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FOCUS Therapy Take on New CDC Developmental Milestones Guidelines

Earlier this year, the U.S. Centers for Disease Control & Prevention (CDC) updated its developmental milestones guidelines used to identify potential red flags indicating a child may need early intervention services. This process was initiated long before the pandemic, and finalized in February.

After taking some time to consider the impact of these new standards, our FOCUS Therapy team has some concerns that we hope parents and local providers will pay attention to when weighing whether a child may require early intervention, such as speech, occupational, physical, feeding, and ABA therapies.

What Are CDC Developmental Milestones?

The milestones guidelines put forth by the CDC are essentially a point-by-point list of activities or skills that most children can do or have mastered by a certain age (primarily between birth and age 5). It includes skills that fall under one of the following categories:

  • Social/emotional
  • Language/communication
  • Cognitive
  • Movement/physical development

Examples of identified milestones would be things like waving “bye-bye” or saying words besides “mamma or dada” or taking a first step.

The old milestones can be found here.

The updated milestones can be found here.

Why Did the CDC Update the Milestones?

The CDC, along with the American Association of Pediatricians (AAP) said that the updates were conducted by a group of its experts, with changes required because the standards had not been revisited since 2004.

A spokeswoman for the CDC told Reuters that the agency had been discussing revising the milestones back in 2017, and that the work began in 2019. Analysis of parent understanding and relatability was conducted in mid-2020.

The goal, say agency leaders, was to make the guidelines more helpful to families. The language contained in the previous guidelines was reportedly vague, with parents on many fronts urged to take a “wait-and-see” approach. That approach is now broadly understood to no longer be the best course of action when children are delayed on key developmental milestones.

The updated version now includes checklists for 15 and 30 months, and milestones that are considered “standard” when 75 percent or more kids can be expected to those skills. That differs from the previous standards, which were based at 50 percent mastery.

Why Our FOCUS Therapists Have Concerns About the New Milestones

Certainly, eliminating a wait-and-see approach to any concern regarding kids’ developmental milestones is important. We now know that prompt intervention therapies (speech, occupational, physical, and ABA) are the critical when there are concerns about a child’s development. Early intervention is strongly correlated with optimal long-term prognoses for these kids.

The CDC says that by resetting the bar, they are able to pinpoint kids whose delays are clinically significant and who unquestionably should be funneled into the pipeline for early intervention services. This is as opposed to “worrying families whose children may developing normally at a slower rate than average.”

Our concern at FOCUS Therapy, however, is that in moving the milestone bench marker from “this is the age at which 50 percent of kids have this skill” to “this is the age at which 75 percent of kids have this skill,” the CDC has effectively lowered the standard for who may qualify for early intervention. In turn, that could mean kids who truly need these services may end up waiting even longer than they are now to obtain them.

“We want parents – at the earliest sign of an issue – to start raising the question, pushing for answers from doctors, and getting the ball rolling for evaluations and early intervention therapy services,” said FOCUS Therapy Owner/Founder Jennifer Voltz-Ronco. “This is especially important in regions like South Florida, where it could take months just to get an evaluation, let alone an appointment to see a pediatric developmental specialist and get therapies lined up from there. We don’t want them waiting any longer than they have to because it is already going to take many months to secure these services. All the while, they’re going to be falling further and further behind their peers. The concern with these updated developmental guidelines is that is exactly what’s going to happen.”

There’s also a worry that health insurance companies may not approve treatment for kids if they’re slightly younger than what’s identified in the new guidelines – even if we as parents, therapists, and other health care providers can clearly see the benefit and need for services.

“Our recommendation, if you have any concerns about your child’s development, is to raise them to your child’s pediatrician and press them for a referral to specialists who can conduct assessments,” Voltz-Ronco said. “The earlier we can intervene for kids who have a delay, the better the long-term outcomes.”

FOCUS offers pediatric speech therapy, occupational therapy, feeding therapy, physical therapy, and ABA therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

CDC’s Developmental Milestones, CDC

More Blog Entries:

A New Diagnosis: Pediatric Feeding Disorder & How Fort Myers Feeding Therapy Can Help, June 27, 2022, Fort Myers FOCUS Therapy Blog

social communication

Fort Myers Speech Therapists Teach Social Communication to Neurodivergent Kids

Our Fort Myers pediatric speech therapists recognize there is SO much more to communication than just saying words. πŸ—£πŸ‘€πŸ‘‚πŸ§ πŸ‘₯

As explained by the American Speech & Hearing Association (ASHA), social communication is how and WHY we use language to interact with others. Even though there isn't precisely a "right" or "wrong" way to communicate, there are so many unwritten rules of communication. Over time, we learn how to adjust not only what we say but how we say it - and when - to meet the particulars of whatever situation we're in.

For example, there are a lot of things you might be thinking that you know would be socially unacceptable to say to someone. You may be bored with the stories they tell or not be the biggest fan of what they're wearing that day. But you know the unwritten rule that saying these things would not only be unkind and hurtful, it doesn't serve any good purpose (like keeping you safe).

When young kids are still learning about social communication, they're likely to break these sorts of rules with regularity. (You may have heard the saying, "Kids say the darndest things." And it's because they are still learning about what "filters" they should be putting on their communication.)

But it's not just about what we say. It's what our body language says, whether we can pick up when someone else is trying to engage us in conversation, whether we can infer what someone might be feeling from their facial expression...

Social communication is something a lot of neurotypical people to take for granted, but for kids with autism and other conditions, it doesn't come easily. Our Fort Myers speech therapists break down each social communication component one-by-one to teach our patients how to better understand the world around them - and effectively communicate.

FOCUS offers pediatric speech therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Social communication in autism, explained, April 19, 2018, By Lydia Denworth, Spectrum News

More Blog Entries:

Why FOCUS Asks Parents to Stay in the Waiting Room During Evals, Sessions, April 2, 2022, FOCUS Therapy Fort Myers Blog

occupational therapy Fort Myers

Occupational Therapists: Essential Oils Aid Self-Regulation in Children With Autism

Many of our Fort Myers occupational therapists at FOCUS Fort Myers believe in a holistic approach to treating children with a wide range of delays and disorders. What that means is we focus on “the whole child,” and not just a series of symptoms or conditions – and treat with evidence-based therapeutic strategy and (hopefully, where it’s possible) avoid the need for pharmaceutical intervention. Part of this can involve essential oils, powerful plant extracts that have proven effective in a wide range of applications from boosting focus and attention to promoting relaxation and calming.

Often referred to as “aromatherapy,” (and many do smell very good), our occupational therapists wouldn’t bother to mention it if it were simply expensive potpourri. Far from a gimmick, the truth is there is real science to support the effectiveness of essential oils in numerous applications – from promoting healing in prematurely-born infants to helping a child who struggles with transitions calm and self-regulate.

Exploratory Study Promotes Essential Oils as a Benefit for Children With Autism

On analysis conducted by researchers at AirAse found that certain combinations of therapeutic grade essential oils applied topically every night for several weeks were associated with positive improvements in children’s behavioral, cognitive and emotional well-being.

Down syndrome speech therapy

Effective Fort Myers Speech Therapy for Children With Down Syndrome

Children with Down syndrome often have speech delays and speech impairments. This is in addition to other differences in growth and development, which includes intellectual disabilities and unique facial features. Fort Myers speech therapy at FOCUS can help children with Down Syndrome make strides in their speech and communication skills, which helps boost overall learning and development.

A study published in the International Journal of Speech-Language Pathology reveals children with Down Syndrome may have motor speech deficits that aren’t being properly or adequately diagnosed, which impacts the type of speech interventions their speech therapists use when treating them.

Researchers pointed out that most children who have Down Syndrome have historically been diagnosed with a condition called childhood dysarthria. It’s basically a condition where the muscles we use to talk or breath (i.e., those in our lips, face, tongue and throat) are weak, leading to a motor speech disorder that can be mild to severe. (In addition to Down syndrome children, dysarthria is also diagnosed frequently among those who have brain injury, cerebral palsy, stroke and brain tumors.) What the study authors discovered is among children with Down syndrome, symptoms of childhood apraxia of speech might be missed among those already diagnosed with dysarthria because many physicians assume these disorders can’t be co-existing. Turns out: They can!

pediatric physical therapy

Pediatric Physical Therapists Say Swapping Seats Can Boost Grades

Could improving grades and classroom behavior be as simple as changing a child’s chair?Β That’s what a number of physical therapy researchers have concluded in recent years.

As pediatric physical therapists, we help children improve fine and gross motor skills using “playtime” designed to strengthen or stretch certain muscle groups, manage pain or work on balance. Many of our FOCUS patients have conditions like down syndrome, cerebral palsy or spinal injuries where this type of intervention is obvious. However, we’re increasingly seeing a number who have conditions (co-occurring or singular) like autism and attention deficient hyperactivity disorder (ADHD).

Children with all these conditions are often very bright (sometimes exceptionally so) but may struggle with how to behave appropriately in a classroom setting, especially when required (like every other student) to sit still for long periods, denied opportunities to retreat from overstimulation or outlets to meet their sensory needs. These elements are just as important for them to achieve success in the classroom as any amount of studying.

Pediatric physical therapists have studied this particular issue, and have discovered that for many children with ADHD, dynamic seating can offer important benefits that can help improve classroom behavior and academic outcomes.