Understanding Developmental Norms for Child Language Development
If you find yourself concerned about your child’s speech and language development, rest assured, you’re not alone. In February 2022, the Centers for Disease Control and Prevention (CDC) introduced significant updates and revisions for their “Learn the Signs. Act Early” program, offering new guidelines to assist caregivers in monitoring and tracking developmental milestones.
What We Liked
The update, commendably, included the addition of checklists for 15-month-olds and 30-month-olds, along with the incorporation of materials that use more parent-friendly language.
What Concerns Us
Significant changes in the CDC's approach has raised eyebrows, particularly in the revised threshold for developmental communication milestones. Instead of basing milestones on the 50th percentile, the CDC now focuses on the average performance of the 25th percentile. This shift lacks credible evidence, causing concern among speech-language pathologists who fear potential delays in early intervention referrals.
Missing Expert Input
Equally troubling is the absence of consultation with speech-language pathologists (SLPs) who play a pivotal role in understanding and addressing language development issues in children. Bringing SLP expertise into the picture would have offered valuable insights into the practical implications of such changes, potentially mitigating some of the concerns that have emerged.
The CDC’s Rationale
The CDC justifies these changes by aiming to discourage a “wait and see” approach with the hope of catching developmental delays earlier. However, altering milestones and halving percentile ranks may lead to changes in State and local criteria for early intervention services. Evidence and history point to a cycle of misdiagnosis, reduced funding and support, less early intervention and children being lost in the shuffle.
The Potential Impact
The most significant potential impact of these changes could be a reduction in funding and support for early intervention services which can have a profound effect on a child's speech and language development. If the criteria for these services become more stringent, caregivers may face challenges in accessing necessary support for their children's language development, leading to far-reaching consequences for long-term language development and overall well-being.
Caregivers are going to need other mechanisms to provide their children with much needed language support. Gaining access to these supports can be cumbersome and frustrating, especially for those who don’t know where to start.
The potential consequences are far-reaching. Children who may benefit from early intervention services could be left without crucial support, affecting their long-term language development and overall well-being.
Empowering Caregivers through Expert Guidance
Families seeking reliable guidance should turn to licensed speech-language pathologists (SLPs) who are dedicated to preventing, assessing, diagnosing, and treating speech, language, and social communication, as well as cognitive-communication, and swallowing disorders in children and adults.
When seeking milestone guidance, I turn to ASHA, the American Speech-Language-Hearing Association. With a mission to make effective communication a human right, ASHA is the nation's leading professional, credentialing, and scientific organization for audiologists, speech-language pathologists, speech, language, and hearing scientists, assistants, and students. ASHA has been the leader of these professions for almost 100 years, initiating the development of national standards for audiology and speech-language pathology certification since 1952.
Advocating for Evidence-Based Approaches
While the CDC's intention to improve early identification of developmental delays is admirable, the current method of implementing these changes raises concerns. By placing an emphasis on percentiles, there is a risk of oversimplifying the complex nature of child development. A more nuanced and comprehensive approach would include input from experts to ensure that the unique needs of each child are addressed appropriately.
Advocating for comprehensive and evidence-based approaches can safeguard the well-being of our children's language development. Striking a balance between early intervention and evidence-based practices is essential for the holistic development of each child, recognizing their unique strengths and challenges. In this dynamic landscape, caregivers, professionals, and communities must work collaboratively to ensure that every child has the opportunity to thrive and reach their full linguistic potential.
Taking Proactive Measures
Caregivers with concerns about their child's speech and language development are advised to contact a speech-language pathologist for a screening or assessment. SLPs can assess a child's development, identify potential issues, and provide appropriate guidance, support, resources and intervention.
Informed Decision-Making
In the face of recent changes to milestone checklists and potential shifts in early intervention services, it's important for caregivers to be more proactive. Seeking information from reliable sources and engaging with professionals who can provide personalized guidance will ensure children and their caregivers receive the best quality treatments and services, leading to better outcomes for all.
