When and How to Seek Help

When and How to Seek Help Ww

WALRUS

What the Science Tells Us

When a parent is concerned, they are often right. If we are worried that our child may be experiencing differences or delays in their communication development or later on, when learning in school (see Delay and Appendix B Milestones) we should not hesitate to seek help.

Early intervention is the ideal, so if our instinct is telling us our child could use additional help, or if a health provider we trust has suggested this, it makes sense for us to follow up right away and request a referral to the appropriate health professional (see “What You Can Do” below for a comprehensive list). They will be able to reassure us if our child is developing typically or recommend a course of action that will help our child.

The descriptions in “What You Can Do” can guide us when we need more information to figure out if our infant or toddler needs extra help. In general, indicators include:

# A failure to meet speech, language or comprehension milestones (see Appendix B Milestones) # Dysfluent speech patterns (stuttering, prolongations, repetitions) # Regression of previously learned words or skills

If the information describes our child, that is another good reason to request a referral right away. Most likely, the first step will be a hearing test and the referral to a speech-language pathologist (SLP). These assessments will help us learn more about the course of action our child needs. Many children need extra help and when they get this help early in life the benefits are long-lasting.

We are fortunate to live in a country where publicly-funded services are available to help with children’s healthy development. Wait times for service can vary between regions, and can be several months long. That is why it makes sense to ask for a referral as soon as we are concerned about our child’s language or other development.

What You Can Do

All children have a wide range of abilities and develop at different rates. Often, children need a little extra help. Intervention, especially when it is early, can change a child’s life and that of the whole family.

If you are concerned about your child, there are many qualified people who can help. Reach out to your health provider.

You can contact:

# Your family doctor # A doctor in a walk-in clinic # Your local health unit # A public health nurse # A nurse practitioner WHALE

“When a parent is concerned they are often right.

# An Infant Development or Aboriginal Infant Development Program # A Supported Child Development or Aboriginal Supported Child Development

Program # Another medical professional

You can also contact HealthLinkBC or call 811 in British Columbia or go to their website: https://www.healthlinkbc.ca/services-and-resources/find-services.

Any of the health professionals you speak with will know how to request a hearing assessment – an important first step – and a referral to a speechlanguage pathologist (SLP).

Speech-language pathologists are members of a team of health professionals who know how to support infants and young children. SLP’s have chosen to work with young children and families to help children reach their communication potential. They have a non-judgemental approach and know how to meet the needs of each child as an individual. And make it fun!

Other members of the health professional team who may support your child include:

# Pediatricians # Audiologists # Psychologists # Ear-nose-and-throat specialists # Other WOLF

Many children need a little additional help and the benefits are long-lasting.

You are the person who knows your child best. If you notice any of the following, ask for help.

Seek help for your newborn or young infant if they:

# Do not startle to sound # Are not smiling or making “cooing sounds” (aaaa,oooo) by 2 months # Show a lack of awareness of you – that is, your baby does not pay any attention to you, does not seem to care that you are there # Do not recognize your voice # Do not make eye contact with you # Are not babbling (making consonant sounds babababa, gagagaga, etc) by 9 months # Do not seem to recognize your names – “mama,” “dada” by 9 months # Do not respond to their name or the affectionate term you call them by 12 months

Seek help for your toddler if they:

# No longer seem to be able to hear you # At 16-18 months are not yet producing words you can understand that are typical for that age (see Appendix B Milestones) # At 18 months are showing a lack of or limited use of words and/or gestures such as pointing, blowing kisses, clapping, shrugging, shaking head for “no,” or are not engaging in pretend play # Have difficulty following simple routines and instructions, or if you have questions about how much they are understanding.

Seek help for your child at any age if they:

# Are banging their head against their fist, biting themselves or showing some other form of self-injury # Show what healthcare professionals call repetitive play or unusual interests • Are not interested in playing with toys, or play with them in “unexpected” ways.  They may play with them in one way only or do the same thing over and over for extended periods, without trying to involve a person • Do not seek out your reaction and do not call you to play or look at them.  If you try to enter their game, your child does not seem to care if you are involved or not # Make up their own signs to communicate but are otherwise quiet

Seek help for your child once they are talking if they:

# Frequently repeat back or “echo” exactly what you have said (echolalia). This may be part of typical language development, especially if your child likes to play games with language (see Appendix E Speech Sound Development) # Repeatedly require you to say the same thing in the same ritualistic way # Repeat sounds, words or phrases (stuttering or dysfluencies) such as, “B-but

I want…,” “But – But I want…,” or “But I But I want.” • Most typically, this is just a sign of their growing vocabulary and enthusiasm to get their words out.  Even adults do this.  The best thing you can do is not draw attention to this and patiently wait for your child to finish what they have to say • If this continues for over six months and your child does three to four repetitions on average or if you notice their dysfluencies getting worse

# Do prolongations or stretch out sounds, such as “I played in the ssssssssand” or “Wwwwwwwwhere are we going, Mama?” # “Block” or have stoppages, that look like your child is trying to push out a word (see companion document “My Child Has a Communication Delay”)

Dysfluencies caught early can be supported; unsupported they can have a serious social-emotional impact for your child.

If your infant or toddler was previously advancing through the stages of development, but now seems to have lost what they had learned (regression), this is a sign that you urgently need to consult with a health provider. For example:

# If your child was previously using words but seems to have lost the ability to use words

• This does not apply to forgetting a few words or no longer being able to correctly pronounce some words that they previously could pronounce, both part of typical language development

Canada is a country where publicly-funded services are available to help with children’s healthy development. Wait times for service can vary between regions, and can be several months long. That is why it makes sense to ask for a referral as soon as you are concerned about your child’s language or other development.

You cannot help but worry if you think your child is not developing as expected. By contacting a professional – as soon as you feel concerned – you do not need to worry alone. You may learn that all is well and feel reassured. Or you may learn that your child, like so many other children, will benefit from extra help and that there are people who can provide that help.