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Missed Milestones

How to know if your child isn't on time

When Stacey Wilsey’s daughter Rachael didn’t walk by her first birthday, it was a little disappointing. When she hadn’t taken a step by the age of 16 months, it was more than a little disconcerting.


Like Rachael, many children don’t reach the milestones put in place to measure development. Wilsey discussed options with her pediatrician and realized that her daughter would need some type of help.


“She didn’t roll, didn’t crawl, didn’t walk. She sat up early but that was it,” says the Poughkeepsie mom. At first, she thought Rachael was delayed because she was a big baby and would eventually do things on her own. Then, she was evaluated for hip dysplasia, but the test was negative. When her daughter was 1, Wilsey’s pediatrician recommended the state’s Early Intervention Program (EIP), something the nurse and mom of two had never before heard of.


The New York State Early Intervention Program is part of a national program for infants and toddlers who have disabilities or delays in development. Administered at the county level, the program aims to identify certain problems and provide appropriate intervention to improve development. Research has shown learning and development happens most rapidly during the preschool years.

“The earlier the parent gets help for the child, the better the chance for improvement,” says Gerri Monahan Jones, Director of Preschool at Orange Count AHRC.


But milestones are just that – benchmarks for behavior that typically happens at a certain age. Experts agree that all children are different and must be evaluated on a case-by-case basis.


“The ranges of ‘normal’ are so wide,” says Dr. Herschel Lessin, senior partner of The Children’s Medical Group, which has offices in Dutchess, Orange and Ulster counties. “It’s always a judgment call, but there is no great downside to getting a child evaluated.”

There are a variety of reasons that a child may be delayed, says Lessin. In some cases, there is a family history, or a child was born extremely premature, or there was a head injury. But, he adds, “the most common reason is no reason at all.”

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Parents also need to consider their child’s environment. Are you worried that your son won’t feed himself, yet you never give him more than one chance to try using a spoon? Do you stop letting your child play on her stomach after just a moment of crying? How parents react to their child’s behavior is just as important to EIP providers as what the child is doing, says Monahan Jones.

After being referred by your pediatrician, a team of EIP specialists will evaluate your child. There is no cost and you do not have to be insured to be a part of the program. Lessin recommends discussing any concerns you have with your pediatrician immediately. Doctors should be asking age-appropriate questions at every well-child visit.


“And you should not be afraid to ask questions,” Lessin says. “If a parent doesn’t think something is right, they should mention it.”


While parents can contact their local health department without a referral, most cases are sent to EIP through the recommendation of pediatricians.