Who should evaluate your child

In our program, we have a multidisciplinary clinic that meets together a few times per month. We evaluate three children in the morning, with a rotating system, and then meet with the parents in the afternoon to discuss our findings and recommendations. Many early intervention programs offer a similar clinic.

In other programs, the different professionals assess a child one at a time, often in the child’s home. In some cases, the evaluating clinicians meet together at the end to compile the results (usually in written report form), but in other cases, the parents get individual reports from each clinician. Either way, the program generally assigns a paraprofessional who can help interpret and integrate the results, and who can help set up the recommended therapy(ies). Your child may not need to be seen by each discipline, and this case manager can help you identify the areas that are most important to look at.

Our program’s evaluating professionals consist of the following people, and this list is fairly standard for early intervention programs. I’ve included a brief description of each person’s role:

Pediatrician: He or she does a basic medical exam, identifies lab work or other screenings that need to take place, plots the child’s height, weight, and head circumference (ideally on growth charts appropriate for the child’s country of origin.)

Psychologist: He or she performs developmental/intelligence testing, discusses attachment, and examines mental health and behavior.

Speech-Language Pathologist: This is my role. I look at speech and language development, including English as a learned language (ELL), identify oral-motor disorders and feeding disorders, and also address sensory integration as it relates to speaking and eating.

Audiologist: This is my husband’s role. ? He evaluates hearing and middle ear function.

Physical Therapist: He or she addresses mobility, muscle tone, gross motor planning, balance, and structural integrity.

Occupational Therapist: He or she looks at sensory integration, body awareness, fine motor skills, motor planning, activities of daily living (dressing, feeding, etc.) and prevocational skills.

Nutritionist: He or she addresses dietary intake, diet restrictions, dietary history, eating habits, food preferences, and any medical issues that affect absorption of nutrients and use of calories from food.

Qualifying for services

There are two primary ways children qualify for services once the evaluation has been completed:

1. The child has a diagnosed physical or mental condition that has a high probability of an ongoing developmental delay (autism and Fetal Alcohol Syndrome are examples.)
2. The child has a 50% delay in one tested area, or a 25% delay in two or more areas.

Even though I work on an assessment team (or maybe because I do), several of our children have been through our clinic. Most recently, our daughter Cora was seen about three weeks after she came home from Haiti, and – no surprise - physical, occupational and speech therapy were recommended. She has made tremendous gains in the three short months since she’s been home. In that time, she went from crawling only a few feet at a time, to using a walker, to walking independently (she’s 21 months old), and has gone from having no expressive language skills to using several signs and about 20 single words. She’s a testament of the blessing of early intervention to adoptive families!

Further recommended reading:

Spotting Problems in Your Child’s Development

Should You Request a Sensory Integration Evaluation for Your Child Adopted from an Institution?

Prenatal Drug Exposure: What Parents Need to Know

Accessing Early Intervention