When it comes to little ones who just aren't quite meeting their language, speech, or early communication milestones, we are constantly hearing from doctors and other medical professionals "it's okay, just wait and see". Oh no. Those dreaded words. Don't get me wrong, all medical professionals mean well and want children to be supported. However, this is an outdated mindset regarding language development. Current research suggests that not only is this approach unhelpful, but it can actually be quite damaging and ultimately put your child at greater risk for delay/impairment (Singleton, 2018).
From friends, family, and even medical professionals, we often hear things like:
"Don't worry, a lot of children are late talkers!"
"Sometimes it just takes a little time for them to catch up. Just give it time."
"Don't spend time and money on an evaluation when they'll probably be fine. Just wait and see if they catch up first!"
There are many reasons why this mindset and approach is problematic. While many children who are late talkers often do catch up to their peers without intervention, a large portion of these children do not catch up on their own and later present with a persistent language delay or impairment that requires intervention. And here's the thing... it is nearly impossible to predict whether any given child is a late talker who will catch up spontaneously, or if they will present with persistent communication difficulties/needs down the road.
Okay, so what? Then I'll just get them therapy if/when they need it. No biggie, right?
Yes, biggie. That is, undoubtedly, a biggie.
Here's where we get stuck. The problem with the "wait and see" approach is the precious, invaluable time we are wasting within the child's most critical years of neurological development. Let me further explain.
The Critical Period of Language Development
The Critical Period of Language Development is a theory regarding language development that suggests there is a critical period of time in the early years of life where a child requires rich, consistent language input in order to reach fluency within their language (Friedmann & Rusou, 2015). This is because in the earliest years of life, the brain is more neuroplastic and primed for language acquisition and new experiences that it will ever be.
Think about it. Early in life, you are developing millions of neural connections per day as you are exposed to and exploring the world. At this point, are brains are ready and primed for learning language. Therefore as a result, these connections are made pretty quickly and without much effort. Babies learn by exploring their environment, through direct connection with caregivers, and incidentally as the world exists around them.
While it's possible to learn new languages later in life, this involves making new neural connections when your brain is no longer as primed and ready to take in language. This means that more repetition, input, and intentional practice is required in order to learn that language to a level of natural fluency (or close to it). For this reason, it will be a lot more difficult to achieve fluency, and you will likely never reach the same level of fluency that you would have if you had learned that language within the critical period of development.
So what does this have to do with why I shouldn't "wait and see" if they catch up before committing to therapy?
It is virtually impossible to determine whether a child is demonstrating a developmental delay, language impairment, or is simply a late talker. If a child requires intervention to "catch up" to their typically developing peers, starting therapy early is the key to fast and effective success. The journey to "closing the gap" between their current skill level and their expected milestones is a much shorter journey, as their brain is taking in all of the implemented strategies and rich language input quickly.
When a child, who requires intervention to "catch up" does not receive early intervention, they often quickly fall behind as their typically developing peers meet more and more milestones. The gap begins to widen, while their brain becomes less neuroplastic by the day. This means that working to "close the gap" will become more effortful, will take longer (more repetition needed), and could lead to reduced overall success.
The Beauty of Early Intervention
The beauty of early intervention is that IT WORKS! There are many reasons why early intervention is successful. To name a few of the most vital aspects:
Play-Based Therapy Young children learn and explore their world through play. Therapy is delivered from a play-based, child-led therapy approach that allows for implementation of language strategies in a developmentally appropriate way that the child understands. It also fosters opportunities for connection, minimizes the pressure of communication (that can often intimidate a child), and allows for more natural learning experiences.
Natural Environment Early intervention is often provided in the child's natural environment. This may include their home, backyard, a family member's home, a neighborhood playground, park, or daycare. Providing services within the child's natural environment leads to greater and faster success because it allows for faster generalization of skills, allows caregivers to be a part of the session, and is simply a setting where the child feels the most comfortable, regulated, and is most likely to participate. It also allows for implementation of strategies within the child's natural environment, routines, and play that caregivers can easily implement/carryover outside of the session.
Caregiver Coaching The final piece of early intervention that is so valuable is caregiver coaching. While the speech-language pathologist is the expert in communication and language development, they can't be there all of the time. Taking a caregiver coaching approach allows the clinician to educate the child's parents/caregivers and teach them strategies that they can implement throughout the remainder of the week. The clinician is able to provide feedback within the session on the caregiver's implementation/use of these strategies, answer questions, and help the caregiver know when and how to most effectively utilize strategies/knowledge to support their child.
Don't wait, EVALUATE!
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