The “Wait and See” Approach to Development: Building a House of Cards

As all parents know, children don’t come with instruction manuals. But they do come with a lot of age-based expectations and developmental milestones. A quick online search produces very specific dates for when a child should do everything–babble, say a first word, turn over, grasp items in their hand, walk, eat solid foods, drink from an open cup, learn their ABCs–the list is endless.

Obviously, the dates found in an online search represent an average. Not every child will say their first word on the day of their first birthday or roll over at exactly four months. But how do you know which delays need to be addressed and which might resolve themselves? Is it ever best to just wait and see?

As a speech-language pathologist who works with dyslexia, I see this question play out frequently. Too often, children who struggle to read in the early school years are placed in a “wait and see” cycle without research-based early intervention. By the time reading deficits are addressed, poor reading and writing skills may be negatively impacting multiple areas of academics, vocabulary acquisition, and a child’s self-confidence.

TPP co-owner and physical therapist Jessi Frencken compares childhood development to a “house of cards.”

“Each skill builds on the one before it,” she explains. “When a child is struggling with one skill, it will limit their ability to fully gain the next skill. A relatively small delay that is ignored or allowed to wait can turn into a much bigger issue over time that takes a much longer time to correct.”

Across pediatric therapy disciplines, experts agree that early intervention can shorten treatment times and improve therapy outcomes. But what is the potential harm in deciding to “wait and see?”

The “Wait and See” Approach Might Increase Treatment Time

“If someone waits to see if a child will ‘outgrow’ a concern, this could be harmful in the long term because the child will get used to performing that skill in a certain way and habits can be formed which take time and lots of practice to correct,” said occupational therapist Emily McKinzie. “For example, if a child is holding their pencil or crayon differently than an age-appropriate grasp and they continue using it this way without correction or adjustment, they get used to doing it that certain way. This can start to affect other areas of their life, such as self-care skills, and it can lead to difficulty with handwriting as well as to hand fatigue and discomfort.”

In the case of dyslexia, research has shown that children who receive early intervention are more likely to catch up to peers. While those who receive assistance later can still make significant strides, they are more likely to require support into the high school years and beyond.

The “Wait and See” Approach Might Result in Additional Challenges

Because developmental milestones often build on each other, unaddressed concerns may lead to additional problems later on. Occupational therapist Courtney Van Alstine has seen this occur for clients with feeding concerns.

“Without intervention, a 2 year old with a restricted diet is at risk to fall into a negative feedback cycle with food,” she explained. “The child may lose or not develop important oral motor skills for chewing and swallowing a variety of textures, which can cause them to limit their diet further. They may become constipated from only eating a few foods that are high in starch and low in fiber, causing their appetite to decrease even further. The child may accidentally internalize the idea that only specific brands/colors/textures of food are “safe” to eat without positive learning opportunities with new foods, causing them to restrict their diet even more as they become older.”

Physical therapist Paige Gunter states that early motor delays that are not addressed may impact development of a range of skills.

“Motor milestones—such as prone endurance, rolling, sitting, crawling, and walking—build upon one another and form the foundation for more complex movements and coordination later in childhood,” she explained. “Delays in achieving these milestones can impact not only physical development, but also cognitive, social, and emotional growth, as children learn about their world through movement and exploration.”

If You Have a Concern, Schedule an Evaluation Sooner Rather Than Later

If you are concerned about your child’s development, call us today to schedule an evaluation. At TPP, we offer research-based evaluation and intervention services in the areas of speech and language, feeding and swallowing, gross and fine motor skills, self-care skills, physical development, nutrition, mental health, behavior, and more. Our therapists are experts in identifying delays and disorders and providing quality intervention to help your child thrive.

“Many parents worry about ‘wasting our time’ with an evaluation for a child who does not need services, but this is absolutely never the case,” Courtney said. “It’s our job to determine if we can be a good support–and if we determine that direct services aren’t needed, we are often still able to help the family connect with other resources for support.”

“Addressing concerns promptly allows us to support development with targeted strategies and reduce the risk of secondary issues,” Paige agreed. “Importantly, scheduling an evaluation doesn’t necessarily mean a child will require ongoing therapy—it simply provides parents with clarity, reassurance, and, if needed, a proactive plan for support.”

Do you have concerns about your child’s development? Call us today at 660-219-9176 (Clinton) or 660-219-9381 (Knob Noster) to schedule an evaluation.

By: Amy Wolcott, M.S. CCC-SLP