If you have concerns regarding your child’s development, you should be taken seriously and advocate for your child. Early screening, diagnosis and treatment should not be delayed if you have concerns. None of us want to think about our child having a developmental problem, yet all of us want to know about how our child learns and the best way to help them. Assessments are the best way to find out.
The Early Red Flags You Shouldn’t Ignore
The literature quite clearly supports early screening and referral programs to promote early diagnosis and early intervention. Parents who report concerns about their child’s development should be taken seriously; they are usually right, and it does them and the child a disservice to delay a full assessment.
1. Communication Delays
Early “red flags” which suggest a child should be referred for a full assessment include:
- Lack of babbling and/or gestures at 12 months
- Lack of single words by age 16 months
- Lack of two-word combinations at 24 months
- Any regression or loss of words or loss of skills
2. Social Communication Difficulties
Other early developmental indicators include:
- Lack of joint attention (e.g., lack of pointing)
- Lack of response to name
- Unusual or absent eye contact and use of facial expressions
3. Behavioural Patterns
You might notice your child:
- Being overly rigid or having difficulty with changes in routine
- Having obsessive interests or preferring unusual items or activities
- Having tantrums that are triggered for no apparent reason
- Being extremely passive or overactive
- Not imitating others
4. Play Differences
- Absence of spontaneous, purposeful or imaginary play
- Engaging in repetitive behaviours with items instead of typical play
- Lining up toys or other objects repeatedly
5. Sensory Issues
- Being extremely sensitive to lights, sounds, or tastes
- Having a fascination with visual stimuli such as lights
- Being under-sensitive to tactile stimuli
Real Parent Experiences: Recognizing the Signs
One parent shared their experience: “It was around 15 months of age that I began to worry. There was something different with our son but I just didn’t know what. At first we dismissed it because he was such a ‘good’ baby. However, when he was 17 months of age, I came across a milestone chart and at that moment I knew something was very wrong.”
Another parent described: “Shortly before our second child was born, I noticed our son was falling behind with his words. He had about twenty, which is normal, but wasn’t picking up new ones. Then he stopped using words that he had used. I knew that this was a bad sign. One day while I was still pregnant, he was lining up his toy cars. Along the arms of our couch, and every surface were toy cars end for end in rows.”
What Happens During Assessment
There is no medical test to diagnose autism. Instead, a diagnosis must be a multi-step process that requires many important pieces of information. Input from parents regarding the child’s developmental history, and observations of the child’s communication, behaviour, social and play skills are necessary to accurately diagnose autism.
The Assessment Process Includes:
Initial Interview: The process begins with a psychologist conducting an interview with the parent(s) and the child to obtain a developmental history and pertinent background information about the family and the child.
Questionnaires: You will likely be given questionnaires to complete that assess your child’s behavioural style (daily living skills, communication, interaction with others, and motor development). The Vineland Adaptive Scales and Child Behaviour Checklist are typically used.
Developmental Testing: For children up to 3½, the Bayley Scales of Infant Development is usually used. This play-based assessment is often fun for little ones. For older children, other standardized tests compare your child’s development to Canadian children within their age range.
Standardized Autism Measures: The psychologist will complete tools like the Childhood Autism Rating Scale if autism is suspected, or the Autism Diagnostic Observation Schedule (ADOS-G).
Academic and Memory Assessment: Many psychologists also include assessment of academic readiness and aspects of visual and verbal memory.
Different Scenarios Leading to Assessment
Scenario 1: Families with a Diagnosis
These families already have the diagnosis and are now looking at treatment options and comparing providers.
Scenario 2: Families Without a Diagnosis
These families are noticing developmental differences but don’t have a formal diagnosis yet. A family member or teacher may have raised some red flags, so they’re looking for advice or a full assessment.
Scenario 3: Families in Denial
Some families have the diagnosis but one or both parents are pushing back against it and don’t believe it. This requires sensitive handling and access to resources and information.
Don’t Wait – Take Action Now
The most important advice: Don’t wait. There are often long wait lists for assessment and treatment, so it will be of benefit to book an assessment as soon as you become concerned. You can always cancel it later.
When booking an assessment, you can have your doctor refer you to the local children’s hospital, but also actively explore private options. Many parents have coverage under their private medical plans to cover the expense of a psychologist.
Assessment Options:
- Public System: Available through your local children’s hospital for infants and preschool children, and through school boards for school-age children
- Private Practice: Psychological assessments are available through psychologists in private practice
- Insurance Coverage: Many employer-based health insurance plans cover some of the costs
Important: There is often a waiting list for assessment services (6 months to 2 years), which tends to be longer for publicly funded institutions than for private practices.
The Benefits of Early Assessment
Assessment of children is a way to learn how your child engages in tasks and understand their strengths and areas where they can advance further. Assessment can reassure you that your child is progressing typically, but it can also isolate any areas of weakness that you can address.
The most important part of the assessment is the recommendations that follow. These recommendations will focus on promoting strengths and addressing any areas of weakness so that through experience, areas of weakness can be strengthened or overcome.
Your child’s assessment will ensure that if needed, treatment can begin. Since there are often long wait lists for intervention services through public programs, the earlier your child is identified, the earlier your child can begin getting the help they need.
System Navigation Support
Families often call us as the first point of contact after they just received a diagnosis or they had some red flags about their child and they’re so overwhelmed. We want parents to have this feeling of wraparound care and that we will be with you every step of the way along your journey.
We help families with system navigation – they often get a diagnosis and don’t know what to do next. As one parent put it: “Most of the questions families have are around ‘I don’t know what to do. Do I get an assessment? Do I not get an assessment? How much therapy do they need? Where do we go?'”
Take the First Step
If you’re noticing any of these signs in your child, don’t wait. Trust your instincts – parents are usually right when they have concerns about their child’s development.
The sooner you take action, the sooner you can help your child reach their full potential. Remember: early identification leads to early intervention, which is key to your child’s success.