Visiting the Specialists
Once you've identified areas of suspected delay in your child's development, make an appointment with your general practitioner or pediatrician. While these doctors rarely get involved in the diagnosis and treatment of developmental disorders, it is generally necessary to get a referral from them for a consultation with the appropriate specialists.
To confirm her suspicion that Declan was undergoing a developmental delay in language, Patricia checked a range of milestone charts. She saw that Declan's problem-solving, cognitive, and motor skills were all normal; however, he was several months overdue for milestones in receptive language (understanding what is spoken to him) as well as expressive language (speaking to others). She took him to the family practitioner, who referred her to a speech pathologist and an audiologist.
As in Declan's case, the referral from a general practitioner or pediatrician will usually include more than one specialist. The audiologist found that Declan's hearing was at the lowest level of the normal range; due to repeated ear infections, he has fluid in his middle ear that will require tubes to drain.
Hearing plays a significant role in children's development of language, especially in children up to three years, who fall into what the National Institute on Deafness and Other Communicative Disorders has termed the critical period for language development. The expectation is that Declan's language abilities will jump once his hearing improves; if they don't, however, there may be other problems preventing his development and further tests by other specialists (such as psychologists and neurologists) would be undertaken.
After the audiologist's testing, the speech pathologist did a developmental assessment on Declan and determined that his receptive language development was six-months delayed and his expressive speech was twelve-months delayed. The specialist recommended speech therapy every two weeks. After two months of therapy, Declan's vocabulary increased from two to 25 words.
Declan's story is turning out well so far, thanks to early and rapid intervention. His mother knew exactly what kind of assessments to expect and which treatments would be recommended depending on the results. However, for concerned parents who feel overwhelmed by a lack of understanding about their child's problems, specialist visits can be intimidating. The National Center for Infants, Toddlers, and Families has a website of information about young children's development, which includes a comprehensive guide for understanding and working with developmental assessments.