Age 4 is quite late to evaluate a child who is not speaking


January 13, 2002|By T. Berry Brazelton, M.D. | T. Berry Brazelton, M.D.,NEW YORK TIMES SPECIAL FEATURES

Q. Your answer to the grandparent of the 4-year-old who did not talk was somewhat incomplete. You suggested that it was time for an evaluation -- and already late. You also suggested having physical causes ruled out and having the child seen by a child psychiatrist or psychologist.

I am a certified teacher of the handicapped and have taught in both preschool handicapped (3-5 years) and early intervention (birth to 3 years) programs. I currently have a preschool class of six children with various types of disabilities, most of which center on significant speech and language delays.

Four years old is indeed late. I wonder why the child mentioned in your column has not been referred to his local public school district for evaluation and testing.

The federal government has mandated that services be provided to all children who qualify for special education. The earlier problems are identified, the greater the chance of eliminating or minimizing them. Early-intervention services can begin at birth.

At 3, children who have suspected delays should be referred to the Child Find coordinator of their local school district. Child Find is a federally mandated program which requires school districts to seek out children with suspected delays in the areas of speech, hearing, movement, thinking or behavior. The school district will test a child free of charge and can provide him with appropriate services immediately.

My heart goes out to these silent children who have so much to say and so little way to say it. In time, and with a lot of help, they often significantly improve their ability to communicate.

A. Thank you for your additions to my answer about when and where to seek help. Parents should know that the Child Find program may have different names in different communities.

I've always felt that if a child is not beginning to communicate verbally by age 2, he should be evaluated. If he can communicate behaviorally, that's a positive sign. If his hearing is intact, it points to other sources for his delay.

I, too, was surprised and saddened that the parents of the 4-year-old had waited so long. All too often, when parents seek help, they're told: "He'll outgrow it." A child isn't likely to outgrow such a speech delay, and parents who are concerned should continue to search until they find the help they need.

Address questions to Dr. T. Berry Brazelton, care of the New York Times Syndication Sales Corp., 122 E. 42nd St., New York, NY 10168. Questions of general interest will be answered in this column; unpublished letters cannot be answered individually.

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