Early intervention: giving children the support they need to thrive

Transcript

 Scott Webb (Host): Reaching developmental milestones is important for our kiddos, and my guest today is here to tell us why early intervention is in the best interest of many kids and families. I’m joined today by Dr. Sara Lilly. She’s a physician with Developmental Behavioral Pediatrics at Prisma Health.

 This is Flourish, the podcast brought to you by Prisma Health. I’m Scott Webb. Dr. Lily, it’s so nice to have you here today. We’re going to talk early intervention so that we can give our children the support they need to thrive. And it makes me wonder, what does that mean? Can you define that for us? What does early intervention mean?

Dr. Sara Lilly: Early intervention refers to services for young children. So, we’re talking like infants and toddlers, typically birth to age three, who may benefit from some extra help related to, you know, developmental delays or, for whatever reason, may be at risk.

Host: Yeah, that’s what I was thinking. I was thinking, you know, my kids are older, as I was telling you, but I was thinking like, you know, those milestones, right? And especially when it’s your first child and everything seems like it’s worth talking to a doctor about, is that where we’re at with this, which is basically like, you know, maybe we feel like they’re not hitting those milestones, or that’s our first child and we worry about everything? Is there a dumb question, or is it good to ask all questions?

Dr. Sara Lilly: Oh man. Yeah, as a parent myself, I can definitely say there are no dumb questions being on both sides of this. I definitely can relate to that sentiment though because it’s all different when you’re on the parenting side. And I think one of the things that pediatricians truly love to do is help guide parents and families.

So yeah, these early intervention services we’re talking about are the ones that we’re really dedicating those first three years of life for kids that might be at-risk. And when I say services, like if you’re not necessarily, you know, familiar with what that might mean, those are going to be things like speech therapy, physical therapy and occupational therapy. And in general for kids this age, we’re really trying to like deliver services in comfortable natural environment. So, it might be like home or daycare. And the focus is always going to be on the child and the family, and specifically sort of what their goals are. And then also like, yes, that buzzword, like the milestones and kind of where that child should be will always be our guide on what services, you know, should be offered.

Host: Yeah, I was just thinking back, you know, just the walking, the talking, you know, all of that stuff, hopefully being on time. And you give us a sense there why early intervention is so important. So, maybe you can talk a little bit more about like how it aids in child development.

Dr. Sara Lilly: Right. So, the reason we focus so much on intervening early is that those first three years of life are really the biggest period of rapid brain development and what we call neuroplasticity. So when the brain is just constantly reshaping and reforming connections, for the best possible outcomes.

So, you know, when we look at evidence, first, what we can do to help a child who is delayed, the earlier that we provide support, the better long-term outcomes are going to be for communication, behavior, social development, learning mindset, all of those things. So, you know, how we’re going to kind of aid the child with these intervention services to hope to build those kind of major foundational skills. So, how to communicate, how to navigate your environment, whether that be ambulatory or with some other type of adaptive equipment, how we do things like interact with others. All those things are being rapidly taught in the first several years of life. And so, it’s the best time to kind of jump on board with extra help if it’s needed.

Host: Yeah. It’s like those are some of my favorite years when my kids were that age, and now that they’re older, they’re 18 and 23, it’s like, you know, one’s into adulthood and he has a job now. And the other one’s getting ready to go to college. And it’s a whole other thing at the other end of the spectrum. But we’re focusing today on those first couple of years. So then, let’s talk about some of the conditions that really benefit the most from early intervention.

Dr. Sara Lilly: Right. It’s a good question. So, I think, you know, sort of from a really broad standpoint, the child that’s going to benefit is any child with a developmental delay or a specific risk. Now, the kind of more specific examples of kids that are going to benefit are ones that have been identified by someone. Likely the pediatrician is in this role picking up on early delays, but also sometimes this comes from someone else. It might be a daycare provider, or it could be someone that works with the child in another way. But we’re talking about kids with speech-language delays, motor delays and motor is just the word we use for movement, right?

So, whether that’s the fine movements of the hands or the bigger movements of the body, like walking, social communication differences. So, big thing in this age group is always looking out for how kids are kind of navigating their environment and socially communicating, which can sometimes give us some insight for sure into maybe things like autism spectrum disorder come onto the table. Kids with certainly genetic syndromes, you know, or have been maybe born premature, all of those kids can likely benefit from early intervention.

Host: Yeah, a lot of kiddos can benefit parents too, of course. And it makes me wonder then, like, who should we reach out to? We referenced pediatricians earlier, and I love pediatricians. My 18-year-old now goes to an adult doctor, and I miss going to the pediatrician’s office with her. But is it something your regular physician, family physician, pediatrician can help with? Or is there someone else to speak to?

Dr. Sara Lilly: Absolutely. I think that’s a great place to get started, is just if there are any concerns that you either have yourself or are brought up by someone else. I think scheduling a visit with your pediatrician or, like you said, family physician to kind of get an idea of where the child currently is. There’s a lot of different tools that we use to kind of identify early delays, and can really just kind of have a conversation work through specific milestones. Because while we have those milestones, that’s, you know, what we’re expecting a large amount of children to do by a certain age, but there’s always the but or if. So for instance, you know, premature children within the first couple of years, they’re kind of catching up. And so, there can be some different things to look for there. So, yeah, the guidance of your pediatrician or family physician can be very helpful.

Another thing that I think probably a lot of families don’t know is, for some reason that’s not attainable at the moment or you still just have a specific concern, and you’d still like your child evaluated for early intervention. It is also a self-referral process. So, that is something that you can even refer yourself to have another individual take a look and hopefully give some peace of mind or get a plan in action to help you feel better about what’s going on.

Host: That’s great. And I like that you mentioned, you know, these are milestones, the averages if you will, for most of the kids. But if kids were premature or they’re a little bit behind, they’re probably going to be fine. But it’s good to reach out, you know, this early intervention. And you know, when we think about early intervention, and maybe we missed that window or we didn’t recognize the signs or whatever happened, right? Even the best parents might have missed this, that, or whatever. Is it ever too late? I guess I’m asking for “early intervention” Like, can we do that with an older child?

Dr. Sara Lilly: Really, early intervention is going to be our kids that are birth to three. But I think to go back, I would say it’s really never too late to seek support or services. To your earlier question of like, are there bad questions about this? And the answer’s definitely no. Anytime there’s a concern, it’s one of the things that pediatricians really love to do is talk through this stuff. But early intervention definitely is focused on kids birth to three.

But after three, we’ve got school-based services. Some of those services transition just under another organization, but continue to be provided. So, really throughout all of early childhood years. So, I’m talking like, you know, birth to even six years old. There are options for sure. And then, you know, therapy services can continue even beyond that, but that early window is sort of what we’re talking about specifically with early intervention.

Host: Yeah, right. Through the lens today of early intervention it’s zero to three, but it’s not like when they’re four, you go, “Well, he’s a goner.”

Dr. Sara Lilly: No help for you.

Host: Yeah, we missed the window. What are we going to do? Maybe the next one, right? This has been great to have you on and learn a little bit more about this early intervention and the programs, what’s available to families, kiddos, you know, everybody really. I’ll just give you a chance here at the end. Final thoughts, takeaways, when you think about this as we’re framing this zero to three early intervention, what do you most want parents to know?

Dr. Sara Lilly: I think, just really trust your instincts as a parent. You know, if something feels off, it’s always okay to ask or seek evaluation and just knowing in the back of our mind that, you know, the earlier we act, the more we can support a child’s development and support families.

Host: Right. There’s no bad questions. Pediatricians are the best. You heard me say it. It’s true. It just is. So, I appreciate your time today, your expertise. Thank you so much.

Dr. Sara Lilly: Absolutely. Happy to be here.

Host: For more information and other podcasts just like this one, head on over to prismahealth.org/podcast. This has been Flourish, a podcast brought to you by Prisma Health. I’m Scott Webb. Stay well.