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Written by Melanie Hsu, Ph.D., Clinical Psychologist and Early Childhood Program Manager at CHC

Many parents note that one silver lining of these scary and unprecedented times is the opportunity to spend much more time with their children. However, this increased attention can sometimes lead to more worries: is my child delayed? Are they reacting to the anxiety of these times? Or am I just more concerned and sensitive because of my own personal stress?

You may have seen commercials from organizations such as First 5 and wondered why professionals often emphasize this age range. This is because the first five years of life is a critical time to build the foundations that children need to be successful in social development, in school, and in other environments. Thus, parents of young children often worry whether their child is “on track” and when it might be helpful to seek more information or support. All children develop at their own individual pace and while for some children differences or delays may be more temporary, others may benefit from professional support, especially when there are situational stressors. Below we discuss five important areas of development and when to consider seeking help.

Sensory Processing

Children explore and make sense of their world through their senses, including sight, touch, sound, smell, and taste. However, some parents notice that their child seems to seek a lot of sensory information, such as liking to climb, jump, crash, touch, and move. While these are all normal behaviors in development, sometimes this seeking leads to other problems, such as injuries, difficulties participating in group activities, or social isolation due to aggression or other children becoming overwhelmed.

Children also sometimes seem to seek only the sensory aspects of experiences, such as repeatedly dumping, stacking, opening, closing, or closely looking at parts of toys. When play becomes less exploratory and more repetitive, this may be a sign that development is stalling. On the opposite side, some children seem overly afraid of exploring and do not like heights, fast movement, noise, textures, or certain tastes. These can cause problems with frequent tantrums due to overstimulation, avoidance of certain activities, and difficulties in public spaces (e.g., grocery stores, malls, playgrounds).

When these sensory seeking or avoiding behaviors start to interfere with the child’s ability to participate in and benefit from same-aged activities or with the family’s ability to leave the home, this may be a sign that the child may benefit from support in making sense of their senses.

Motor Development

As babies gain more control over their motor abilities, they are more able to explore and learn from their environments, leading to the development of more independence. If a child is not meeting their motor milestones (e.g., sitting independently, crawling, walking, picking up items, dropping and picking up toys), this can limit their ability to interact and feel successful and can lead to frustration. This can also cause the child to become more socially isolated on the playground, lead to higher risk of injury because of clumsiness, or interfere with daily living skills such as eating and dressing. Delays in achieving motor milestones can also sometimes be an early sign of other delays, as development links across multiple domains.

Communication

Before babies can say an intelligible word, they are already communicating through their eye gaze, facial expressions, gestures, and vocalizations – sometimes quite emphatically! The first step of functional communication is communicative intent, or using something (e.g., facial expression, vocalization, gesture, words) to deliver a message.

  • Is your child showing communicative intent and do they understand that their behaviors can affect the behaviors of others?
  • If they are not talking yet, do they use these other ways to compensate?
  • Do they check in with caregivers with eye contact or are they more intent on the action (e.g., taking your hand and putting it on something to open it rather than looking from you to the item and using a gesture)?
  • Can they imitate sounds and are they understandable by others outside of the family?
  • Are they frustrated because they are not understood?
  • Do they seem like they are not hearing you or is it hard for them to consistently follow directions?

As communication is the way we interact with others, these difficulties are often the first area of concern for parents, and delays often contribute to difficulties in social and behavioral domains.

Social Abilities

Children naturally seek attention from others and delight in copying their actions (e.g., wearing mommy’s shoes, pretending to cook like daddy). They are born curious and want to be around others. Through play, children learn how to take the perspective of others, practice and process experiences, and learn to compromise, share, and work with others. One of the first red flags in early development is the lack of the natural development of play or social imitation, which can parallel language delays. Also, in play, children enjoy both the activity and the process of sharing that activity with others. While all children have different personalities and some are more or less outgoing than others, sometimes children are more focused on the activity than in the social interaction.

Despite exposure to situations, sometimes children do not seem to learn how to share, compromise, or understand the normal give and take of interactions, leading to avoidance of peers, difficulties in group activities, and difficulties with starting or sustaining interactions. While some of these difficulties may stem from emotions (e.g., anxiety) and sometimes they can indicate intrinsic social difficulties that may benefit from further assessment and support.

Behavior

Social growth runs in parallel with behavioral development, and children learn their limits by testing them. While this can be frustrating while it develops, children often learn by doing; for example, learning that hitting someone else leads to tears, hurt, and other consequences. Through this social exposure, they learn what is expected of them and how to regulate their emotions and behaviors. Play dates and other social opportunities are important in helping children have these experiences and learning to play and negotiate with others. While all children test their limits, sometimes children do not seem to learn how to regulate or negotiate without using physical means, which often causes difficulties in daycare or preschool settings, as well as in their relationships with peers. As we want to be the masters of their emotions and behaviors rather than the other way around, sometimes children may benefit from support in learning how to recognize their emotions, tolerate distress, and deal with their feelings in a prosocial way.

Wrap-Up

It is easy (and natural) to be worried about your child’s development, especially in these times, but the important thing to remember is that you are not alone. If you are concerned, consult with a professional; do not wait and see! Even if the difficulties are due to your child’s reaction to general stress, our specialists are available to consult and provide guidance and support in real-time. Occupational therapists help with gross and fine motor development, including learning daily living skills (e.g., buttoning, feeding) as well as sensory processing and regulation. Speech and language pathologists help with verbal and nonverbal communication, including encouraging language development and teaching parents how to support this with everyday activities in the home. Psychologists help with social-emotional development and behavior, including learning and practicing coping and social skills, targeting problematic behavior, fostering emotional insight, developing and implementing structure, and integrating information from the rest of the team.

Even if there are delays, early intervention is proven to be very effective in making significant positive differences in development. Development occurs along a spectrum and we always want to celebrate the uniqueness of each individual child while keeping an eye out for potential areas of support to maximize each child’s strengths. It is also important to remember that much of the information available online is not vetted and to always consult with your child’s pediatrician and other licensed professionals before making decisions. If you are concerned, please reach out to your child’s pediatrician and other experts, and if you are not feeling heard, persist! You are the expert in your child, and we encourage parents to be empowered to advocate for their children.


Dr. Hsu’s passion for working with children and families with Autism Spectrum Disorder and developmental disabilities started during a practicum at Children’s Hospital Oakland at the Children’s Hospital Autism Intervention (CHAI). Dr. Hsu currently continues to work part-time at the Kaiser Permanente Division of Research with the Autism Research Project as the clinical lead for two research studies, SEED (Study to Explore Early Development) and EARLI (Early Autism Risk Longitudinal Investigation).


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