What should parents do if they suspect there may be something not quite right about their child’s development?

“Don’t worry—he’ll grow out of it.”

Those comforting words are often offered to parents who are not quite sure whether their child’s behavior is “normal” for his or her age.

Sometimes, of course, it’s true.

As any pediatrician or preschool teacher or child development expert will tell you, there is a wide range of “normal”:

Susie learns to walk at 9 months and Billy at 14 months. Either way, it’s still within the guidelines for typical development. No need to worry. Nevertheless, sometimes children don’t just “grow out of it,” and the earlier they get some help, the better their chances of overcoming whatever problem or delay they may face. The good news is that there are free services available to every Pennsylvania family to help with identifying developmental problems and then treating them.

For children 3 years old to school age, these free services are offered by the intermediate unit. According to Jan Salwocki, Preschool Supervisor at the Central Susquehanna I.U., which serves Snyder, Union, Northumberland, Montour, and Columbia counties, “We see children in early intervention who go on to school and never need continuing special education.” This is the best possible result for early intervention, but even if delays or problems don’t entirely disappear, it’s safe to say that the child will do better if services are started as early as possible. Parents can call the intermediate unit themselves to request a screening, and I.U. staff will come to the family’s home, the child’s day care center, or Grandma’s house—wherever it is most convenient for the family. If a child is found to have a delay that qualifies him or her for services such as speech therapy, occupational therapy, or a special preschool teacher, these services can also be provided wherever the child spends the day. And it is important to note that parents always have a choice about whether or not to accept these services.

From birth to a child’s third birthday, the early intervention programs are housed in the Mental Health/ Mental Retardation agencies. Kathy Hollabaugh, Early Intervention Service Coordinator for Northumberland County MH/MR, advises parents not to worry about the MH/MR label. Most of the children who receive services from her agency do not have either of these problems. Rather, they are seen for speech and language delays, physical problems, and a whole host of developmental issues. Many of the referrals for the youngest babies come from physicians or hospitals, but parents are also encouraged to call if they are not comfortable with something about their young child’s development. “This is not a welfare program,” Ms. Hollabaugh says. “It’s an entitlement. There are no income guidelines, and the program is completely voluntary.” As with the I.U. program for preschool age children, parents can decide whether or not to accept services once their child has been tested and found to have a delay.

Becky Laubach, Early Intervention Supervisor for the CMSU Mental Health/Mental Retardation agency, which serves children who live in Columbia, Montour, Snyder, and Union counties, advises parents to talk first with their child’s pediatrician, nurse practitioner, or family doctor—whoever provides the child’s regular health care. Parents shouldn’t be reluctant to do this. They know their own child best, and their hunches are often right. They can help the professionals by tracking their child’s behavior: How long has this been going on? Is it worse or better at certain times of the day, or in certain circumstances? Has this child typically been early or later with other behaviors? She says that parents should remember that babies need opportunities to move in order to learn, and that children under three SHOULD be “looking for ways to get into trouble” most of the time. “A lack of interest is always a concern.”

Certain developmental alerts for infants and toddlers can indicate a childhood development concern. The following list of developmental alerts is offered as a guide.

Check with your child's doctor or an early childhood specialist if by the ages listed you have NOT observed the following behaviors:

Developmental Alerts for Infants and Toddlers

By One Month

• Shows alarm or startle responses to loud noise

• Sucks and swallows with ease

• Shows gains in height, weight

• Grasps with equal strength in both hands

• Makes eye-to-eye contact when awake and being held

• Quiets soon after being picked up

By Four Months

• Continues to show steady increases in height and weight

• Smiles in response to the smiles of others

• Follows a moving object with eyes focusing together

• Brings hands to midline over mid chest

• Turns head to locate sounds

• Begins to raise head and upper body when placed on stomach

• Reaches for objects or familiar persons

By Eight Months

• Shows even and steady increases in height and weight

• Explores own hands and objects placed in hands

• Holds and shakes a rattle

• Smiles, babbles and laughs out loud

• Searches for hidden objects

• Uses finger and thumb to pick up objects

• Plays games such as "pat-a-cake" and "peek-a-boo"

• Reaches for and grasps objects

• Sits alone

By Twelve Months

• Blinks when fast moving objects approach the eye

• Initiates simple sounds

• Follows simple verbal requests: no-no, bye-bye

• Pulls to stand

• Transfers objects from hand to hand

• Shows anxiety toward strangers

• Interacts playfully with family members and caregivers

• Feeds self, holds own cup or bottle, picks up finger foods

• Creeps and crawls.

By Twenty-Four Months

• Attempts to talk or repeat words

• Responds to simple questions with a yes or no

• Walks alone or with little help

• Exhibits a variety of emotions: anger, delight, fear

• Shows interest in pictures

• Recognizes self in mirror

• Attempts self-feeding: holds own cup to mouth and drinks.

By Thirty Six Months

• Speaks in 2-3 word sentences.

• Follows a series of two simple commands.

• Enjoys being read to.

• Avoids bumping into objects.

• Indicates a beginning interest in toilet training.

• Sorts familiar objects according to a single characteristic, such as type, color, or size.

Developmental Alerts for Preschoolers

Check with your child's doctor or an early childhood specialist if by the ages listed you have NOT observed the following behaviors:

By the Fourth Year

• Has intelligible speech most of the time.

• Understands and follows simple commands/directions.

• Gives own name.

• Enjoys playing near other children.

• Jumps in place without falling.

• Uses 3-4 word sentences.

• Stays with an activity for at least 5 minutes.

• Helps with dressing

• Balances on one foot

By the Fifth Year

• Alternates feet when walking down stairs

• Follows a series of 3 directions: " Stop, pick up your sock and bring it here."

• Plays with other children.

• Uses 4-5 word sentences.

• Sits still to listen to an entire short story. (5 minutes)

• Speaks in moderate voice-not too loud or soft

Developmental Alerts for Young School Aged Children

Check with your child's doctor or an early childhood specialist if by the ages listed you have NOT observed the following behaviors:

By the Sixth Year

• Alternates feet when walking up and down stairs

• Uses four or five word sentences

• Cuts on a line with scissors

• Sits still and listens to a story for 5-7 minutes

• Maintains eye contact when spoken to (unless this is cultural taboo)

• Plays well with other children

• Performs self-help tasks independently

By the Seventh Year

• Shows an interest in reading and trying to reproduce letters, especially own name

• Follows through with simple directions

• Follows simple multiple step directions

By the Eighth Year

• Makes friends

• Shows improved motor skills

• Seems to hear and see adequately

• Goes to school willingly

• Attends to the task at hand and responds appropriately

Alerts were adapted from Allen, E., & Marotz, L. (2003). Developmental profiles: pre-birth through twelve. (4e). Albany, NY: Delmar Publishers.

For more information, call: For children ages birth to three, call the Early Intervention program in the MH/MR agency for your county.

In Northumberland County: 570-495-2016. In Columbia, Montour, Snyder, and Union Counties: 800-451-9720.

For children from age three to school age, call the Preschool Program at the Central Susquehanna I.U.: 570-523-1155, ext. 2229.



Karen Woland Payne is the director of The Children's Learning Center at Penn College, Williamsport.