education. Any elementary school can provide you with the local contact information you need if you think your child may need specialist help. The school is required by law to “identify, locate, and evaluate” children with developmental disabilities. They have a free assessment process to help you assess your child’s needs.
Preschool is an important transition for any child. Parents of all children should be actively involved in helping with this transition, but parents of children with developmental delays should be even more so. An IFSP (Individualized Family Service Plan) is a written plan that focuses on the child and family and the services a family needs to help them enhance their child’s development. It differs slightly from an IEP (Individualized Education Program) which focuses on the educational needs of the child.
The IFSP reflects the developmental level of your child with cerebral palsy, your family’s income, and the parents’ concerns and priorities. It sets goals for both the family and the child and recommends specific services, such as therapy, that should be used to reach the goals. An IFSP specifically identifies the projected start days, the projected duration of services, and any other steps to be taken for the child’s transition to preschool. It also assigns a service coordinator to the case.
There are variations, but the University of Illinois College of Education has developed a helpful guide. It details 6 strategies for parents, family members, and service providers to follow as part of the transition to preschool. In general, they are 1) begin transition planning early, 6 to 9 months before the planned transition date 2) express positive views about the new environment, including expressing pride in the child’s growing maturity and independence 3) sensitively encourage the child to express fears and ask questions and never take their concerns lightly 4) engage the child in concrete experiences, such as exposure to larger groups of children (such as story time at your local library) 5 ) teach the child specific skills and routines that will be helpful in the new program, such as putting toys away and simulating “circle time” 6) communicate and share information between programs (such as feeding techniques, positioning, and handling) in advance.