Get ‘Em While They’re Young: How Infant Stimulation Programs Can Make a Big Difference with Little Ones

By William Frea, Ph.D., BCBA-D

Every new parent struggles with uncertainty about how their baby is developing. Should he be walking by now? Shouldn’t she be using words soon? It is a natural part of parenting, but it becomes more frustrating when concerns linger and answers are not readily available.

Well-meaning pediatricians often try to comfort worried parents, assuring them that the rate of development is not predictable and there can be a huge variation among typically developing children. Most of the time the pediatrician is correct, and the child is really not far behind and eventually catches up.

Unfortunately, pediatricians often do not have enough time or access to a child to be able to properly assess developmental delays. Or they may be reluctant to highlight early developmental delays for fear that parents will be unnecessarily alarmed. The problem with this cautious approach is that it can hinder access to early intervention for children who could benefit most from it.

Specialized programs, such as “infant stimulation programs,” can help by providing detailed goals and training for families with babies considered at-risk for developmental delays. These programs provide a therapist to work side-by-side in the home with parents in order to get the child back onto a more typical developmental path.

Early Intervention: The Sooner, The Better

Early intervention programs serve many critical functions, such as providing clear developmental expectations and goals, parent education and hands-on training, feedback from trained professionals, and a means to monitor progress.

Developmental expectation is crucial for families. Even in cases where there is not much cause for concern, whenever there is a noticeable delay it is important to quantify and qualify that delay. How serious a problem is this? What will it take to get our child back on track? Having a basic sense of typical developmental milestones can provide some comfort and direction for families.

Parent education is another benefit of early intervention programs. Families with young children experiencing delays should look for programs utilizing natural teaching methods that can be built into daily routines at home. Once mastered, these strategies can be used by the entire family to create a home environment that supports a child’s therapeutic goals. For example, the parents of a child with language delays will learn to set expectations for language, to establish opportunities for using language, and to reward the child’s language attempts. Under the guidance of a good early intervention program such learning opportunities are “embedded” within fun and interactive routines in the family home, seamlessly steering the child towards a more typical developmental path. By establishing expectations, the family gains greater confidence in their ability to have a positive, lasting impact on the child’s developmental progress.

Early intervention programs also make it easier for parents to monitor their child’s progress. Developmental delays can have an impact on the entire family, and it is enormously satisfying for family members to witness the progress being made. At the same time, it is important to understand how the child is progressing in reference to developmental norms. This achieves multiple goals. It gives the family feedback for accomplishing goals, it celebrates successes, and it motivates family members to continue working to reach developmental goals. Having good data on progress can also indicate when the need for early intervention is complete. In many cases, the child only needed to be caught up and henceforth his or her progress will continue in a predictable manner without further concern.

For other children, monitoring can provide early detection of more serious concerns such as autism, which can be detected as early as the child’s first birthday. Oftentimes, this disorder is identified when the child is already in an infant stimulation program. In these situations, there is little progression even with the parents’ concentrated efforts to stimulate and engage their child, and there is clearly a need for more intensive therapy. While children with more common delays often see gains in a matter of months with their parents’ help, children with greater needs tend to reveal additional signs of delay. In disorders such as autism the therapist may begin to notice repetitive behaviors, social avoidance, behavioral concerns, and other developmental “red flags.” Fortunately, early detection allows the child to get into an intensive program as soon as possible, ideally one based on applied behavior analysis. These scientifically-validated programs have been found to have the greatest impact and can help many children overcome the symptoms of autism.

“Our Daughter Isn’t Talking”: One Family’s Experience

When Abby and Zachary first hired a therapist to help them better understand their daughter’s seemingly sluggish development, they were unsure what to expect. They had concerns that Elise was not yet using words at 16 months, especially since their other two children had started talking much earlier. Even though they were not first-time parents, they still felt awkward asking if there was a problem.

After reviewing the results of a developmental assessment with the therapist, they were comforted to see that most of Elise’s development was within typical ranges. Her speech was somewhat delayed, but the therapist was optimistic that they could give it a “shot in the arm” by implementing some targeted teaching strategies in the home. Abby and Zachary agreed to participate in an infant stimulation program designed to help Elise “catch up” in regards to her language skills.

The therapist pointed out that Elise already utilized a lot of intentional and effective language, but little of it was verbal. She primarily indicated what she wanted by pointing and gesturing, and was quite assertive in getting her needs met, even with her siblings. Perhaps her language development was becoming delayed because she didn’t really need it - i.e., speech was not an expectation. This is not a critique of Abby and Zach’s parenting skills. In the context of a busy household, there simply may not have been many opportunities for them to demand verbalizations or vocalizations from their daughter.

The therapist explained that with their older children, Abby and Zach may have spent more time encouraging them to speak. For example, they might have held off on giving juice or a favorite book until the child tried to say the word. They probably gave lots of prompts, such as, “Say…ball.” And they probably had more time and patience to hold out until the child was successful.

By the time Elise came along, her parents’ lives were far busier. And with older siblings to play with Elise and to help out with her, Abby and Zach unfortunately got out of the habit of requiring her to use words. It was possible that her delay might simply be a normal response to her environment, rather than a more serious developmental concern. In the end, this proved to be the case. During some of her favorite play routines, Elise was prompted to use sounds to communicate her intentions. Her parents, with coaching from the therapist, modeled the words Elise needed to attempt and held back any toy she might want until she tried to properly ask for it.

Once Elise knew what was expected of her, she made more frequent attempts to use words to communicate her needs. She produced more and more sounds, especially when prompted to use specific words. This is how speech begins. A child uses sounds to express a request. Then she hears models of how the words should sound. This shapes a child’s speech as she builds a vocabulary of words.

Elise’s vocabulary was zero at the beginning of the intervention (when she was approximately 16 months old). Within the first month of in-home support, her parents were able to generate speech attempts from Elise 100% of the time. She had a vocabulary of four words by 19 months, and nine words by 20 months. The intervention ended then, as it was no longer needed. Elise was well on track to having the typical 50-word vocabulary that would be expected around her second birth day. More importantly, Elise’s parents were empowered and effective teachers. Abby and Zach were thankful for the experience, and felt the skills they had acquired could be generalized and used in other areas of family life

Expert Advice Provides Peace of Mind

It is important for parents to understand that they are not alone. Many mothers and fathers recognize subtle differences in their infants or toddlers but are unsure who to ask for help or how to find out if there is cause for genuine concern.

One suggestion is to request a formal developmental assessment. Parents can have a professional come to their home and spend time with the child. They should ask questions, present any of their concerns, and read any materials that might be provided on typical childhood development and different teaching strategies.

When hiring someone to work with their child, parent should ask some critical questions up front: What is their approach to teaching? What outcomes have they seen in children with the same needs as yours? What happens during a typical session? What types of data will they collect, how will it be shared, and how often? , It is also very important to get references of other families that parents can call. If their own experience was a positive and productive one, they’ll be more than happy to talk to other parents in the same situation.

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Dr. William Frea is a licensed psychologist and a Board Certified Behavior Analyst. He is Co-Founder and Chief Clinical Officer of Autism Spectrum Therapies (AST), a private agency serving children and families throughout Southern California. More information about AST’s Infant Stimulation Program workshops and numerous other services can be found on their website at www.autismtherapies.com.