42 results for: "developmental milestones"
Developmental milestones for second and third graders
By the time kids start second and third grade, school isn’t new to them. But the skills they develop in these years are. At this age, kids make leaps in language and in the ways they think. Their social-emotional skills grow, too.Check out these developmental milestones to get a sense of the skills kids develop as 7- and 8-year-olds.Physical milestonesAt ages 7 and 8, kids work on refining their physical skills. Their fine motor control and stamina may improve. Most second and third graders:Gain strength in both big and small muscles Can play and be active for longer periods without getting tired Use the small muscles in their hands to get better at things like holding a pencil correctly and forming letters accurately Can run farther and for longer Ride a bike without training wheels Develop sports skills like catching a small ball Tie shoes, button, and do up zippers without help Coordinate movements to do things like follow a dance routine May begin to type fairly quickly on a keyboard Cognitive milestonesAt this age, thinking and problem-solving skills are taking off. Kids tend to talk at a more adult level and start to explore specific activities that interest them. Most kids this age:Look for the reasons behind things and ask questions for more informationUnderstand cause and effect and make more in-depth connections (for example, know that if 6 + 2 = 8, then 8 ‒ 6 = 2)Use those connections to do more complex math like multiplication and division Start planning ahead (for example, create a drawing of something to build or make a plan for an experiment)Can sit and pay attention to something that interests them for at least 30–45 minutesStart collecting thingsMay try out different types of writing, like narratives and opinion papers (“Why I liked this book”)Use complex sentences and different types of sentences to express ideas clearlyRecognize and know the value of coinsLearn how to do addition and subtraction with regrouping (also known as “borrowing”)Language milestonesLanguage development typically continues at a steady pace these two years. Kids start trying out words they’ve read but not heard, so you may hear some mispronunciations. By the end of third grade, most kids:Understand what they read and begin to move from “learning to read” to “reading to learn”Learn vocabulary through readingUse words to talk through problems, both socially and academicallyStart playing with words to make puns; understand jokes and riddlesTest out “bad” words for shock valueUse all letter sounds correctly; don’t substitute w for r anymore when speakingUse writing to express feelings, tell stories, and summarize informationSocial and emotional milestonesSecond and third grade can be a little rough socially and emotionally. Kids often start narrowing down to a few good friends, but those friendships can change quickly. Most kids are eager to fit in and try out new personalities to see where they fit. By the end of third grade, most kids:Have moments of extreme insecurity and need a lot of encouragement from family and loved onesChange often between being helpful and upbeat to being unhelpful and grouchy Enjoy being part of a team, group, or clubSpend more time with and are easily influenced by peersExperience periods of dramatic emotion and impatience (feeling that everyone is against them) and then bounce right back to everything being just fineStart seeing things from other points of view and incorporate that into everyday lifeBe somewhat aware of others’ perceptions of themWant to behave well, but aren’t yet very attentive to directionsShare secrets and jokes with friendsThese milestones are typical for this two-year span, but kids develop at their own pace. If you have concerns about development, share them. Parents, teachers, and health care providers can work together to find answers and come up with a plan.Take a look forward at developmental milestones for fourth and fifth graders.
The Opportunity GapEarly intervention and kids of color
Co-host Marissa Wallace opens up about her biracial son who had language delays as a toddler. Hear her story. Thousands of kids of color from marginalized communities enter kindergarten behind. One cause: Families often don’t know that there’s free help for babies and toddlers with developmental delays. In this episode, co-host Marissa Wallace opens up about her biracial son who had language delays as a toddler. Even though Marissa is a teacher, she didn’t know exactly what to do. That’s when her doctor recommended free early intervention services. To make sure other families don’t miss out, Marissa and co-host Julian Saavedra raise awareness about early childhood intervention services. They also talk about barriers that kids in low-income areas face. And they share tips on how families can seek out early intervention.Reports mentioned in this episodeOur Youngest Learners: Increasing Equity in Early Intervention, by The Education TrustEarly Inequities: How Underfunding Early Intervention Leaves Low-Income Children of Color Behind, by Citizens’ Committee for Children of New YorkRelated resourcesWhat is early intervention?How to get an early intervention evaluationFederal government developmental milestonesEpisode transcriptJulian: Welcome to "The Opportunity Gap," a podcast for families of kids of color who learn and think differently. We explore issues of privilege, race, and identity. And our goal is to help you advocate for your child. I'm Julian Saavedra.Marissa: And I'm Marissa Wallace. Julian and I worked together for years as teachers in a public charter school in Philadelphia, where we saw opportunity gaps firsthand.Julian: And we're both parents of kids of color. So this is personal to us.Marissa, what's up? How're you doing today?Marissa: I'm doing well, Julian. How are you?Julian: Excited to jump into what we're going to talk about.Marissa: Yeah, I think this kind of came up in a conversation that we had recently. And I think it's an important topic because it's the beginning part of our children's educational experience. I'm looking forward to having an honest conversation about early intervention, what that means, and then just talking about some potential shortcomings of the program, some areas in which it's not doing what it's meant for, which is supporting children from birth until they're school age, is that what happens before they go into school. I'm looking forward to having this conversation.Julian: I think today's really important to bring about something that doesn't really get talked about a lot, the idea of early intervention specifically for, you know, our babies, our toddlers, before students are going into school. And how there's such a disparity between the experiences of our white students and our Black and brown students. You know, I remember when our son was a couple of weeks old and my wife had made sure that we had all the books. We had the American Academy of Pediatrics book, and we had "What not to" — or "What to Expect When You're Expecting." And I remember in the books, a lot of them had month-by-month explanations of specific things that should be happening for developmental milestones for children as they reached different markers in their lives, when they should start to make sounds, or when they should be able to hold themselves upright by themselves, or when they should start crawling, or when they should start recognizing words. And a lot of those things are really based on physical milestones, those language milestones, and obviously the social and emotional milestones. That's really where we're looking at, where are the early intervention programming come into play? Like, where are those things that we need to pay attention to? A lot of times people are very stuck on what those books are telling them, that, uh-oh, my kid didn't crawl as soon as your kid did.Marissa: You're right. We're constantly thinking about, are they hitting the milestones? You, we're having conversations, we're seeing other parents with their children and we're, like, making that comparison. So what early intervention is, it's services and supports that really are in place to help young children who are experiencing developmental delays. And so those developmental delays can be small to large. Like, I know that it's, often what happens is when there is a notice of, whether it's a language or a physical milestone or something, social, emotional, where it's a child is performing not where they're supposed to be or below average in those areas, oftentimes, their pediatrician would have that conversation with the family and then recommend going through an evaluation process. So we're going to hear and talk about some terms that are similar in the early intervention process to what we've talked about on the show, as far as the evaluation process at this school-age level. But so it's important to understand and differentiate between an early intervention program and a school-age program for special education because they are different. I will say, though, this is a step that's overlooked often but so incredibly and critically important to a child's development and to what their school life is going to be like. Because if you start this process early, it really has an amazing way of providing students with those services before they become a student.Julian: I think a lot of our listeners probably have children that are older than this age range, maybe not. But if you have people in your lives that have younger children, or if you know or interact with people who have toddlers or babies at some point, I completely empathize with the anxiety that comes along with parenting a newborn, parenting a baby, parenting a toddler, especially if it's your first one. There's a lot of things that go along with it. A lot of feelings that come with it, and it's a nerve-racking experience to begin with. It's a beautiful thing, definitely, but it's also really hard, and you're getting advice and information from all places. From your friends, from your mother-in-law, and or your mom, or your dad, or your aunt, or your grandma, or the neighbor across the street, social media, all the pictures of Facebook telling you this, that, and the third. If you're in those spaces and you're somebody that might be wondering or worrying about your child, are they hitting these milestones? Should parents just wait for them to hit the milestones? Should they, like, when should they start to take action?Marissa: Right. And so I'm so glad you bring that up, because I can, like, vividly remember, like, our process. So I think the first piece of it is, right, is, like, making sure, especially in those very beginning months, weeks, and years of your child's life, making sure that they are going to their regular checkups with their pediatrician, because that's, for us, where this kind of unraveled and where we got the information. Because even as an educator, I honestly did not know anything about early intervention until I became a parent. I had heard about early intervention, but I didn't personally interact with it until my son. Two things, right, there's, like, a knowledge gap that we have, and then there is an access. We have to also talk about sometimes the access to these services are not easily accessible for all families. So for us, like I, because I was an educator, I had some thoughts, and some, again, also falling into the comparison trap. I was like, ooh, Lincoln's not communicating verbally as much as I believe he should for his age. It was his 18-month appointment that we were going for his check-in with his pediatrician.And so if you're a parent out there, or a guardian, and you've ever taken a kiddo at that age, you may or may not remember there, they ask you all these questions before you even get seen by a doctor, there's just this list of questions about their development. So all the things that, you know, Julian and I brought up — the physical milestones, language milestones, social and emotional — they start asking those questions.And so, for us, it was one, I encourage everyone to answer those questions and those surveys honestly. The part that stuck out to our pediatrician was his limited words. So he didn't have a whole lot of words at 18 months. And so, of course, that led to some behaviors, right? Because he's not able to verbally tell us or ask us. And so therefore there was crying and tantrum-ing and some other actions and behaviors that were happening because of his limited vocabulary at that time.There wasn't like a huge concern. However, our pediatrician was on it and was like, "Here's my suggestion. Let me give you the contact and the information to follow up with early intervention services. Give them a call and set something up."And so that was, like, our beginning. Again, step one, OK? So now it's, I could have done one of two things: I could have ignored it. I could have been, like, he's fine, he'll grow out of it. Or I could have just been a busy mom and not ever followed up. But thankfully we made the call, we got an appointment to have him evaluated. And the great thing, and something now I know it's pandemic time so life is very different, but at that time, they came to our house. So it was a really easy process. Yeah. They came right to our house and did the evaluation at our house, and were pretty communicative with getting us information and letting us know that he did qualify. He qualified for speech services.Julian: I know that's probably really hard, like, at that point where you're evaluating your 18-month-old son. Did that cause any feelings?Marissa: It did, and I'm the kind of person, like, I want the information, you know what I'm saying? So I was more relieved that someone was going to give me information so that I knew what to do next, and that I knew that my child could get the support, because that's really what early intervention is, is identifying a delay. Whether that delay is, in this case, it was a language delay, whether it's a physical delay, social-emotionally, whatever that delay is, they identify it. And then the really amazing thing is they believe in incorporating the families into providing the support. So once we knew what his delay was in, it turned into really hands-on therapy, where now I was working at the time and Mario was home, so it was more, like, teaching the parent how to interact and how to build these language skills together, which was really cool.Julian: So let's bring out a couple of things with what you said. First, thank you for sharing your experience so far. And we're obviously a little different than all parents out there because we both are educators too. So how we take these things is going to be a little bit different because it's been part of our career. But I'm thinking about all the parents that are not in education. I'm thinking of all the parents that are potentially experiencing this, and they might not have the immediate wherewithal to know, "Oh, maybe something's going on. Maybe I need to speak up to my pediatrician." Maybe — the whole point of this show particularly is focusing on the gap in opportunities for our people of color versus those that are not. The statistics are wild. That's also something that, that, again, we don't really talk about this side of things, but listen to this: For families of color, access is far more limited.So this statistic comes from the Education Trust: "The probability of a child being identified as having a developmental delay and using early intervention services is drastically different depending on their race and ethnicity, comparing this to their white peers with developmental delays. Black and Latino children with developmental delays are 78 percent less likely to have their need for early intervention services identified. Black children, specifically, with developmental delays are 78 percent less likely to receive early intervention services."This report will be found in our show notes. And honestly, I didn't even know that. Like, until we started to really dig into this, I had no idea that there was such a drastic gap between the identification but also the actual reception of the services that are out there.And, Marissa, tell them, what are early intervention services in terms of costs?Marissa: Certain early intervention services are free in all states, so, again, I said —Julian: Say that again?Marissa: Certain early intervention services are free in all states.Julian: Free! Free!Marissa: We were really fortunate because every single service that our kiddo had was completely paid and taken care of.So it does, just to further that, you may be charged on a sliding scale or through your insurance for early intervention services that are not free. So there are, again, there's different classifications, there's different levels of services? I can't speak for every child and every family. However, for the most part and at least the initial piece, right? The initial piece of getting into early intervention, that part and finding out what your child needs is going to be free. So you cannot be denied services, though, if you can't afford to pay for them. So that's important for families to know, too, that even if there is a cost attached to it, you cannot be denied for that service.So it is, so again, just similar to when we've talked about the special education piece, there are things in place to protect and to ensure that children are receiving the support that they need, because, I promise you, early intervention is so critical in your child's development. And it is a game-changer for when they transition to school age.So it has so many benefits. However, right now, I think our conversation based on these statistics is what the heck is the barriers? That's really concerning to hear that such a large percentage less are receiving such important services. What's the why behind it?Julian: Well, yeah, I mean, I was shocked, you know, I knew about early intervention from, again, from my educational background. I knew what it was, and then our pediatrician was amazing. So she always told us, like, what to expect coming up. And she was way more well informed than the books, so I felt comfortable with her. But I know that that's not the same experience for everybody. I think that we were able to procure a really solid pediatrician that could devote lots of time to us because we were going to a hospital in a wealthier neighborhood. And we were privileged enough to have that. And I think one of the largest barriers is always going to be around income. And we know that income and systemic racism are tied together. And for many of our Black and brown students, and pre-students, children who are not even in school yet, those that are in low-income neighborhoods don't have access to adequate health care.They also, because they don't have this access to adequate health care, they don't have the same pediatrician experience that those of means have. So instead of having a 25- or 30-minute appointment with a pediatrician where you can ask lots of questions, where you can have this working relationship, where you can email back and forth or text message to call, you might have a situation where you're going into a clinic and the appointment is five minutes. It's a really quick, "Let me check off the list. Let me weigh the child. Let me make sure there's nothing wrong. All right, let's go on to the next person." So the relationship isn't even developed to a point where you feel comfortable as a parent with bringing up some of the worries that you might have. So I think one of those big barriers is in low-income communities, specifically the lack of health care, the lack of adequate pediatric services, and the lack of access to a working relationship is really something that holds people back.Marissa: And it's concerning because it actually made me think about if a parent that I was talking to, this was years ago, and similar to us, like, the parent came from a place of understanding and some privilege and knowledge of what their child deserved. However, they had to take their knowledge and actually, like, step up to the pediatrician and was like, "Hey, I know there's these services out there. Can you tell me about them?" because it didn't come up in a conversation. But now I'm also wondering and concerned with how much we know that our health care system is so overwhelmed. Now I'm thinking, what does that look like now? So in these places where they're overwhelmed, and in these places where they're not taking the time to really talk to families or have these well visits even, right? Think of how much is missing with being able to identify any developmental delays and then provide any next steps for access to early intervention. Because if a parent like ourselves, or like this parent that I know didn't have the know-how or the knowledge to have the conversation, you would go to these appointments and if the conversation didn't happen, you wouldn't even think twice. Do you know what I mean? You would have walked out. Like, if, if you didn't, if it never came up, you could have totally missed the opportunity.Julian: Yeah, and that's, that's something I don't think would just be restricted to the cities. I imagine that if we dug deeper, this is across rural communities, this is probably across any communities where there's just a lack of sufficient health care. I mean, we hear about health care in the news a lot, and a lot of times we talk about health care in relation to older people or, you know, folks that are not getting health care for existing conditions, but we don't really talk about the beginning of someone's life.Marissa: Right. And this is the preventive, right? The preventive piece.Julian: Exactly. And this is a very, like, extremely preventive measure that, in many cases, if some of these developmental delays were brought up early on, then it could potentially prevent further down the line, issues that happen in school. You know, because a lot of times we see that our students of color are coming to school behind their white and wealthier peers due to all of the things that are happening related to systemic racism, but also due to the fact that potentially they're not getting intervened with all of the potential things that could be solved or addressed like you had with Lincoln.Marissa: And we were fortunate, because like I said, it was me, it was every piece of the process. It was me having my own assumptions. It was me taking the time. I hate doing surveys. Like, just real talk. Like, when I sit down, and I vividly remember sitting at that appointment and I'm like, oh, it was like 30 questions. And I'm just like, oh, I really just want to click anything right now. I just want to be done with this survey. I'm thankful that I obviously allowed myself to be honest because then it triggered the next conversation, which was, "OK, here's the next step." And then again, I had a choice. I left the doctor's office with this information. I could have just ignored it and not made the call, but then I made the call, got the services. And so just for everyone out there who's listening, understand that there's such a wide variety of services they provide too. So it's anything from, like, in our case where we had the speech therapist coming to the home and working alongside my husband to work with Lincoln, to having, if your child is at a daycare, they will have services where they will go with the child to the daycare and provide the services there.I had a family who had a child who, they had some behavioral developmental delays, and they actually had an assistant who was with the child in the daycare multiple times throughout the week. So it is a variety of things that are really involved in early intervention. And the cool thing, too, is just like if they were school age, there's progress monitoring. So there's checks that happen. And there's, I still have, I have saved to this day, notes, tons of notes. Every time our person would come, they would document everything that happened, and they would give it to us. A copy for them, a copy for us. So I have this whole, like, year of Lincoln's life documented on the progress he made.So I hope even though there's barriers, my goal is to have everyone who's listening understand the benefits and know that, just like we said in that blurb about the fact that they are free services and that you cannot be denied for services. So hopefully that's sparking in families who might be concerned about their young ones to have these conversations with a pediatrician or a trusted friend or someone who can connect them in their community to these services, because that connection piece is key.Julian: It is, and I think on the flip side, even the impact is also felt in underfunding the early intervention programs that are available in low-income areas. There's the pediatric side and the health care side, but then the other side of it is the actual intervention program. So say, by chance, the families procure some sort of programming and they finally get early intervention services. What we're finding across the country, many of our programs that are available are not getting funded properly. For example, in the Bronx and Manhattan, in 2019, there was a social service agency called University Settlement, and they employed early intervention therapists that spoke 11 different languages, providing services to over 350 kids. This program was closed in 2019. Over the 10 years, other programs like that closed all across the city of New York. A lot of these evaluations that are happening were by therapists who would have to travel a lot farther from their homes in the suburbs or their homes away from the low-income areas, and so they couldn't service as many kids in one day as if they were in the suburban areas. So if I'm a therapist, and I'm a mobile therapist, and I'm located in one of the suburbs, but I need to do all of my programming in the city and I'm not located or my office is not in the city, the amount of families that I can see in any given day is vastly smaller than the amount of families that I might be able to see if I'm closer to where I service the kids. So that barrier in and of itself impacts the amount of people who are seen. How is that even remotely close to being OK?Marissa: But it's because, just like the shortage in the teaching world, right? There's shortages in this area as well, and that's a huge issue. And we have consistently as a country sit there and pump funding into the, to reactionary services as opposed to prevention, like that's been like an ongoing thing. Like these preventative services that would be, would help so that there wouldn't need to be all of these reactionary services, where we've always been backwards with that. Because I'm sure we were super fortunate, but I know our story is not, clearly, is not what everyone's experiencing. And I do think you bring up a great point is there's just not enough funding to cover those that are doing this work. And that's why there's probably not people out there doing the evaluations, because the ones that are probably overworked and underpaid.Julian: How do we start to actually make some movement on making some of this happen in low-income areas in Black and brown communities? Because 78 percent is unacceptable.Marissa: And I, and I'm hoping that our first step today was just the awareness, right? Like I just think that there is, as I mentioned, like I, as an educator, did not really understand or know enough about early intervention until I was a parent.So there is clearly just knowledge gaps. So I hope that our first thing that we've done for our listeners is provided awareness. I think the second thing is providing facts, right? We don't sugarcoat it for our listeners. We are honest, and we tell the truth. And so now that you have the facts, like, knowledge, though, is power, so now that you have the facts and you know that there are services that are free, and you know that you are not, should not be denied those services if you can't afford them, it is now about having, finding those people to have those conversations with. Whether it's your pediatrician, whether it's someone within your own circle or your community that can get you connected to make sure that your child has what they need.Because I will tell you this, like, the success story that I've experienced. Lincoln did an entire year of early intervention services. And then when he was 2½, he tested out. And we went from being concerned that he was going to need to continue to have early intervention, and most likely we were, like, preparing for him to get identified as a child with a speech or language impairment, that would have then carried and transitioned over to school age. And he would have then needed special education, which we were fine with. We really were. We had accepted that was potentially his journey. However, in one year, the progress that my kid made — give so much credit to Ms. Tanya and to the other people that worked with Lincolna. And it was truly a team effort, and I believe because of them and because of those services, he was able to transition out and not need school-age services.Julian: So it's just another one of those things that goes not said. But we don't talk about it, and it just, other people are benefiting from it, but it's designed to benefit everybody. All children should be experiencing a situation where they get what they need. And if there's a position where we can potentially intervene before students go to school so that they are prepared and ready to walk into a school building and ready to learn, then we need to make sure that it's happening. Share that early intervention is a right. It is not a privilege. It is a thing designed to help everybody. Make sure that you're opening up conversation and ask those questions. And, Marissa, thank you so much for sharing your story and sharing the success story because it works.Marissa: Right.Julian: It works.Marissa: And that's right. And I want there to be more stories like that. I'm hoping that we achieve — that's the goal is by making this an awareness, by working towards equity for every child. Lincoln is a unique kid, so I'm just glad he received what he did receive. We were very fortunate.Julian: For more information, please check out show notes for all of our resources that we mentioned today.This has been "The Opportunity Gap," a part of the Understood Podcast Network. You can listen and subscribe to "The Opportunity Gap" on Apple, Spotify, or wherever you get your podcasts.Marissa: If you found what you heard today valuable, please share the podcast. "The Opportunity Gap" is for you. We want to hear your voice.Go to u.org/opportunitygap to find resources from every episode. That's the letter U as in understood, dot O R G, slash opportunity gap.Julian: Do you have something you'd like to say about the issues we discussed on this podcast? Email us at opportunitygap@understood.org. We'd love to share and react to your thoughts about "The Opportunity Gap."Marissa: As a nonprofit and social impact organization, Understood relies on the help of listeners like you to create podcasts like this one to reach and support more people in more places.We have an ambitious mission to shape the world for difference. And we welcome you to join us in achieving our goals. Learn more at understood.org/mission. "The Opportunity Gap" is produced by Andrew Lee, Cinthia Pimentel, and Justin D. Wright, who also wrote our theme song. Laura Key is our editorial director at Understood.Scott Cocchiere is our creative director. Seth Melnick and Briana Berry are our production directors.Julian: Thanks again for listening.
Developmental milestones for preschoolers
What are the developmental milestones for preschoolers? Take a look at these lists to get an idea of skills typically expected of preschoolers. Remember that kids develop at different rates. So if your child is behind on a few, it’s not uncommon.Then take a look ahead at developmental milestones for kindergartners.
Understood Explains Season 2What happens in an ADHD test for adults?
Find out how doctors test adults for ADHD. What kind of questions do they ask? How long does it take? Know what to expect in a thorough evaluation. How do doctors test adults for ADHD? What kind of questions do they ask? How long does it take? Understood Explains host Dr. Roberto Olivardia breaks down the process and explains what to look for in a thorough evaluation. Get an overview and answers to common questions: What does an ADHD evaluation look like? [00:51]So, what are ADHD rating scales? [03:48]How long does this whole testing process take? [04:59]What is the diagnostic criteria for ADHD in adults? [06:02]Why is it so important to be open and honest during an ADHD evaluation? [07:42]Key takeaway, next episode, and credits [08:31]Related resourcesHow do doctors test for ADHD in adults?What are ADHD rating scales?The 3 types of ADHDEpisode transcriptYou’re listening to Season 2 of Understood Explains: ADHD Diagnosis in Adults.Today, we’re going to talk about what happens in an ADHD test for adults.My name is Dr. Roberto Olivardia, and I’m a clinical psychologist with more than 20 years of experience evaluating people for things like ADHD. I’m also one of the millions of people who have been diagnosed with ADHD as an adult. I’ll be your host.My goal here is to answer the most common questions about ADHD diagnosis. Along the way, you’ll learn a lot about ADHD in general. We’re going to do this quickly — in the next 10 or so minutes. So, let’s get to it.What does an ADHD evaluation look like? [00:51] First, I want to tell you what the testing doesn’t look like. There are no blood tests, no hooking you up to a machine, no brain scans — nothing like what you might see in other parts of a medical facility. In a nutshell, an ADHD evaluation tends to involve some multiple-choice questions and a wide-ranging conversation with a trained professional, like the kinds of providers we talked about in Episode 2. OK, so now let’s drill down into five key components of ADHD testing:The first is patient history — getting to know your past. The provider will ask for information about your childhood, including your birth weight and developmental milestones, like when you learned to walk and talk.This is also when it’s good to share details about any hospitalizations, as well as any ongoing health issues you might have. The second big part asks open-ended questions about different aspects of your life, like school, work, relationships, sleep patterns, appetite, etc. This is all essential for the evaluator to know, because ADHD can impact so many different aspects of daily life. But it can also affect different people in different ways. Let’s look at sleep, for example. If you say you don’t get enough sleep, the evaluator can really dig into this area: Do you have trouble falling asleep, but then you sleep like a rock and it takes four alarm clocks to wake you up? Or do you have trouble staying asleep because every little noise wakes you up? Is your sleep disrupted because you’re drinking too much and keep getting up to go to the bathroom? Another example is the evaluator asking open-ended questions about school. If you say you were an A student, the evaluator might ask what went into getting those A’s.Did you have to pull a lot of all-nighters? Were your parents very involved in structuring your schedule? Did the wheels fall off when you went to college or got your first job?The third part is a questionnaire that asks a bunch of quick questions using what’s called an ADHD rating scale, which we’ll get into in the next section. But before we jump to that…Another really important part of an ADHD evaluation asks about other conditions. For example, maybe your symptoms are pointing to something that looks a lot like ADHD or that often co-occurs with ADHD, such as anxiety, depression, or obsessive-compulsive disorder. That’s really, really important to keep in mind. And the last big part of the process that I want to highlight is meeting again with the provider to go over the evaluation report. This report is typically several pages long and should sound like whoever did the testing really got to know you. The report should also include recommendations on how to help. If you notice any inaccuracies or need clarifications, you should raise those concerns with the evaluator right away. And if you need certain recommendations spelled out so you can get accommodations at work or maybe for college or grad school, talk with the evaluator about that too. So, what are ADHD rating scales? [03:48] You’ll probably hear the phrase “rating scale” quite a bit during the ADHD diagnosis process. Essentially, it’s a questionnaire — a series of brief multiple-choice questions that you might fill out at home, or in-person with the evaluator. These scales ask you to rate how often you experience behaviors related to ADHD, like running late to important events or making careless mistakes when you’re working on a boring project.The answers you’re choosing from are typically something like “never,” “occasionally,” “often,” or “very often.”There are several different versions of rating scales, but they’re all working toward the same goal and are a key part of a comprehensive evaluation. Generally, different providers tend to use whichever questionnaire or rating scale they like best and fill in any gaps during the one-on-one conversation or clinical interview. Sometimes, an evaluator may also ask someone who knows you very well — like a spouse or roommate — to fill out a questionnaire. Getting other people’s perspectives is commonly done when kids are being tested for ADHD, but it can help with adult diagnosis too.How long does this whole testing process take? [04:59] The length of time an evaluation takes can really vary from person to person. I’ve had some thorough evaluations take an hour to complete. Others have taken four or five hours. Some could be finished in one visit. Others need to be spread out over a number of visits.But in general, the process tends to break down like this:The ADHD rating scales typically take anywhere from 10 minutes to 45 minutes to fill out.The patient history and other open-ended questions may take an hour or so.And then there’s the follow-up, where the evaluator explains the results and recommendations. This typically takes an hour too.There are lots of possible reasons why some evaluations take longer than others…Like if there’s a lot of personal history to review, or if there are any co-occurring conditions to go over in addition to possible ADHD.The timing also depends on how quickly the provider and patient are able to move through these conversations.What is the diagnostic criteria for ADHD in adults? [06:02]There are three official types of ADHD, and each has a different threshold that patients must meet for a diagnosis. There’s the inattentive type of ADHD, which used to be called “attention-deficit disorder,” or ADD. Patients need at least six symptoms of inattention for a diagnosis.To be diagnosed with the hyperactive/impulsive type of ADHD, a patient needs at least six symptoms of hyperactivity or impulsivity.Many folks have a third kind, which is called the “combined type of ADHD,” where you qualify for both types I just mentioned.The official diagnostic guidelines are part of a big manual that’s called the Diagnostic and Statistical Manual of Mental Disorders, or DSM. The DSM lists the criteria for the three kinds of ADHD. These guidelines are also looking to see if you started having symptoms before a certain age and if you’re having symptoms in two or more settings, like home and work.But these criteria are all really nuanced, which is why it’s so important to talk one-on-one with the evaluator. For example, it may seem like you’re mainly struggling in one area, like time management. But that one area could have a huge, negative impact on your life — like getting fired, losing friends, not achieving goals, etc. Context is also really, really important. For example, are you noticing fewer symptoms in some settings because you’re getting more support in those areas? A highly trained evaluator can suss out these kinds of things during your one-on-one conversations. Why is it so important to be open and honest during an ADHD evaluation? [07:42] As you’re going through the ADHD evaluation process and you’re filling out the rating scales, it’s pretty easy to guess which “often” and “very often” answers lead to an ADHD diagnosis.But I want to caution you against trying to answer in a way to ensure you get a diagnosis. If you don’t truly have ADHD, then getting treated for ADHD may not help you. And it could be dangerous if you’re incorrectly prescribed ADHD medication. It might actually make it take longer to figure out what’s really going on, like if you have a sleep disorder instead of ADHD. Different conditions require different treatments. So try to be as open and honest as possible. Key takeaway, next episode, and credits [08:31]OK, that’s all for Episode 3. The key takeaway I’m hoping you remember from today is why ADHD evaluations need to be so thorough.Evaluators ask so many questions to make sure that you do, in fact, have ADHD and not some other disorder that looks like ADHD. And since ADHD often doesn’t travel alone, it’s also really important to tease out any co-occurring conditions so your provider can develop a comprehensive treatment plan. Thanks for listening, and I hope you’ll join me for Episode 4, which explains what you need to know if you’re thinking about getting online testing for ADHD.You’ve been listening to Season 2 of Understood Explains from the Understood Podcast Network. If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources, as well as links to anything we’ve mentioned in the episode. One important note: I don’t prescribe ADHD medication and I don’t have any affiliation with pharmaceutical companies — and neither does Understood. This podcast is intended solely for informational purposes and is not a substitute for a professional diagnosis or for medical advice or treatment. Talk with your health care provider before making any medical decisions.Understood Explains is produced by Julie Rawe and Cody Nelson, who also edited the show. Briana Berry is our production director. Our theme music was written by Justin D. Wright, who also mixes the show.For the Understood Podcast Network, Laura Key is our editorial director, Scott Cocchiere is our creative director, and Seth Melnick is our executive producer. Understood is a nonprofit organization dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission.
Developmental milestones for first graders
Moving up from kindergarten means big changes. Not so much in physical skills, but in the way kids begin to think and interact with the world. There’s a lot of growth in social and thinking skills in first grade.Check out these developmental milestones to get a sense of which skills are typical for first graders.Physical milestonesMost kids gain stamina and coordination during first grade. They may start the year a little uncoordinated, because the big muscles in their arms and legs are better developed than the small muscles they use for smaller movements. What kids can do physically this year doesn’t change as much as how well they’re able to do it. By the end of first grade, most kids will:Have improved hand-eye coordination for things like tying shoelacesBe able to dance in time with the music — and even add some cool moves like spinning in place without moving from one spotHave handwriting that’s getting neater and easier to readRun, hop, skip, and jumpThrow and kick a ball, and catch it with both handsCopy shapes and lettersKnow how to use utensils the right way (even if they don’t always do it!)May begin playing a musical instrumentRide a bike without training wheelsBe capable of doing chores like sweeping or making the bedTie shoes and button and zip independentlyCognitive milestonesKids’ thinking skills this year allow them to start exploring the world to find answers to their own questions. During first grade, most kids:Start developing the skills to reason and think logicallyTry to think about things before making decisionsLearn from what they hear and read — not just from what they see and doHave trouble making choices because they want to do everything at onceCan read several sight words (words they see frequently and can read without sounding out) and sound out other wordsBegin to have a better sense of time, understanding increments of time, days, weeks, months, and seasonsPredict what comes next in a pattern, and recognize and create their own patternsCount to 100 by ones, twos, fives, and tensWrite and recognize the numerals 0 to 100, and the words for numbers from one to twentyDo basic addition and subtraction up to 20Language milestonesBy the start of first grade, kids may use language in long and complicated sentences to talk about the past, present, and future. But this year, they may start combining spoken language with reading and writing. First graders typically:Start sounding out wordsUnderstand the relationship between letters and soundsKnow, use, and understand thousands of wordsStop reversing letters (by the end of first grade)Try to express feelings with words, but may resort to aggression when upsetUse words to convince people of their viewpoint and to tell storiesTell jokes and riddles, and may understand simple punsTell little lies about everyday thingsSocial and emotional milestonesFirst-grade social-emotional skills are an interesting mix of independence and an increased need for your attention and approval. By the time they turn 7, kids typically start to understand that friendships aren’t something they can control by themselves. That may make them a little anxious. Many kids also:Are more independent, but less secure (they may want a lot of attention and approval from adults)Form and break friendships easily, and can be critical of other kidsGet their feelings hurt more easily and start being very aware of other people’s feelingsAre eager to please and want to “be first” and winUnderstand right from wrong, but look for the loopholes in rules to get what they wantAre more aware of how others see themBegin to understand what it means to feel embarrassedThere’s a lot of variation in how quickly kids develop skills throughout first grade. But if a child isn’t doing most of these things by the end of first grade, parents and teachers should talk about what they’re seeing, and what might help. Parents and caregivers should also share their concerns with their child’s health care provider. If a child needs support in some skill areas, now is a good time to start.Take a look forward at developmental milestones for second and third graders.
In ItAll about language disorders
Understanding what a language disorder means for your child can be overwhelming. Here’s help from an expert. Language disorders can lead to many questions, both in the classroom and elsewhere. How will the school handle it? What can you do to help at home? And what if you’re not even sure if a language disorder is what your child is struggling with?In this episode of In It, hosts Gretchen Vierstra and Rachel Bozek talk with Kelli Johnson, a Minneapolis-based educational speech-language pathologist who is also a writer and expert reviewer at Understood. Kelli explains what her job is all about, and what it means to have a language disorder. She also talks about making her work with students fun while helping them navigate this learning and thinking difference.Related resourcesLanguage disorder fact sheet What are language disorders How speech-language pathologists work with kidsEpisode transcriptGretchen: From the Understood Podcast Network, this is "In It," a podcast about the ins and outs... Rachel: ...the ups and downs... Gretchen: ...of supporting kids who learn and think differently. I'm Gretchen Vierstra, a former classroom teacher and an editor here at Understood.Rachel: And I'm Rachel Bozek, a writer and editor with a family that's definitely in it. Today we're getting into language disorder.Gretchen: A term which includes receptive language disorder and expressive language disorder. Rachel: Joining us to break it all down is Kelli Johnson, an educational speech-language pathologist based in Minneapolis. Gretchen: Kelli holds a master in communication disorders and is also a writer and expert reviewer here at Understood. Rachel: We're so glad to have her helping us out today. So, Hello Kelli. Kelli: Hello. Rachel: Welcome to "In It." We're so glad to have you here. To get us started, would you mind telling us what it means to be an educational speech-language pathologist? Kelli: Well, an educational speech-language pathologist is somebody who serves disabilities in the school setting as they relate to a child's ability to participate in the school curriculum. And so, the disability areas we deal with are things like stuttering, speech sound disorders, or articulation, where kids have difficulty saying specific speech sounds.And what we're going to talk about today, which is language disorder, where kids' language development is really significantly... they have significant challenges compared to their same-age peers. Gretchen: Let's go into a little more depth. What is a language disorder, exactly? Kelli: Broadly speaking, language disorder is a disorder or an impairment that involves the ability to understand the language that's all around you. The meanings of language, the language that we get in writing or verbally, and also expression. So, how we use language to convey the messages that we want to put out there. Gretchen: How common are language disorders? Kelli: So, you know, the studies that we have available on five-year-olds — which is kind of when, language disorder tends to be discovered — is that it occurs for 1 in 14 kids. And that is the rate at which it's identified in kindergarten. But those language difficulties generally persist in some way or other, in some severity or other through adulthood. Rachel: Wow. You've touched on this already, but I wonder if you could say more about the difference between receptive and expressive language disorder. Kelli: Sure. So, receptive language is all about what you're taking in. It's language understanding or language comprehension. And so, these are kiddos that are going to have difficulty taking in, longer directions like 3-step directions. These are kiddos that, may not understand the question you just asked them. They will certainly have difficulty understanding verbal instruction. You know, when teachers are teaching a longer lesson. Expressive language is how kids or how people use language to say their own ideas express themselves. And so, these are kiddos that are going to have trouble putting sentences together in a way that is meaningful to the people around them. And so, that can look like, difficulty with grammar. It can look like difficulty with what we call syntax, which is sort of how we put all these words together, telling stories, or difficulty organizing sentences. But broadly speaking, expressive language disorder is difficulty putting the message out there in the way that you want to say it. Rachel: So, what are some of the signs? We talked a little bit about kindergarten being kind of the beginning of when this might get spotted. What are some of the signs that might indicate that a younger child has a language disorder? Kelli: Right. And I do want to just kind of clarify a little bit. We've got good studies in kindergarten that tell us that often those distinctions will get spotted really early because, you know, little children aren't meeting those really well-explained developmental milestones, you know, with their checkups with their pediatrician. So, they're not starting to put two words together at the age that you would expect them to put two words together. As they're getting a little bit older, you know, as teachers are sort of interacting with them in class, they might notice, "Wow, this kiddo is using just single words or pointing at a lot of things." They might notice that when that child is trying to say something that happened to them — you know, they have a conflict with another kiddo — they can't tell the story of what happened to them. They might have a more limited vocabulary. They tend to be not the kids that are raising their hands to participate. If it's a receptive or receptive-expressive difficulty, those are the children that are going to struggle to follow directions in the classroom setting. They're going to be the children that answer questions in an off-topic way. So, you're saying you know, "Who did you see?" And they might start telling you a story that is, you know, completely unrelated. And some of that is just a thing that children do. But as you're comparing it, you know, you're comparing it to the other kids in class you're going to find that that's much more of a trend with children who struggle with receptive language. Rachel: And how does that differ as they get older, like, is what you see different with older kids? Kelli: It is. I mean, I should say, for children with language disorder, we generally see those concerns much earlier. It's not usual to identify, say, a fifth-grade child with language disorder. However, the things that stick out are going to be different because the academic demands have been increased. So, you know, in classroom discussions, you might find that they're just not as able to show what they know. Maybe they do understand what's going on. And you can kind of tease that out if you ask questions that don't require longer responses, but they're not going to be the child that can kind of explain things in a complex way. You're going to start seeing it in their writing. If it's an expressive language disorder, those are going to be kids that really struggle with those composition assignments. In part because, you know, these are often children who also have reading and writing difficulties. You know, they're getting support in those areas, too. If it's a child who's experiencing receptive language problems, reading comprehension is going to continue to be difficult. And you may see this mismatch between decoding and comprehension. Many of these children are fluent readers. They can decode words but when you ask them, you know, just to check up on comprehension questions, they will typically have a lot of difficulty. And these are often kids that will sort of like use what they know about the subject to answer the question instead of what's really on the page. There are children who are not going to do as well under, you know, answering questions on tests. And those are also children who may start to have some social difficulties because they are not, you know, they're not able to pick up on all of the language that's coming at them from their peers. And so they're not responding in a way that their peers would expect. Gretchen: So, who would be the one at a school or anywhere to typically diagnose a language disorder? Kelli: That's me. Yeah. It goes to the speech-language pathologist and it you know, there's a process, right? The teacher or parent will identify an area of difficulty. And schools do have a process for getting everybody together and saying, "I'm concerned about this child." And there's an early phase where you sort of try to tease out what, what needs another look. But I'm the person on the team that does all of the testing to identify language disorder. Rachel: So, a quick question before my next question. When we're talking about all of this is the kind of like common terminology to say, "Kids who have a language disorder" or "Kids who have language disorder," like, that's the name of it? I just want to make sure we're kind of like, asking it the right way. Kelli: I think you're asking it the right way. Children who have language disorder. Yeah. Rachel: OKKelli: Yeah, yeah. Or a language disorder. That's really fine. Rachel: OK. So, can you tell us a little bit about what your work with kids who have language disorder looks like, and maybe walk us through, like, the kinds of exercises that you might do with younger kids first, and then we can talk about older kids. Kelli: Yeah. So, we always start with what the evaluation tells us about that specific child. And language disorder breaks down into all these little subsets of skills. Right. So, some children might have a really difficult time with using what we call morphemes. Right. How we create the past tense, how we show that something is going to happen versus did happen. So, that child, you know, obviously would have a goal in that area. Some children might have difficulties with prepositions — in, on, whatever — and then there's some variability in how every speech pathologist works. I embed those skills in play for little kids. And that can also be books. You know, we sort of want to get them interested in books pretty early because that's where we're going in the academic setting. But we might do play-based things. So, for a child that is struggling with place, right? I might read a book about — there's really, there's a book I use a lot — called "Rosie's Walk," where a chicken's being followed by a fox, and the fox keeps changing position. And so we can talk about "On top of" "Behind" "Between." And then, you know, because this play-based, I get a little toy fox at the end and we play a little game where we put the fox at different places around us. If it's a child who's working on using longer sentences, I might get a bunch of toys that that child likes. And, you know, they can practice asking me. I'll give them a little frame for, "I want the... red one. I want the... black one." And so little by little, we add these words in and we start to expand. We can also just do things where they give me an answer, and I reframe it to add a couple more words and then say, "You tell me that." But for little children, trying to tap into what they are already interested in, is where we really want to go with that, because we want language to have a payoff. It should stay fun. Rachel: Yeah, yeah. Kelli: So, older kids, we start thinking a lot more about the direct connection of language to academic expectations. I try very hard to use texts or adapted versions of those texts in the context of our language sessions, and we might work on how do we summarize that. You know, some of the kids I see because you know, they have reading challenges as well. We might do this in a verbal way. You know, stories have these parts. They have a character, they have a setting, have kickoff where the story starts. So, they'll learn all those parts, and then they learn how to tell a cohesive — what we call a narrative or a summary — about that story. And the great thing is, it kind of applies to when we're telling stories about our lives and trying to give details about, you know, what happened when I got in a conflict with this other student? We might use writing more. I do a lot with what are called graphic organizers, where, you know, they may have an assignment in their class to write a report. And so, I kind of consult with a teacher about what those expectations are. And we put that in the context of a graphic organizer. And I might supplement it with, you know, kind of the step-by-step instructions from the classroom that I can add visuals to. And then that, you know, the other piece of that is, I would collaborate with the classroom teacher a lot to see how can we sync up what we're doing. How can you use these sorts of visuals, these sorts of verbal cues or written cues to help this child be more successful when they're actually in the classroom? And how can I pick up on my end to help them understand the expectations and meet the expectations with a little bit of language support. Gretchen: That relates to this question I have, which is what are some common classroom accommodations that kids might get in their IEP if they have language disorder? Kelli: Right. So, when I'm thinking of receptive language difficulties in particular, you might see an accommodation that says "The teacher should check for understanding after delivering a direction. Direction should be given in small pieces. Check with the child within five minutes of starting the assignment to give feedback or redirection." Expressive language accommodations might look like having graphic organizers available, having extra time to complete assignments, having a visual of what the expectations are, you know, because that puts it — without getting too deep in the weeds — kids who are trying to complete something that's really, really difficult might not have the working memory, right?The ability to kind of keep one thing in their head while they're doing another thing. They might not have the working memory to remember what the expectation is, and also use their little, graphic organizer to complete the assignment. I like to do buddies — you know, so to help kids access a peer who can maybe work with them to do, like, if it's a written assignment that will be a presentation — how can we work with a buddy, and how can the teacher help divvy up the responsibilities of each part of the buddy system? And then also, there's usually an accommodation that the speech-language pathologist will connect with the teacher on the specific accommodations that are needed by that kiddo, right?Because language disorder looks different for different children. And so, what they're working on at any given time will be different. You know, they're so just sort of staying in touch with the classroom teacher and saying, "This is the specific thing we're working on right now. Here are some ways that you can practice this in class." Rachel: So, can language disorder be cured? Or is there a point at which some children are not struggling with it anymore? And those might not be the same thing, but... Kelli: Well, it might. Yeah, exactly. When children are identified really young with language disorder, sometimes it is a need for more exposure. Right? Every household is different. What every kid is exposed to is different. And so, sometimes those little people, when they end up in, say, an early childhood program, which is all language, all the time, super engaging. I have seen kids just blossom. And so, you know that in those cases, we've just come across a child that just needed some really intense stimulation, maybe a little bit of extra time and maybe the, you know, the speech therapist is no longer involved after age 5 or 6. Typically, language disorder is something that is going to persist into adulthood. People can acquire skills. You know, therapy is helpful. It can make a difference, but it doesn't really go away. It is generally the case that while folks who are adults who had language disorder as a child are very functional, it is likely going to be the case that their verbal skills are not going to be their best skill. And, you know, the best-case scenario is that they have learned ways to self-advocate. They have learned specific skills that help them be better at communicating their ideas. But it might be still an area where they feel like, "Yeah, communication is not my strong suit."Gretchen: Yeah. And it seems like you said, too. All the strategies, hopefully right, that they've learned over the years just come into play. And so, it's less of a challenge because they're used to using strategies to work with that challenge. Kelli: Right. And you know, I think too, you know, the best outcome for people who've had therapy for language disorder is that they sort of just come to appreciate the totality of who they are. Right. That there's just this "Yes, this is a thing. Nobody's perfect. This is just something that I've had to work on in my life. And, you know, I'm proud of the things I've done to work on it." Gretchen: What are some things that you encourage parents and caregivers to do at home to help a child with a language disorder? Kelli: I would say the first thing is, you know, talk to your child's speech pathologist because they are going to know specifically what's being worked on at that time. One really fun one that we tell parents to do with the littles is engage them in everyday household stuff. "Let's do this together." Usually at that age, they love it, right? As kids get older, they may not be as interested in making dinner with their mom, but at that young age they are often very excited about it. It gives an opportunity to talk things through, use vocabulary they maybe haven't heard before, and it keeps it really fun. I really feel like kids need it to have a payoff. It shouldn't feel like homework. For parents who are, you know, trying to help their older child who, has a language disorder, making them aware of maybe what supports are needed. You know, at the end of the day, when you want to talk to your child about their day, maybe we can have like a specific set of questions we go through. Maybe when the child gives a short answer, you can sort of recast that and confirm with a slightly longer answer and not necessarily have the expectation that the child's going to copy you, but keeping it natural, you know, just talking through what you're seeing with them. Keeping as much verbal communication as possible open as a model, as an opportunity, without having this huge expectation that feels like homework for the child. And there may be some specific little things, like when a child uses the present tense to express all things that happen. They might need some really specific practice, and I might send home, "Hey, you know, we're working on adding -ed to make the past tense. Maybe you can, you know, go through these flashcards during the day." But mostly just like, use it or find opportunities to say, "Oh, wait, I didn't understand that. You know? did that happen? Is that happening right now or did that happen before?" There are lots of different ways, and the best jumping-off point for the parent is to connect with the speech pathologist and say, "You know, what are you working on? How can I include that in our everyday communication?" Rachel: So, we hear a lot about how some learning differences, like ADHD also have upsides, where, you know, we hear a lot of the word lately, "Superpowers." Like they have the ability to kind of hyperfocus on things that they're really good at or that they're interested in, like we've talked about here. Is there any kind of equivalent or parallel that you've seen with kids with language disorder? Kelli: Well, I'll tell you. One thing I see — and I can't really say their causal right, that the absence of strong language skills leads to this other skill — but what I can say is that every single child I see has something they're just superstars at. Maybe they have strong math skills. Maybe they are just that kid that's got really great social skills in spite of not being really conversational. You know, I have those children that are just beloved because they are so kind and they're so interested and they want to help. I have children who are phenomenal at art, and I have among my receptive language kids with receptive language difficulties, kids who get really good at observing what's going on around them. Because when you don't understand the directions, you are looking around to see what the expectation is. So, I don't know that we can say, you know, there's a causal relationship between those things, but all of my kids have areas that are huge strengths for them. I have kids that are better than I am at lots of things, and I point this out to them all the time that, "Wow, you just taught me something today." That is not an infrequent occurrence. Rachel: That's great. That's great. Gretchen: Yeah, yeah, I think it's a good note to end on. Right. Strengths, that everyone's got their strengths. Kelli: Absolutely. It keeps me coming to work every day. Gretchen: Well, thank you so much for talking with us today. Kelli: Thank you for having me. It was a wonderful conversation. Gretchen: You've been listening to "In It" from the Understood Podcast Network.Rachel: This show is for you. So we want to make sure you're getting what you need. Email us at init@understood.org to share your thoughts. We love hearing from you. Gretchen: If you want to learn more about the topics we've covered today, check out our show notes. We include more resources as well as links to anything we mentioned in the episode. Rachel: Understood.org is a resource dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission. Gretchen: "In It" is produced by Julie Subrin. Ilana Millner is our production director. Justin D. Wright mixes the show. Mike Ericco wrote our theme music. Rachel: For the Understood Podcast Network, Laura Key is our editorial director, Scott Cocchiere is our creative director, and Seth Melnick is our executive producer. Thanks for listening. Gretchen: And thanks for always being "in it" with us.
Developmental milestones for high-schoolers
In high school, kids’ development really takes off. Just as with middle-schoolers, high-schoolers develop at widely varied rates. For the most part, tweens turn into high-schoolers who start looking more like adults while also building the skills to think about and plan for the future.Physical milestonesThe difference in growth between boys and girls is very noticeable at this age. And there’s a big difference in physical milestones among individual kids, too. Boys are hitting the age when they start to grow rapidly, while girls are just starting to slow down.By the end of high school, many girls are likely to have grown as tall as they’re going to be. Boys, on the other hand, often are still growing and gaining muscle strength. Many high-schoolers:Have a big appetiteNeed more sleep and may be sleepy in schoolHave the visual-spatial coordination to judge distance and speed and react quickly when learning to driveAre more agile and coordinated, making it easier to do things like type on a keyboard or build complex projects (Some teens may be uncoordinated, though, because they’re growing so quickly.)Cognitive milestonesIn the mid- to late-teenage years, kids start thinking not just about their own lives, but also more about how the whole world works. That change is a gradual process. It doesn’t happen all at once. During high school, teens are likely to:Show an increasing ability to reason, make educated guesses, and sort fact from fiction Start thinking more abstractly, comparing what is to what could be Think about and come up with ways to deal with hypothetical situations Begin to set their own goals for the future; take other opinions into account but make their own decisions Understand the consequences of actions, not just today, but also in far-reaching ways (For example, understanding that failing English isn’t just a bummer — it can mean summer school, too.) Develop a strong sense of right and wrong and make decisions based on following their conscience Write with complexity about a variety of content areas (science, social studies, literature) Use strategies to search for, use, and compare information from multiple sources Use numbers in real-life situations (like calculating tax or a tip)Social and emotional milestonesThere are huge changes in social and emotional skills between ages 14 and 18. The emotional maturity of a high school freshman is very different from that of a graduating senior. Here’s what you might see at different ages.14-year-oldsCan recognize personal strengths and challengesAre embarrassed by family and parentsStrive to be independentAre eager to be accepted by peers and to have friendsMay seem self-centered, impulsive, or moody15-year-oldsDon’t want to talk as much; are argumentativeMay appreciate siblings more than parentsNarrow down to a few close friends and may start datingAnalyze their own feelings and try to find the cause of them16- to 18-year-oldsStart relating to family better; begin to see parents as real peopleDevelop a better sense of who they are and what positive things they can contribute to friendships and other relationshipsSpend a lot of time with friendsAre able to voice emotions (both negative and positive) and try to find solutions to conflictsFrom learning to drive to starting to think about the future, high school is a time of big change and growth. Learn about different paths to success kids can take after high school.
Understood Explains Season 1What happens after an evaluation for special education
The evaluation report is done. Now what? Learn about eligibility determination meetings and different kinds of supports for struggling students. Adverse impact. Eligibility determination. IEPs. 504 plans. What are these things? And what do they have to do with evaluations? This episode of Understood Explains covers how school evaluation teams decide which kids need which kinds of support.Host Dr. Andy Kahn is a psychologist who has spent nearly 20 years evaluating kids for public and private schools. His first guest on this episode is special education teacher Lauren Jewett. They’ll explain:What happens at an eligibility determination meetingHow schools decide who qualifies for an Individualized Education Program (IEP) What other kinds of support can help struggling studentsAndy’s second guest is parenting expert Amanda Morin. They’ll share tips on what to say to your child after an eligibility meeting — and what not to say.Related resourcesWhat to expect at an IEP eligibility meetingThe 13 disability categories under IDEAThe difference between IEPs and 504 plans10 smart responses when the school cuts or denies servicesParent training centers: A free resource in your stateEpisode transcriptLeslie: Hi, I'm Leslie from Little Rock, Arkansas. In second grade, within the first couple of weeks, it was decided by these evaluations that Sarah needed speech therapy, occupational therapy, and I think physical therapy. She wasn't holding her pencil right, she had her wrist turned the wrong way, she had some speech impediments. And then we would receive the results of that and eventually she reached her milestone and those kind of fell away. But she did always receive accommodations for reading and math, and that was evaluated every semester. And that IEP followed her from second grade until she graduated from Central High School with a 3.5 grade point average that last semester.Andy: From the Understood Podcast Network, this is "Understood Explains." You're listening to Season 1, where we explain evaluations for special education. Over 10 episodes, we cover the ins and outs of the process that school districts use to evaluate children for special education services. My name is Andy Kahn, and I'm a licensed psychologist and an in-house expert and understood.org. I've spent nearly 20 years evaluating kids for both public and private schools, I'll be your host.Today's episode is about what happens after the evaluation. All the testing and data collection is done, the evaluation report is done. The next step is a real mouthful; it's called eligibility determination. This is when the evaluation team meets to decide if the student is eligible for special education. Today's episode is going to cover three key things: how the eligibility determination process works, what kind of supports schools offer to students — including what's available to kids who don't qualify for special education — and what to say to your child after an eligibility meeting, and what not to say. But first, let's hear another parent story.Jennifer: Hi, my name is Jennifer and I live in Atlanta, Georgia. So, in the eligibility report, they enter all of the testing information into this program, and it automatically determines which categories the student could potentially qualify under. And so, one of those categories for my son was like, brain something, I can't remember. I wish I could remember what it was called. But it was something that was like crazy. And I was like, "Wait a minute, what?" It's just that even in the meeting, they'll tell you, you know, "This is automated, and just because it like flags it doesn't mean that we're really considering it, but we do have to talk through it."Andy: What Jennifer was just describing can be a jarring part of the eligibility determination meeting. This is the part of the meeting when the team goes through a dozen or so disability categories to see if the child qualifies for special education under any of them. And folks, just so you know, the name of the category that Jennifer was trying to remember is called traumatic brain injury. We're going to talk more about the disability categories and other key parts of the eligibility determination process.To help me explain all this, I want to bring in my first guest. Lauren Jewett is a special education teacher at an elementary school in New Orleans. She's also a special education case manager, which means she's been a part of a lot of evaluation teams. She's also a national board-certified teacher, and an Understood teacher fellow. Lauren, it's so great to have you here with us today. How're you doing?Lauren: I'm good. Thank you for having me on this show.Andy: So, Lauren, after an evaluation, the school team holds an important meeting called eligibility determination. This is where the team uses the evaluation report to help decide if the student qualifies for special education. So, if the student qualifies, then the next step is to develop an IEP, which stands for Individualized Education Program. So, this part of the process, determining eligibility for special education and then developing an IEP, this is all covered under IDEA. Lauren, can you remind everyone what IDEA stands for?Lauren: IDEA is the federal special education law that stands for the Individuals with Disabilities and Education Act. And it covers all the ways that a student would get into special education for their servicing, and all the different disability categories that they could qualify under. And then after the evaluation period or process, what they could get, you know, in terms of an IEP and what that looks like and all the legal procedures with the student.Andy: Gotcha. So, all states have to follow this federal law, but, you know, different states may handle eligibility determination in slightly different ways. I'm located in the state of Maine. So, in Maine, we determine eligibility, and we actually use a very specific form for eligibility determination, so we use what we call an adverse impact form. The purpose, really, is to see whether someone is eligible or not for services, based on all of the data that we have. We use our adverse impact form and we go through a series of checklists. But in different states, it's done in different ways. How do you guys do that in Louisiana?Lauren: So, our process is covered by a state bulletin; we have a state bulletin called Bulletin 1508, and Bulletin 1508 covers all of the ways that people appraisal and the school psychologists can qualify a student for the different disability categories. So, IDEA, which we talked about, that law has a bunch of different disability categories. And so that bulletin, 1508, outlines all of the different procedures that one would have to look at and use to determine what category or what classification the student would qualify under.Andy: OK, so taking a look at the big picture, you're talking about state regulations that make the evaluation team fill out checklists and answer very specific questions. And you have to do all this to determine if a child meets the IDEA’s two most important requirements to be eligible for special education. Number one, the child has to have a disabling condition, and number two, that disabling condition must adversely impact the child's education. So, when we talk about adverse impact, like an example, let's say we're looking at a specific learning disability, if a child was let's say, half a grade level behind, would that typically be adverse impact, or would that not be enough?Lauren: We usually, you know, if I'm thinking for an example of like, specific learning disability, you know, in our state, in order to qualify for a specific learning disability, there has to be an area of strength, and then an area where the student is, you know, struggling. And then they look at standard deviations below a mean, or above a mean.Andy: OK, so I'm going to decode some of this information. Because again, it's really, really helpful. When we talk about things like standard deviations, what we're talking about is, when you're comparing a child's piece of information to a large group, and how far they fall from that large group, if it's far enough away, that would be something that might be considered adverse impact, meaning adverse impact really refers to is the child able to do what they're needing to do, like other students of their age or grade level? The adverse impact would be "I can't do this because I have dyslexia," or they can't focus and engage and participate in a way that would be manageable for them because of severe ADHD or some other disabling condition. So adverse impact's really about there's a functional thing that isn't happening. You could have a diagnosis, but not necessarily show adverse impacts. And that can be confusing for people. How do you go about explaining adverse impact to your families if you're talking to them about that?Lauren: Yeah, I think when I'm thinking about adverse impact — especially when I look to write IEPs, right? — we think about a disability impact statement, which is kind of similar, you know, like, how is the disability impacting the student in class? So, for example, if the student has dyslexia, how is that affecting what they're doing in class across different subjects all day? So, if the student has a specific learning disability in reading, and they are two to three grade levels behind, thinking about, OK, this is the student's disability, this affects their ability to read on grade level texts that are going to be provided to them and given to them in class. So not just in reading class, but in all those content areas that have a lot of academic domain vocabulary, a lot of reading comprehension needs.And so, when I break that down, I'm trying to give more applicable information to a family, you know, because again, there's so much jargon. So then let's, like I say, let's take a step back and look at how is this going to look like in the classroom? How is this affecting them on a day-to-day basis?Andy: Gotcha. So really, adverse impact is important because you're talking about the how, right? How do we know that this child isn't doing as well as we hoped that they would do because of this disabling condition? OK, and that's really important for families. So, when we talk about the information being considered, who's typically present at the meetings where you're going over the evaluations and making that eligibility determination?Lauren: It usually would be the school psychologist or educational diagnostician — those are the people who maybe conducted the different set of tests and assessments that were given to the student, or the person, you know, who wrote and did the comprehensive report — you're gonna have the parent there, the parent may have another family member there, maybe an advocate. But you could have a special education coordinator there, the teacher, other members who contributed to the report, or additional teachers. You know, if it's a reevaluation for a student that's already been in special education, then it is likely that the special education teacher may be there because that student has already been receiving services.Andy: That was super helpful, Lauren. When we talk about the disability categories, we traditionally talk about the 13 disability categories in IDEA. I understand that in certain states, we can actually see as many as 14, or even 15 categories. The categories that I most commonly see us use in schools are specific learning disabilities, speech and language impairment, other health impairment, and autism. Less commonly, we might see intellectual disabilities, for example, or deaf-blindness.I'd like to shift our conversation a little bit. So, Lauren, when we have a child who's found eligible for special education services, and they meet those two requirements, they've got their identified disability, they meet the adverse impact, adverse effect criteria, what happens next? Let's assume we're at that next meeting.Lauren: Yeah. So, the next step would be for the IEP team to convene and meet, and look at the information that's been provided in the evaluation, and then create an IEP for the student. So oftentimes, you know, these evaluations are very long. And you know, when I receive those evaluations, I have to read them and go through everything and think about what makes sense for the student. But the main thing in that meeting, the IEP development, is really taking that information from the evaluation, and making sure that it's reflected in the spirit of the document.Andy: Yeah. So, let's pause on that for a minute. You're talking about how you can make sure the IEP reflects what's in the evaluation report. How can parents help with this? Like, what role can parents play in developing the IEP?Lauren: I always encourage families to, you know, as we start those meetings, those IEP meetings, I always say, "There's going to be a lot of information. You know, stop if you have questions." And also like, every page that we go through, whoever is leading that part of the meeting, we have the person who's leading that part, like stop and ask the parent like, ''How does that sound? Do you have input? Do you have anything you want to add?'' You know, it just depends. But I always, you know, tell parents ahead of time to, I explain — especially if it's their first meeting ever — I just say, you know, like, ''Bring your ideas of what you would like to see. What do you hope for your child to get out of this? What are your concerns? What's not currently working?''Andy: So, Lauren, what if the child has a disability, but isn't eligible for special education? What are we gonna do in a situation like that? Because if a child's not getting an IEP, how do you explain that to a parent?Lauren: In that conversation, you know, if they're not going to have an IEP, sometimes we do try to provide supports in the classroom through a 504 plan. So, a 504 plan comes from section 504 of the Rehabilitation Act. And that's a civil rights law. So, a 504 plan is more like an accommodation plan that a student might have in the general education class. It's not specially designed instruction, it could be the student gets some extra time when they're doing assignments, it might be specified seating; it doesn't have as many accommodations or modifications listed as an IEP because an IEP is going to be more situated and individualized for the student on their goals.And then it is also allowing, like I said, specially designed instruction modifications, you're not going to see that as much with a 504 plan. A student could have a 504 plan for a short period of time as well. Maybe they break their arm, and they need a scribe or need some different assistance in class for that period of time. So, it could range in different situations. But again, it's different because it's not, you know, listing a bunch of different goals and related services like an IEP would.Andy: At the eligibility determination, is a common outcome that the team decides that the student qualifies for a 504? Or does that happen at a different meeting if they don't qualify for services under IDEA?Lauren: It may be a separate meeting; maybe the team comes together, they go over the evaluation — no exceptionality is found. And so, we talk as a team and say, well, you know, sometimes teachers will be indicating that they still have concerns about the student, and how they're going to be able to do everything in class without certain supports that are formalized. So, you know, maybe their recommendation would be a 504 plan. And so, it could be a separate meeting that happens with maybe not all the same people at the table, but definitely the teacher and the parent, and the person who's responsible for, you know, handling the 504 plans, because that's a whole other system, you know, a 504 plan versus the IEP. The team looks at what accommodations would be appropriate for the student. And it could be accommodations like the student gets some extra time on assignments and tests, maybe they get a small group or individual testing because they need to focus.So those are some examples of things that we put, you know, in 504 plans, and we have students that have 504 plans and still get those accommodations when it comes to standardized and state testing, they still get those things. So, it's not like they only get them in the classroom, and then they don't get them in other things. It goes through all the different situations and circumstances that the student could have those supports.Andy: So, you mentioned that for kids who don't qualify for an IEP, sometimes you try to provide a 504 plan. What about kids who have a disability, but don't have an IEP or a 504? What are some of the things a school can do to help support those kids?Lauren: You know, a student that has an IEP, right? They have specific rights that are outlined, but every kid has all different specific learning needs, whether they have that IEP or not. So, establishing a mindset of how do we make the classroom environment, as well as the learning materials more accessible? There's things that students might need from time to time, and we just have to provide them and make sure that there's still supports that are in place there that may not need to be supports that are there long-standing.But we know we don't just like, you know, not give supports as a teacher, if we see a student struggling, we want to help. And so, I think reframing it is like, "OK, well, just because they have an IEP, only those groups of students can get help." No, like all students can get help. So, I think that there's still a way to design supports within a classroom or for students, whether they have that IEP or not.Andy: So, Lauren, I want to circle back to some really good advice you gave about encouraging parents to come to these meetings ready to ask questions and make suggestions. And listeners, one thing that can help you do this is to make sure you get a copy of your child's evaluation report before you go to that meeting. You have a right to see that report in advance. We've got a lot more information in episode three about your evaluation rights.But I want to make sure you know that you have this right in particular, because it can be really helpful to look at the report ahead of time, think about what questions you want to ask and what suggestions you want to make, so you can be an active member of the team during the eligibility meeting. Lauren, thanks so much for being with us today. I've really appreciated your input and it's been so awesome to learn about how you do your work down in Louisiana.Lauren: Yeah, thank you, I really enjoyed this conversation.Michele: My name is Michele and I live in the Bronx, New York. My oldest son was not given a diagnosis because they deemed him not eligible for special education services, because they basically said there's nothing, there's no real issue. He's just very creative, his mind needs to be stimulated, but they couldn't justify providing services. So, he was never given an IEP, he was never in special education.Andy: So, we've been talking about what adults can expect after an evaluation, an IEP, a 504, or informal supports. But what can adults say to kids about these things? And how are kids likely to react? So, to help me unpack all this, I'd like to bring in my next guest, Amanda Morin, she co-hosts Understood's "In It" podcast, about the joys and frustrations of parenting kids who learn and think differently. She's the mom of two kids who learn differently, and she has also worked as a classroom teacher and as an early intervention specialist. Amanda, welcome.Amanda: Thank you so much, Andy. And as you know, I've also attended a number of IEP meetings on my own too, right? As a parent. Andy: You've been at this table. Yeah. So, let's jump into this a bit. I mean, you know, what kind of things can parents talk to their kids about when we're talking about getting an IEP or a 504, or some of these supports?Amanda: So, I think the first thing is to know that kids have so many reactions to things, right? The same way we as parents have reactions to things, your child's gonna have a whole bunch of reactions to things, and it may not be what you expect, right? For some kids, it may be relief, "OK, phew! We're going to sit down and finally have this conversation. And maybe I'm going to feel better at school, maybe I'm going to feel like I can really do this, there's going to be more help." And a lot of parents don't expect that reaction. And so, as a parent, I think being open to whatever your child's reaction is, really matters.So, to be able to say to them "How do you feel?" instead of saying to them "Do you feel sad? Do you feel angry?" Like, don't put those emotions in their minds until they tell you what's on their minds. And I think that's important, too.Andy: Yeah. So, you're talking about their emotions relative to the reaction to all the things they're learning, which is a ton of information. And I think it's really important — you mentioned — when you ask about how they're feeling, the open-ended question, right? "What are you feeling? What's it feel like?" I mean, and I think for younger kids, they may struggle in expressing that. And yeah, I think you made a great point that you're not always going to know what to expect, because they may say things that just shock you or surprise you, or please you, I don't know.Amanda: Or they may not even care, right? Like sometimes kids don't care the way we do as parents, and we're like, "What? This is such a big deal." And your child's like, ''No, not really. Not that big a deal.'' And so, I think you can follow their lead in that situation and be like, "Oh, OK. Well, this is a big deal for me. And I'm sorry to assume that it was a big deal for you." And I don't mean that in a sarcastic way, I mean like sincerely to be able to say to your child "Oh, it feels like a big deal to me. I didn't mean to assume that it was a big deal for you too." And then sort of move on from there.Andy: For sure. For sure. So, let's say that your child's starting to express some of those, you know, unhappy emotions, that anger, or saying, "Well, this isn't true" or are feeling sort of down about it. Where do you go? How do you really navigate that?Amanda: That one's really hard. I mean, I'm just going to be honest, and say it's really hard. Because what it does is, your child is all of a sudden hearing about themselves in a totally different way, right? They're hearing about themselves, especially because unfortunately, a lot of evaluations are around looking for weaknesses, right? Looking for deficits is the word that comes up a lot. And I think the way to handle that with a child is to say, "Of course you're angry; of course you're sad. Of course this tells you about yourself in a way you hadn't thought about yourself before. But you're still you, you know. You haven't changed; the paperwork says one thing, it's just talking about you. It's a snapshot, it's a picture of you, but you're still the same person you were. And what this does is allow us to talk to the school about whether or not you're eligible for help, for additional support, for ways to make you feel like you are more you than you've ever been before." Because when kids have the support they need at a school, whether it's through an IEP or a 504 plan or informal accommodations and support, they really do feel like they get to be more of their full selves because they get to show what they know, right? In that moment, you can say "You're angry because you're not able yet to show what you know." But I think it's OK to just say, "You feel this, and we can sit with it. It's really hard, right? It's really hard." And they may be angry at you.And I think it's important to know that because you're the person delivering the information. You're the person who may have started this process. You're the person who's talking to them about this. If they're angry at you, that's hard. But I think you need to redirect it. And oftentimes that's about "I hear that you're angry, and I really want to talk to you about this. I'm not able to have this conversation while you're yelling at me." Right? ''So, we're gonna take a moment. When you can talk to me calmly, we can have this conversation.''Andy: Amanda, this is amazing advice. And I'm really glad we could do this today. Thanks so much for being here.Amanda: Yeah, thanks for having me.Andy: So, we've talked about how schools determine who is eligible for special education, and other ways schools support struggling students. We've also talked about how to ask open-ended questions to help your child talk about how they're feeling. If there's one thing you can take away from this discussion, is that you can play an active role in what happens after the evaluation. So don't be afraid to ask lots of questions until you understand what's happening and why. As always, remember that as a parent, you are the first and best expert on your child.In our next episode, we'll focus on the difference between private and school-based evaluations and why some families choose to get one or the other or both. We hope you'll join us.You've been listening to Season 1 of "Understood Explains" from the Understood Podcast Network. If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources as well as links to anything we've mentioned in the episode. And now, just as a reminder of who we're doing all this for, I'm going to turn it over to Abraham to read our credits. Take it away, Abraham.Abram: "Understood Explains" is produced by Julie Rawe and Cody Nelson, who also did the sound design for this show. Briana Berry is our production director. Andrew Lee is our editorial lead. Our theme music was written by Justin D. Wright, who also mixes the show. For the Understood Podcast Network, Laura Key is our editorial director. Scott Cocchiere is our creative director. Seth Melnick is our executive producer. A very special thanks to Amanda Morin and all the other parents and experts who helped us make this show. Thanks for listening and see you next time.Andy: Understood is a nonprofit organization dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission
Developmental milestones for kindergartners
This is a big year of growth. Most 5-year-olds are either gearing up for or starting kindergarten, where they face new expectations. You may wonder how your child’s skills compare to those of other kids this age. The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The agency moved some of the milestones to different age ranges, which some experts question.The CDC milestones below can help you know what to expect. If your child isn’t meeting many of these milestones, it could point to possible developmental delays. Talk to your child’s doctor or other health care provider to start getting answers.You can also learn more about: How coordination and motor skills develop at different agesHow social-emotional skills develop at different ages Social/emotional milestonesFollows rules or takes turns when playing games with other childrenSings, dances, or acts for youDoes simple chores at home, like matching socks or clearing the table after eating Language/communication milestonesTells a story with at least two events: “It started to rain, and the dog ran back home.”Answers simple questions about a book or story after you read or tell it to themKeeps a conversation going with more than three back-and-forth exchangesUses or recognizes simple rhymes (bat-cat, ball-tall)Cognitive milestones (learning, thinking, problem-solving)Counts to 10Names some numerals between 1 and 5 when you point to themUses words about time, like yesterday, tomorrow, morning, or nightPays attention for 5 to 10 minutes during activities, like during story time (screen time doesn’t count).Writes some of the letters in their nameNames some letters when you point to themMovement/physical development milestonesButtons some buttonsHops on one footIf your child isn’t meeting milestones, don’t panic. But do talk to your child’s doctor or other health care provider about what can help your child. It could be a good idea to get an evaluation for special education from your local school.Take a look ahead at developmental milestones for first graders.
Developmental milestones for fourth and fifth graders
Fourth and fifth grade are years of growth in many ways — socially, academically, and physically. You may notice growth spurts, an increasing need for independence, and a desire to be accepted by peers. Learn more about developmental milestones for 10-year-olds and 11-year-olds.Physical milestonesMost kids grow steadily, only to speed up by age 11 or 12. As puberty approaches, girls and boys start developing at different rates. Girls tend to have their growth spurt between ages 9 and 11, while boys have theirs between ages 11 and 12. Most kids in fourth and fifth grade: Have a bigger appetite and need more sleep May be clumsy because of growth spurts Use one hand and foot much better than the other (“Right/left dominance” starts at around age 7 and is set around fourth or fifth grade.)Develop hand-eye coordination quickly (This might be when you learn a child needs glasses.)Show improvement in handwriting and the ability to use toolsComplain of growing pains or muscle crampsCoordinate movements (like dribbling and shooting a basketball or doing martial arts)May try to develop strength and endurance due to increased muscle mass — especially in boysStart showing signs of puberty, like hair growth or oily skin; girls may have weight gain or redistribution and boys’ voices may start to change Cognitive milestonesKids this age typically start thinking more about abstract ideas, and not just about things they can observe. They get better at organizing thoughts and planning, too. Don’t expect them to be able to sort facts from opinions quite yet, though. That skill is still in process. Most kids this age:Realize that thoughts are private and that people see others differently than they see themselvesStart predicting the consequences of an action and plan accordingly Can argue more than just one side of an issue Begin to rely on friends, the news, and social media to get information and form opinionsDevelop a better sense of responsibility and help out around the house (For example, kids may look out for younger siblings.)Start understanding how things are connected (For example, kids may understand the effects of climate change or how the mood of one person can impact others.)Social and emotional milestonesFourth and fifth graders start to have active social and emotional lives. At this age, kids may be trying hard to find their own talents while also trying to be and look like everyone else. Kids this age often:Are uncertain about puberty and changes to their bodiesAre insecure or have mood swings and struggle with self-esteem (This tends to be more pronounced in girls.)Test limits and push boundariesAre increasingly independent from family, withdraw more from family activities, and need privacyForm stronger and more complex friendshipsMay face strong peer pressure and find it hard to resist if they struggle with self-esteemHave a deeper understanding of how relationships with others can include more than just common interestsHave a first crush or pretend to have crushes to fit in with peersValue friends’ opinions; share secrets and inside jokes Are kind, silly, and curious, but also can be self-involved, moody, and disrespectfulMay test out new attitudes, clothing styles, and mannerisms while figuring out where/how to fit in Ten- and 11-year-olds have varying levels of maturity. That’s true physically and emotionally. They may reach milestones earlier or later than expected. But if there are concerns, parents and caregivers should check in with their child’s health care provider. Parents and teachers should also connect. They can work together to find ways to provide support.And take a look forward at developmental milestones for middle-schoolers.
Developmental milestones for 4-year-olds
If you think 4-year-olds are hard to keep up with, it’s probably because they develop lots of new skills very quickly this year. Still, you may wonder what a typical 4-year-old is able to do.The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The agency moved some of the milestones to different age ranges, which some experts question.The CDC milestones below can help you know what to expect. If your child isn’t meeting these milestones, it can point to possible developmental delays. Talk with your child’s doctor or other health care provider. And if your child is in preschool, share your concerns with the teacher. You can also learn more about: How coordination and motor skills develop at different agesHow social-emotional skills develop at different agesSocial/emotional milestonesPretends to be something else during play (teacher, superhero, dog)Asks to go play with children if none are around, like “Can I play with Alex?”Comforts others who are hurt or sad, like hugging a crying friendKnows to avoid danger, like not jumping from tall heights at the playgroundLikes to be a “helper”Changes behavior to fit the setting (the grocery store versus the playground)Language/communication milestonesSays sentences with four or more wordsSays some words from a song, story, or nursery rhymeTalks about at least one thing that happened during the day, like “I played soccer.”Answers simple questions like “What is a coat for?” or “Where’s the dog?”Cognitive milestones (learning, thinking, problem-solving)Names the color of items correctly Tells what comes next in a well-known storyDraws a person with three or more body partsMovement/physical development milestonesCatches a large ball most of the timePours water or serves themselves food, with adult supervisionUnbuttons some buttonsHolds crayon or pencil between fingers and thumb (not a fist)Kids don’t all develop at the same rate. Some 4-year-olds are a bit behind their peers, and some are ahead of schedule. But if your child hasn’t met many of these milestones, it’s important to find out why. Talk with your child’s health care provider about what might help your child catch up. Be sure to ask about evaluation options for special education support from your local school.Take a look forward at developmental milestones for 5-year-olds.
Developmental milestones for 1-year-olds
If you have a 1- to 2-year-old child, you know how busy toddlers can be at this age. Every day is filled with exploration and learning. But you may not be sure what skills are typical for kids this age. The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The agency moved some of the milestones to different age ranges, which some experts question.The CDC milestones below can help you know what to expect. If your child isn’t meeting them, it can point to possible developmental delays. If you have concerns, be sure to talk to your child’s health care provider. The CDC milestones below can help you know what to expect by 12 months, 15 months, 18 months, and 24 months.You can also learn more about: How coordination and motor skills develop at different agesHow social-emotional skills develop at different agesAt 12 monthsSocial/emotional milestonesPlays games with you, like patty-cakeLanguage/communication milestonesWaves “bye-bye”Calls parent “Mama,” “Dada,” or another nameUnderstands “no” (pauses or stops when you say it)Cognitive milestones (learning, thinking, problem-solving)Puts things into a container, like a block in a cupLooks for things they see you hide, like a toy under a blanketMovement/physical milestonesPulls up to standWalks holding on to furniture (“cruising”)Drinks from a cup without a lid while someone else holds itUses thumb and pointer finger to pick things upBy 15 monthsSocial/emotional milestonesCopies other children while playing, like taking toys out of a container when another child doesShows you an object they likeClaps when excitedHugs stuffed doll or other toyShows you affection (hugs, cuddles, or kisses you) Language/communication milestonesTries to say one or two words besides “Mama” or “Dada,” like “ba” for “ball” or “da” for “dog”Looks at a familiar object when you name itFollows directions given with both a gesture and words. For example, giving you a toy when you hold out your hand and say, “Give me the toy.”Points to ask for something or to get help Cognitive milestones (learning, thinking, problem-solving) Tries to use objects the right way, like a phone, cup, or bookStacks at least two small objects, like blocksMovement/physical development milestonesTakes a few steps without helpUses fingers to feed themselves some foodBy 18 monthsSocial/emotional milestonesMoves away from you, but looks to make sure you are close byPoints to show you something interestingPuts hands out for you to wash themLooks at a few pages in a book with youHelps you dress them by pushing arm through sleeve or lifting up footLanguage/communication milestonesTries to say three or more words besides “Mama” or “Dada”Follows one-step directions without any gestures, like giving you the toy when you say, “Give it to me.”Cognitive milestones (learning, thinking, problem-solving)Copies you doing chores, like sweeping with a broomPlays with toys in a simple way, like pushing a toy car Movement/physical development milestonesWalks without holding on to anyone or anythingScribblesDrinks from a cup without a lid and may spill sometimesFeeds themselves with their fingersTries to use a spoonClimbs on and off a couch or chair without helpBy 24 monthsSocial/emotional milestonesNotices when others are hurt or upset, like pausing or looking sad when someone is cryingLooks at your face to see how to react in a new situationLanguage/communication milestonesPoints to things in a book when you ask, like “Where is the bear?”Says at least two words together, like “More milk.”Points to at least two body parts you name, like nose or toesUses more gestures than just waving and pointing, like blowing a kiss or nodding yesCognitive milestones (learning, thinking, problem-solving)Holds something in one hand while using the other hand; for example, holding a crayon box and taking out a crayonTries to use switches, knobs, or buttons on a toyPlays with more than one toy at the same time, like putting toy food on a toy plateMovement/physical development milestonesKicks a ballRunsWalks (not climbs) up a few stairs with or without helpEats with a spoonKeep in mind that kids develop at different rates. Your child might meet some of these milestones a little earlier or a little later. But if your child isn’t meeting most of them, talk to your child’s health care provider. It might be helpful to get an evaluation to look at your child’s skills. That lets you talk about early intervention strategies and other ways to help.And take a look forward at developmental milestones for 2-year-olds.
Developmental milestones for 2-year-olds
The toddler years are in full swing for 2-year-olds, and it’s a big time for growth. But you may not be sure what skills are typical for kids this age. The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The agency moved some of the milestones to different age ranges, which some experts question. The CDC milestones below can help you know what to expect. If your child isn’t meeting them, it can point to possible developmental delays. If you have concerns, be sure to talk to your child’s health care provider. The CDC milestones below can help you know what to expect by 24 months, 30 months, and 36 months.You can also learn more about: How coordination and motor skills develop at different agesHow social-emotional skills develop at different agesAt 24 monthsSocial/emotional milestonesNotices when others are hurt or upset, like pausing or looking sad when someone is cryingLooks at your face to see how to react in a new situationLanguage/communication milestonesPoints to things in a book when you ask, like “Where is the bear?”Says at least two words together, like “More milk.”Points to at least two body parts you name, like nose or toesUses more gestures than just waving and pointing, like blowing a kiss or nodding yes Cognitive milestones (learning, thinking, problem-solving)Holds something in one hand while using the other hand; for example, holding a crayon box and taking out a crayonTries to use switches, knobs, or buttons on a toyPlays with more than one toy at the same time, like putting toy food on a toy plate Movement/physical development milestonesKicks a ballRunsWalks (not climbs) up a few stairs with or without helpEats with a spoon By 30 monthsSocial/emotional milestonesPlays next to other children and sometimes plays with themShows you what they can do by saying, “Look at me!”Follows simple routines when told, like helping to pick up toys when you say, “It’s clean-up time.”Language/communication milestonesSays about 50 wordsSays two or more words together, with one action word, like “Doggie run”Names things in a book when you point and ask, “What is this?”Says words like “I,” “me,” or “we”Cognitive milestones (learning, thinking, problem-solving)Uses things to pretend, like feeding a block to a doll as if it were foodShows simple problem-solving skills, like standing on a small stool to reach somethingFollows two-step instructions like “Put the toy down and close the door.”Shows they know at least one color, like pointing to a red crayon when you ask, “Which one is red?”Movement/physical development milestonesUses hands to twist things, like turning doorknobs or unscrewing lidsTakes some clothes off without help, like loose pants or an open jacketJumps off the ground with both feetTurns book pages, one at a time, when you read out loudBy 36 monthsSocial/emotional milestonesCalms down within 10 minutes after you leave (if they have separation anxiety)Notices other children and joins them to playLanguage/communication milestonesTalks with you in conversation using at least two back-and-forth exchangesAsks “who,” “what,” “where,” or “why” questions, like “Where is Mommy/Daddy?”Says what action is happening in a picture or book when asked, like “running,” “eating,” or “playing”Says first name, when askedTalks well enough for others to understand, most of the timeCognitive milestones (learning, thinking, problem-solving)Copies a circle when you show them howAvoids touching hot objects, like a stove, when warnedMovement/physical development milestonesStrings items together, like large beads or macaroniPuts on some clothes without help, like loose pants or a jacketUses a forkAll kids develop at their own rate, and some take more time than others. But if your toddler isn’t meeting the majority of these milestones by 3, let your child’s health care provider know. You can talk about whether an early intervention evaluation makes sense for your toddler.Take a look forward at developmental milestones for 3-year-olds.
Developmental milestones for middle-schoolers
Most middle schools have sixth, seventh, and eighth graders, which means kids may be as young as 11 or as old as 15 during their years there. Between those ages, kids grow in different ways and at their own pace. You just have to walk into a middle school to see the huge variation in both physical and emotional maturity. Middle-schoolers are working toward developing certain skills by the time high school rolls around. Learn about the developmental milestones at this age.Physical milestonesAs puberty begins, kids go through big physical changes. Growth spurts are common now. And though girls tend to develop earlier than boys, there’s a big difference in physical milestones among individual kids. Still, most middle-schoolers:Get a little less coordinated as height and weight change quicklyStart showing uneven development in skills like agility, balance, strength, and flexibility (For example, they may be able to run fast, but not gracefully.) Need more rest since so much energy is being used for growingHave a difference between body and brain growth; may be more mature physically than cognitively or emotionallyGet better at fine motor and gross motor movements, like those used in team sportsMay try to develop strength and endurance because of increased muscle mass (especially boys)Cognitive milestonesProblem-solving skills and thinking skills develop a lot at this age. Kids may also start to pay more attention to decision making and to organizing ideas, time, and things. Middle-schoolers often:Start to understand concepts like power and influenceQuestion things and don’t take everything at face valueThink about how current actions affect the future and may worry about things like climate change and warMemorize information more easilyUse flexible thinking, like checking work and changing approaches as neededBegin developing a worldview and a basic set of valuesWant to contribute and make their own moneyLanguage milestonesIn middle school, language skills typically develop much more quickly than they did the past few years. You might notice that your child can better understand what people communicate — with or without words. In middle school, kids often:Use metaphors, slang, text speak, and other ways of talkingAre interested in having discussions, debates, and arguments (sometimes just for the sake of it)Start to “get” and pay more attention to body language, tone of voice, and other nonverbal language cues Go through “what if” scenarios and talk through other ways of solving problemsContinue to build grammar knowledge and vocabularyStart to use writing to describe personal experiencesSocial and emotional milestonesMiddle school is a time of major social and emotional growth. Kids may struggle to fit in even while looking for ways to be an individual. And they may not ask for advice as often as before. It’s not uncommon for middle-schoolers to do these things:Bow to peer pressure to be like othersHave experiences with bullying or cyberbullying Be sensitive to other people’s opinions and reactions, and think the whole world is watching themDevelop a sense of pride in accomplishments and awareness of their challengesKeep secrets (often just having a secret is more important than the secret they’re keeping)Have a better awareness of what’s appropriate to say in conversation Are introspective and moody, and need more privacyMay test out new clothing styles and try on “personalities” while figuring out where they fit inKeep in mind that middle-schoolers develop at different rates. But when a child this age isn’t meeting a number of these milestones or is struggling, it’s a good idea for parents and teachers to talk. Parents and caregivers may also want to talk with their child’s health care provider.Take a look forward at developmental milestones for high-schoolers.
Developmental milestones from birth to age 1
Babies gain skills quickly during the first year. They develop new ways to think, communicate, and solve problems. (These are called cognitive skills.) And they develop physically and learn to interact with people.You may not be sure what skills are typical for infants. The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The CDC moved some of the milestones to different age ranges, which some experts question. The CDC milestones below can help you know what to expect at 2 months, 4 months, 6 months, 9 months, and 12 months. If your child isn’t meeting these milestones, it can point to possible developmental delays. Be sure to talk to your child’s health care provider if you have concerns. You can also learn more about: How coordination and motor skills develop at different ages How social-emotional skills develop at different ages By 2 monthsSocial/emotional milestonesSmiles when spoken to or smiled atBecomes calm when spoken to or heldLooks at people’s facesSeems happy when approached by a familiar personLanguage/communication milestonesMakes sounds other than cryingReacts to loud soundsMovement/physical development milestonesHolds head up when lying on tummyMoves both arms and legsOpens hands brieflyCognitive milestones (learning, thinking, problem-solving)Can focus on and track faces and objects as they move from side to sideWatches people as they moveLooks at a toy for several secondsBy 4 monthsSocial/emotional milestonesSmiles spontaneouslyChuckles or giggles when you try to make them laughLooks at you, moves, or makes sounds to get or keep your attentionLanguage/communication milestonesMakes sounds like “ooh” and “aah” (cooing)Makes sounds in response to someone talking to themTurns head toward the sound of your voiceMovement/physical development milestonesReaches for and grabs objectsMay be able to roll from tummy to backHolds head up without support when heldHolds a toy when you put it in their handUses arm to swing at a toy or other objectProps up on elbows or forearms when lying on their tummyCognitive milestones (learning, thinking, problem-solving)Explores things by putting them in mouthIf hungry, opens mouth when they see breast or bottleLooks at hands with interestBy 6 monthsSocial/emotional milestones Recognizes familiar peopleEnjoys looking in the mirrorLaughs Language/communication milestonesTakes turns making sounds with youBlows “raspberries” (sticks tongue out and blows)Makes squealing noisesCognitive milestones (learning, thinking, problem-solving)Puts things in mouth to explore themReaches for toysCloses mouth to show that they’re finished eatingMovement/physical development milestonesRolls from back to tummy and tummy to backSits with supportDoes straight-armed “push-ups” with palms on the floorLeans on hands for support when sittingBy 9 monthsSocial/emotional milestonesBegins having stranger anxietyMay be upset when separated from caregiversMakes several facial expressions, like happy, sad, angry, and surprisedTurns when name is calledSmiles or laughs when playing “peekaboo”Language/communication milestonesLifts arms to ask for parent to pick them upMakes a lot of different sounds like “mamamama” and “bababa”Cognitive milestones (learning, thinking, problem-solving)Looks for objects that leave their sightEnjoys interactive games like “peekaboo” and “so big”Bangs two objects togetherPhysical milestonesGets into a sitting position without helpMoves things from one hand to the otherUses fingers to “rake” food closerSits without supportBy 12 monthsSocial/emotional milestonesPlays games with you, like patty-cakeEnjoys being read to and looking at picture booksCries when you leave the roomLanguage milestonesWaves “bye-bye”Calls parent “Mama,” “Dada,” or another nameUnderstands “no” (pauses or stops when you say it)Cognitive milestones (learning, thinking, problem-solving)Looks for things they see you hide (such as a toy under a blanket)Puts things into a container, like a block in a cupMovement/physical development milestonesWalks holding on to furniture (“cruising”)Can pull themself up to a standing positionDrinks from a cup without a lid while someone else holds itUses thumb and pointer finger to pick things upKeep in mind that babies develop at different rates. If your baby isn’t reaching some of these milestones, don’t panic. But be sure to bring it up with your child’s health care provider. You can talk together about whether it’s a good idea to have an early intervention evaluation. And take a look forward at developmental milestones for 1-year-olds and 2-year-olds.
Developmental milestones for 3-year-olds
During this year, kids suddenly go from being toddlers to being old enough for preschool. But they don’t gain all the preschool skills at once — or even at the same rate. If you have a 3-year-old, you may wonder what most kids are able to do at this age.The Centers for Disease Control and Prevention (CDC) has a list of milestones, which it updated with many changes in 2022. The agency moved some of the milestones to different age ranges, which some experts question.The CDC milestones below can help you know what to expect. If your child isn’t meeting a fair number of them, it can point to possible developmental delays. You can also learn more about: How coordination and motor skills develop at different agesHow social-emotional skills develop at different agesSocial/emotional milestonesCalms down within 10 minutes after you leave (if they have separation anxiety)Notices other children and joins them to playLanguage/communication milestonesTalks with you in conversation using at least two back-and-forth exchangesAsks “who,” “what,” “where,” or “why” questions, like “Where is Mommy/Daddy?”Says what action is happening in a picture or book when asked, like “running,” “eating,” or “playing”Says first name, when asked by a familiar personTalks well enough for others to understand, most of the timeCognitive milestones (learning, thinking, problem-solving)Copies a circle when you show them howAvoids touching hot objects, like a stove, when warnedMovement/physical development milestonesStrings items together, like large beads or macaroniPuts on some clothes without help, like loose pants or a jacketUses a forkAll kids develop on their own timetable. But if after turning 3, your child isn’t able to do many of these things, it’s important to look into why. Talk with your child’s health care provider about evaluation options for special education support from your local school. Take a look forward at developmental milestones for 4-year-olds.
Typical developmental milestones for grade-schoolers
What skills do kids typically develop in grade school? Knowing what to expect can make it easier to notice potential trouble spots. Learn about developmental milestones to look for in your grade-schooler.
My preschooler isn’t hitting developmental milestones. Now what?
Once kids start preschool, it’s easier to observe them around other kids their age. That can make for some uncomfortable comparisons. You might start to wonder why your child doesn’t climb to the top of the play structure, isn’t playing silly rhyming games, or doesn’t speak as clearly as so-and-so. You might also question whether you should be worried.It can be hard to know if what you’re seeing is developmentally appropriate for your child’s age. Here are steps you can take to find out if what you’re seeing is a cause for concern, and where to go from there.Write down the milestones you’re concerned about.Get familiar with typical preschool milestones. You can also look at preschool readiness skills to learn about the basic skills needed for group learning. Take notes on the milestones you don’t think your child is hitting. Try to be very specific about what you see. Having a clear list of concerns makes it easier to explain your concerns to others.Find out how things are going at school.Connect with your child’s preschool teacher or whoever watches your child during the day. If your child is mostly with you every day, talk with someone you trust who knows your child. You can also talk with your child’s doctor.Ask how they view your child’s development. Refer to your list to explain what’s worrying you. Ask if they see the same things, and whether what you’re seeing can be within the typical range for kids that age. Keep in mind that even if others tell you to “wait and see,” it’s OK to trust your instincts.Know that age can make a difference. Keep in mind that for 3- or 4-year-olds, being even just six months younger than the rest of the kids can make a big difference. What might look like a delay compared with other kids may still be typical development for your child’s age.Learn what a developmental delay is. Being slower than other kids to meet developmental milestones isn’t always a reason to worry. Minor differences can be typical. But when kids are consistently behind in gaining many skills expected by a certain age, that’s considered a developmental delay. Talk with your child’s health care provider. Bring up what you’re seeing at a well-child visit if you have one scheduled. Or schedule an appointment for sooner if you feel like you need to. Be as specific as you can. You can also share any insights your child’s teacher or childcare provider shared.Know the power of early intervention. After talking with your doctor or health care provider, you may still be concerned about delays. If so, you can look into free help from your state or local school district. Kids under age 3 may be able to get therapy or specialists from the state to help them “catch up.” This is called early intervention. Clinics and doctor’s offices will have information on how to request this.Learn how your child can be evaluated for early intervention. If your child is older but hasn’t started school yet, you can still get help. It will typically come from the local school district. Ask your child’s daycare, clinic, or doctor’s office for how to get in touch with the right person. For kids who are getting ready to start school, the local district will typically provide a free screening and possibly services. In some cases, this could mean a free preschool program.Continue to observe your child, and follow up as needed.Keep tracking your concerns and follow up in six months. Young kids’ skills develop fast. Note which milestones you were concerned about so you can check to see if your child hit them or not. If after six months you’re still seeing delays, you’ll have your notes to use when you follow up with the teacher or health care provider. Connect with other families. Try to talk openly with other families about what’s going on. You may find they have similar worries. Read how one family reframed their thinking to focus on getting supports instead of worrying about labels. Hearing other people’s experiences and stories — and even joining the Understood Community — can help you build a support network.
Specialists who work with babies and toddlers
Several types of early intervention specialists work with babies and toddlers on reaching developmental milestones. Find out what they do and how they can help.Speech-language pathologists Speech-language pathologists help with communication skills. They provide services to help with any delays in language, speech, beginning literacy, and feeding or swallowing.Physical therapists Physical therapists help kids improve their movement and gross motor skills. This includes addressing any problems with balance, strength, and coordination. Occupational therapists Occupational therapists can help with fine motor skills, like grasping small objects. They also can help with cognitive, sensory processing, communication, and play skills. They may teach you how to adapt your home and teach your child feeding and self-care skills. Psychologists Psychologists and other family counselors help you with your child’s behavior, mental health, and learning. They help your child learn how to express and regulate emotions, form close relationships, and explore the world around them. Nurses Nurses can assess your child’s health status and help improve it. They provide ideas for feeding, growth, and medical concerns. They can also provide medication or treatment prescribed by a licensed doctor. Nutritionists Nutritionists look at and help with any problems with feeding or diet. Audiologists Audiologists test to see if your child has any hearing loss. If so, they can provide lip-reading training, hearing devices, or other services related to hearing and communication.Social workers Social workers may evaluate your child’s social and emotional development. They also help you find resources your child needs.Developmental therapists Developmental therapists (also sometimes called developmental educators) help design activities and learning situations to promote a child’s thinking and learning skills and social interaction. Vision specialists Vision specialists can assess problems with vision and teach eye exercises if needed. They refer your child for any needed medical or professional services.Learn more about early intervention for kids who have developmental delays. Find out what to expect during early intervention evaluations.
What is early intervention?
Early intervention refers to services and supports that can help young children with developmental delays. It’s like special education but it’s for eligible infants and toddlers who are behind at reaching developmental milestones. Through early intervention, kids from birth to age 3 can get services at home or in the community. Different types of specialists work with kids and their families depending on which skills are delayed. Early intervention focuses on skills in these areas:Physical skills (reaching, crawling, walking, drawing, building)Cognitive skills (thinking, learning, solving problems)Communication skills (talking, listening, understanding others)Self-help or adaptive skills (eating, dressing)Social or emotional skills (playing, interacting with others)Although all states offer early intervention, not all states do it the same way. A health care provider or a childcare provider might refer kids for an early intervention evaluation. Some states allow families to make their own referrals if they’re concerned. If kids are found eligible, a team from the state’s early intervention program works with the family to develop an Individualized Family Service Plan (IFSP). This plan defines goals and the types of services to help children and their families.
5 common myths about early intervention
Early intervention can be confusing to navigate. You may hear myths that make it hard to know what’s true and how best to help your child. Knowing the facts can help you make informed decisions. Here’s the truth behind five common myths about early intervention. Myth #1: Early intervention is only for kids with severe challenges.Fact: Kids are eligible for early intervention services if they need them. It’s not based on the severity of the disability they have. Kids under 3 are eligible for early intervention if they have a disability or developmental delay. This includes kids who haven’t reached certain developmental milestones, including communication or social-emotional milestones.Myth #2: Early intervention is expensive. Fact: The Individuals with Disabilities Education Act (IDEA) says that families whose kids are eligible should receive several services at no cost. Once your child has an early intervention evaluation and is found eligible, you’ll work with a service coordinator to get a plan in place.Depending on your state, more specialized services may be available on a sliding fee scale. That means you may be asked to pay for some early intervention, but it’s based on how much you make.Some services may be covered by health insurance or Medicaid. But that only happens if you give written consent for your insurance to be charged. However, if you can’t afford services or don’t provide permission to use your insurance, your child still can’t be denied services. If your family doesn’t have insurance, visit this government website to learn about free or low-cost options.Myth #3: Early intervention “cures” kids. Fact: Intensive early intervention can help young children with developmental delays catch up. But it can’t “cure” lifelong conditions, like autism, ADHD, or Down syndrome. It can make a big difference, though, and it can have long-term positive effects. That’s because between birth and 5 years of age, kids’ brains are developing quickly and making new connections. It’s a prime time to teach skills to young children and their families.Myth #4: You spend tons of time in transit and in waiting rooms. Fact: Families are key partners in early intervention. Professionals work with kids for a few hours (or more) per week. But you and your child’s other caregivers are the ones who practice with your child when the professionals aren’t around. Plus, the law says that these services should take place in “natural environments” as much as possible. Natural environments are familiar places. They’re environments where your child, family, and care providers can participate in everyday activities. This might be your home or a nearby park. Or outside gardening, grocery shopping, or visiting friends.All of this makes it easier for your child to practice new skills without leaving home. It also makes it easier for you to learn what you need to know to help and practice with your child. And as much as possible, service providers come to your child instead of you and your child going to the provider. Learn more about where early intervention specialists will work with your child.Myth #5: Kids who aren’t eligible have to wait until kindergarten.Fact: If you disagree with the results of an evaluation, you can challenge the decision. You can request to meet with officials to talk about concerns. This is known as mediation. You can also request an impartial hearing, called a due process hearing.If you agree that your child isn’t eligible and you still need help, ask the service coordinator to help you find services in your community.Learn more about what to do if your child doesn’t qualify for early intervention.
What are developmental delays?
“How old was yours when she first rolled over?”“Mine has been talking in complete sentences for months!”Talking about meeting milestones is common among proud parents and caregivers. But it can be nerve-racking to see or hear about other kids passing milestones before your child does. You may worry about developmental delays. There’s more to it than being “slower to develop” or “a little behind.” A developmental delay means kids are continually behind in gaining the skills expected by a certain age. A developmental delay can happen in just one area or in a few. A global developmental delay is when kids have delays in at least two areas. Not meeting developmental milestones at the same rate as other kids isn’t always a reason to worry. Children don’t all develop skills on a strict timetable. And developmental delays are typically caused by things beyond a family’s control. For example, a speech delay can be caused by temporary hearing loss from multiple ear infections, which aren’t uncommon in babies and toddlers. When a child isn’t meeting multiple milestones as quickly as expected, a health care provider or a childcare provider may suggest an early intervention evaluation to understand what’s going on.
Language delays, dyslexia, dysgraphia, and ADHD — and now thriving
When my son Henry was 18 months old, I took him to our pediatrician for a regular checkup. She asked if he was speaking yet. He wasn’t, so she recommended I take him to a specialist.This referral led to that referral, and before I knew it, my son was sitting through a screening for early intervention services. He also sat through testing by a speech-language pathologist. These would turn out to be the first of many evaluations he’d have over the years.The results were heartbreaking to me. Henry had both expressive and receptive language delays. He also had delayed fine motor skills and a host of other issues.So I followed the recommendations of experts and began treatment. Twice a week he went to an occupational therapist. And once a week, he went for speech therapy.The treatment seemed to work. A year later, my son was talking up a storm and hitting most of his developmental milestones.So when he was almost 3, I decided to have him reevaluated by the same speech-language pathologist to ease my mind. Now that my son knew more than 200 words and was stringing together simple sentences, I hoped an evaluation would show that he was now on a “normal” developmental curve.But that didn’t happen.This time, the evaluation found that Henry talked excessively and had trouble with transitions (read: he pitched a fit when it was time to move from one activity to the next). He also wasn’t making eye contact. And in the evaluation report, there was a statement I’ll never forget: “It may be prudent to consider whether Henry will be capable of participating in a ‘regular’ preschool program.”I cried myself to sleep that night. I couldn’t come to terms with the report. My once cantankerous toddler had, in my eyes, blossomed into a joyful and adventurous 3-year-old.Despite what felt to me like a gloom-and-doom report, I chose to enroll him in a “regular” preschool. As his very first parent-teacher conference approached, I braced myself for the worst.But to his teachers, who knew nothing about his history, he was just a typical 3-year-old. All of the things that were flagged as issues — difficulty with transitions, excessive talking, and lack of eye contact — didn’t seem to register any warning signs for his teachers.I wish I could tell you that that was the end of my worrying. But it wasn’t. Years later, through a private evaluation, my son was eventually diagnosed with dyslexia, dysgraphia and ADHD.And since starting kindergarten, Henry has had three school-based evaluations. (He needs to sit for them every three years to keep his IEP.)Each evaluation has been hard for me as a mother, but I’m glad we’ve done them. Without them, my son wouldn’t qualify for accommodations such as extended time. Nor would he get curriculum adjustments like not being marked down for spelling errors in his assignments. The evaluations also allow him access to a keyboard to help with writing and basic computation.Today, Henry is thriving. Nearly every teacher who has ever taught Henry has made a point of telling me just how bright he is.“He’s extremely articulate,” they’d say to me. “He often grasps concepts that are way above the other students’ heads.” What’s more, he finished the seventh grade with the reading comprehension of an 11th grader.Yes, he has deficits. His spelling and writing are atrocious, and the ADHD makes it difficult for him to stay on task.I left his most recent school evaluation feeling very calm. Not much had changed.Afterward, I called my husband and we laughed: “I guess we just have to accept that Henry is never going to win the spelling bee.”But to me, the fact that Henry is doing well is a sign of how far he’s come and how powerful his mind truly is.
Why your child’s school may deny your evaluation request
You made a request for a special education evaluation, but the school denied your request. Can the school really say no? What reasons must the school have? Learn why your child’s school can deny your evaluation request.The school can deny your request only if there’s no sign of a disabilityThe Individuals with Disabilities Education Act (IDEA) makes schools provide services to any child who qualifies for special education. The law also makes schools look for, find, and evaluate any kids who may qualify. If a school suspects or should suspect a child has a disability, it must evaluate that child. This part of IDEA is known as Child Find.When you request an evaluation, you’re asking the school to fulfill this Child Find responsibility. And the law says there’s only one valid reason the school can deny your request. The school must reasonably believe there’s no evidence your child has a disability.The school must explain its decisionIf the school decides not to evaluate, it must tell you in writing. And it has to explain its reasoning. IDEA refers to this as prior written notice.The school should also explain why it believes there’s no evidence your child has a disability. Keep in mind that each child is unique. What might be a reason to deny an evaluation to one child might not apply to another.Common reasons for denying evaluation requestsHere are six of the most common explanations schools give:1. Your child just started grade school. In early grades, kids may struggle because of differences in meeting developmental milestones. For instance, if your child is in kindergarten and is a little behind in reading, school staff may believe your child will catch up. For the school to agree to an evaluation, there needs to be some evidence that a child’s struggles could be due to an underlying issue.2. Your child is performing at grade level or above. If your child is doing OK academically, the school may cite this as a reason to deny your request. But IDEA says that kids who are passing grade to grade may still need to be evaluated for services. For instance, twice-exceptional kids are gifted and have a disability.3. Your child is struggling, but it’s due to willful behavior.If your child acts out in class, fools around, or is otherwise unengaged, the school may say your child is struggling because of intentional bad behavior. The school may think there’s no underlying issue. But in many cases, behavior problems should give the school reason to suspect a qualifying disability like ADHD.4. The school is offering help, and your child’s grades are improving. Many schools offer academic help as soon as a child is struggling. Response to intervention (RTI) is one approach that does this. If your child is getting help and is learning, the school may say this shows there’s no issue. Keep in mind that a school can’t use RTI as an excuse to delay an evaluation. But data from RTI could show that a child doesn’t need special education.5. Your child is an English language learner. Kids who are just beginning to learn English may fall behind academically. The school may think your child needs more language instruction, not special education.But there are key questions to ask if an English language learner is struggling in school. For instance, is your child showing signs of learning and thinking differences in English and in their home language?6. Your child was evaluated recently. If the school evaluated your child a few months ago, it will probably deny a new request. You may need new data or information to get the school to agree to a new evaluation. But there are steps you can take if you disagree with the previous evaluation. For instance, you can request an independent educational evaluation (IEE).Whatever reason the school gives, it’s important to remember that each child is unique. Common explanations don't apply to all kids. The key is that the school can deny a request to evaluate only if there’s no evidence of disability. And the school must explain its decision.Why it’s important to submit a written request Some parents or guardians who are new to the special education process may say in a school meeting that they’d like an evaluation. But unwritten requests may get overlooked. The school might not remember to respond to a spoken request. That’s why it’s best to submit your evaluation request in writing. Here’s a letter template you can use to request an evaluation. Next stepsIf school staff deny your evaluation request, that doesn’t mean they’re right. You can challenge the school’s decision.Explore steps you can take if the school denies your evaluation request. Learn more about your rights in the evaluation process.Get information on independent educational evaluations outside the school.
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