When Your Child Needs Early Intervention

(Q&A with ABA Therapist Rosalind Greenberg below)

At 17 months, my son started showing signs of unsettling behavior. The tantrums were long and exhaustive, he started biting and scratching and he was extremely hyperactive. I didn’t think much of any of this as I knew the “terrible twos” were approaching, he wasn’t able to communicate abundantly yet, and I guess I just thought my son just had it a little worse than other toddlers.

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The Daycare where Luke attended at the time suggested getting him evaluated and reluctantly, I agreed as I was tired of hearing how disruptive he had become. I had been challenged myself with Luke at home but also rationalized that kids are always worse with their parents than outside the home.

Luke was evaluated at around 21 months and cognitively there were no issues. The OT therapist (Occupational Therapy) also told me there were no major issues, but he would recommend some OT just to keep him grounded and focused, great, it can only help I thought. He didn’t qualify for speech because I was told his receptive language was developing at the standard rate even though his expressive language skills were a bit lacking, okay I could live with that. Then came the eye-opener, the behavioral evaluation.

Like most toddlers, Luke had good and bad days. On the day of his behavioral evaluation, he had a complete meltdown, throwing things, crying, not listening, not making eye-contact, very little communication, so when I finally spoke to this evaluator, she told me there could be signs of Luke being on the Autism Spectrum. As any parent, I was in complete denial and quite angry and upset over this news.

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Based on his behavioral evaluation, Luke was granted ABA services (applied behavioral analysis) and we came to find later that fortunately, Luke was not on the Autism Spectrum. While that was a huge relief to me, it also made me worry about what was really going on with him.

Luke is now three years old and there still isn’t a clear diagnosis of what’s going on with him, but we all agree it’s something, perhaps ADHD although it’s difficult to diagnose ADHD at such a young age.

At age three, the Department of Education gets involved, and they bring in their own standardized test measurements. They almost didn’t grant him services as he did fairly well on his evaluations this time around, the DOE has to find a big area of deficit or weakness to provide services and if that isn’t strong, they give it to other kids who may be more in need. All the help he had gotten in the previous 10 months had no doubt helped. Luke received a lot of one-on-one attention so when he would have a melt-down, he had someone there to re-direct him, calm him down and it was working.

After much pleading and cajoling at the meeting to see if Luke would get continued services, the DOE granted Luke an IEP (individualized education plan) but with minimal behavioral assistance. He received continued OT but this time Speech was added as we started to realize, his communication was a big source of his frustration. I was concerned about the reduced hours, he went from 20 hours of behavioral therapy a week to only 10 now, and my fears proved true, the reduced hours were hindering Luke and he was starting to regress and act out again.

I’ve been working with the DOE to figure out the best solution for him and it’s been challenging and emotional.  I think as a parent, you just want your child to be well-adjusted, learn and be an overall good kid. Of course, all kids have behavioral issues, they are just little humans full of energy and impulsivity. They don’t understand the rules of society or classrooms or standards that we sometimes place on them. I will continue to do whatever it takes to help my son as that’s what parents do, but there are many lessons to be learned, even as I move forward to figuring out what the problem is and getting him the right help.

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Here some of what I have learned 1) put aside your preconceived ideas about special education and get your child help, however and whatever that may be 2) any help is better than no help and will only be beneficial 3) Talk to as many people as possible, parent, teachers, psychologists, etc. 4) get yourself some help as you will surely need it whether that’s talking to a therapist, or medication or an extra set of hands so you have some relief, trust me on this one.

For more lessons, I spoke with Rosalind Greenberg (Licensed Master Social Worker that specializes in ABA therapy and Luke’s best buddy) for professional advice:

Q. What are the biggest misperceptions about Early Childhood Intervention?
The biggest misconception is that if a child is receiving early intervention services it will negatively impact his future educational choices and how others will look at him.
Q. How do you know if your child needs special services such as OT or Speech or ABA?  What are the signs?
The first sign is when a child has a difficult time communicating. It can start as early as 12-months. The child is not babbling or not saying “mama” “dada”. The need for OT usually revolves around play and feeding. Is the child having difficulty holding toys, picking up finger foods. Is he holding a cup/bottle/spoon with all fingers. Is the child able to tolerate all textures of foods in terms of sensory. ABA is discussed and needed when the child has poor eye contact, not responding to his name, showing behaviors that are impacting his development. ABA while used primarily for children with Autism, is also provided for children who need help in terms of behavior and following routines and structure.
Q. In your experience, how has early childhood intervention been beneficial?  Was there ever a case that it didn’t work or help?
Early intervention is beneficial because it gives the children and their caregivers the tools, structure and routines that the child needs to develop. Not every child will be able to speak, but every child will be able to communicate. Therapy is only a short time in a child’s day and life, the activities that the caregivers need to follow when the child is not receiving therapy is crucial. It’s about consistently working in helping a child as a team. Early Intervention always helps but not always as much as a family wants. Its gives tools, activities, exercises that has to be consistently done. It may be able to get rid of certain issues, but it does not “cure” diagnoses.
Q. With Luke it was tricky because his behavior was never extensively bad but he clearly needed help, how are the standard evaluations/tests helpful or not helpful in this case.  In other words, are the tests and evaluations enough to see what’s really going on?  What other measures are there?
Evaluations are important because it highlights where the delay is, i.e cognitive, speech, or adaptive related to activities of daily living. Most important is the observation and the interview the parents gave with the evaluator.
Q. It seems like kids today are more scrutinized and under a microscope than ever before, do you agree and if so, how do you take that into account when observing a child? 
The education system has different expectations of a child than even 10-years ago. A child is expected to be in an educational environment by the age of 3, be aware of his environment, follow a classroom routine and sit for a period of time. Yes, when observing a child, this is taken into account.
Q. I’ve gotten the sense that there’s added pressure on kids today in school to be obedient, smart and cooperative kids, which doesn’t leave much room for them to play and just be kids.  How important is free play for a child and at what age should they really be attentive and studious children?
Free play and physical activity is crucial for children of all ages. Obviously, the older a child gets, there is more school work, but there always needs to be a balance. By the age of 6 child needs to be able to sit behind a desk, but again needs time to play ball, jump rope etc. Going to the park, movement classes are just as crucial as learning the alphabet and addition and subtraction.
Q. Any other advice for parents that are perhaps dealing with a child that needs special attention?
To get your child services as early as possible. When in doubt, have the child evaluated. The earlier the better. Be involved with your child’s services, so you can follow the structure on your own.
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