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Late Bloomer or Developmentally Delayed?

Tips on Where to Begin if you Think Your Child is not Meeting their Milestones originally published on

5 Tips on Where to Begin if you Think Your Child is not Meeting their Milestones

Our daughter turned 18 months old and had experienced six ear infections in four months. We felt powerless and helpless as her parents. Something else had changed during this time. Her vocabulary had decreased from 6 articulate 1-2 syllable words to one, “baba”, which used to be “mama”. We seemed to live at the pediatrician’s office. I expressed my suspicion many times about her changes in communication. My concerns were dismissed. We were told “she is being stubborn” or “she is a late bloomer”. Luckily, I am also a pediatric nurse practitioner and knew better. Along my journey of advocating for our children and their needs I have often had to be “momma bear” and felt for those that did not have the same knowledge of resources as I did. I will provide to you 5 things you can do as a parent that has concerns about their child’s development.

1) Talk to your child’s medical provider

It is important to start these conversations with your child’s healthcare providers. They should be able to direct you to the appropriate specialists for further evaluation.

2) Get a second opinion

If you know that something is not normal about your child and your healthcare provider seems to dismiss your concerns get a second opinion (this may mean going to a new pediatric practice or if your insurance allows going directly to a specialist without a referral).

3) Contact your region’s version of “Infants and Toddlers”

In most counties within the United States there is an early child development department that will provide a free developmental evaluation and if your child qualifies, they can provide your child with speech, occupational, and/or physical therapy.

4) After you have obtained a referral from your child’s primary care medical provider call and get on waiting lists for additional evaluations (if you do not need a referral then skip obtaining one and get on the phone now)

This step is important because there is often a shortage of providers for children that require developmental and/or behavioral evaluations. For our daughter we were on the waiting list for 12-18 months for occupational therapy. She did not meet the criteria to receive occupational therapy through our county and had we not put her name on those waiting lists she would not have received the services she needed. This was essential because private therapist (not provided through public school system) are able to provide services to your child continuously because they do not follow the school year calendar (you do not have to worry about missing session due to Spring or Summer break).

5) Document your concerns in writing with your child’s school and request an Individual Education Plan meeting

Each public school system has a legal obligation to provide a free and appropriate public education. While the regulations may vary from one location to another, for public schools to receive federal funding they must comply with mandates to create provisions to provide adequate resources for children with special and/or medical needs.

Author: Alita-Geri Carter, MSN, RN, CPNP-PC

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