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Updated: May 11, 2021

Decades of research on early intervention has shown it to be most effective for improving children’s developmental delays. Federal and state legislation has established birth-to-three intervention programs in every US state and territory. Common sense says that waiting doesn’t help.

Despite all that, studies show that 50-70% of primary care medical providers give a “wait and see” answer when parents first approach them with concerns about their child’s development.

Most of the time, wait-and-see advice is given after a short physical exam and some input from the parent. There’s good evidence that parents give reliable reports about what their children can and can’t do. Sadly, these “wait” providers give much more weight to their brief observations than they do the parents’ information.


All medical providers have access to standardized questionnaires that collect parent input. These tools provide a score that can be used to identify which children should be referred right now versus those who can wait. Why doesn’t every pediatrician’s office use something like this? Good question.

On your next visit to your provider, show them the results from the data tracking you did on the Milestones Tracker app. If your provider’s office isn’t using something systematic to collect parent reports, tell them about the CDC website. This page has free resources they can use for every child.

Your provider could also ask every parent to fill out a free standardized screener before or during an office visit. The ASQ–3 is one example.. Screeners give valid scores that can be used to make a data-based decision about whether or not to refer your child for an evaluation.

The graph at the top of this post is a summary of research studies that were done over 15 years. These were studies on identifying autism, but the pattern is also the same when we look at identifying other types of developmental concerns.

The green lines in 1999 and 2015 are good. They show the average age when parents first talked to their provider about developmental concerns. That has stayed about the same, around 24 months. Parents were noticing early and speaking up about their observations.

The blue lines are not good. These show the average age when the child was first diagnosed—at or beyond five years old. That’s a three-year wait! This result was in spite of decades of effort to educate health care providers about the importance of early intervention, how to identify children who need a referral for evaluation, and where to refer.

There are other factors that delay identification of children, as well. A huge one in the US is the income level of parents, which affects access to health care. Another one is distance to services—rural areas have fewer health care and intervention providers. Sadly, a huge number of children with delays start school after they have missed out on every opportunity for early intervention.


The good news is, you don’t need any kind of referral to access early intervention services for infants, toddlers and preschoolers.

Use this list to find out who to contact in your state.

Skip the wait. Use the Development Tracker app to monitor your child’s development. Use an online screener to get a measurement. If you see red flags, jump on the phone to your local contact for intervention services. If there’s a waiting list, contact us to help find a telepractice provider who can get started with your child now.

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Joyce is very knowledgeable. Not only as a speech therapist but also on how the school system works. Which is very helpful going through the IEP process. She was able to engage with my daughter and was never hesitant to help in any way. I would definitely recommend Joyce to anyone that is looking for a trustworthy, caring and informed speech therapist.

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