The TODAY show on NBC began a 3 part series on parenting children with special needs on August 29, 2001. Below are excerpts from the interview with Dr. Stanley Greenspan.
The TODAY show on NBC began a 3 part series on parenting children with special needs on August 29, 2001
Does your child have special needs?
Tips for recognizing the signs and what you can do to help
TODAY SHOW CONTRIBUTOR
Aug. 29, 2001 — Some parents know right away that their children have a mental or physical problem from birth, but for others it takes months or even years to discover there is something wrong. On NBC’s “Today” show, child psychiatrist Dr. Stanley Greenspan, the author of many books including “The Child with Special Needs,” shares some advice on recognizing when your child has a problem. Read his thoughts below.
THERE ARE millions of parents who are affected in some way by a child with special needs. Autism and PDD (Pervasive Developmental Disorder) occur in approximately five to 15 per 10,000 births. There are an estimated 7.5 million people with mental retardation, and also included in “special needs” are children who are blind, deaf, with ADD (Attention Deficit Disorder) and other disabilities. This topic strikes many homes.
DEFINING SPECIAL NEEDS: I think the best way to define “special needs” is a delay or problem in one or many areas of developing — problems with forming relationships, in communication skills, motor skills and movement or in thinking skills — all the things I think people can relate to. Basically there is a problem in one or more of these four areas: -The ability to relate or form relationships -The ability to move or movement -The ability to communicate (gesture and preverbal as well as words) -And having thinking skills
There can be many different reasons for them, from thyroid problems to Down Syndrome. A problem or delay in one or more of these areas means there is a problem. Those four areas are the framework of what to look for.
EARLY IDENTIFICATION AND LABELS: Are there any signs parents should look out for? What parents want to look out for are the following. In addition to the traditional motor (sitting up and walking) and language skills, which are pretty well known signs, there are other thinks to look for that are more subtle, but can help detect problems at an early age. So again in addition to the traditional motor and language milestones, look for the following. These are the three best early indicators:
AFTER 4 MONTHS: WARMTH AND JOY IN RELATING Anytime after four months of age, look for whether your child relates with real warmth and joy, with big smiles and delight. If you are not seeing that you may want to get an evaluation.
AFTER 8-9 MONTHS: BACK-AND-FORTH COMMUNICATION WITH GESTURES This is based on communication. After 8-9 months you should expect your baby to engage in back-and-forth communication. Returning sound with sound, reaching out with hands, smiling back or initiating smiling. Again, if you notice your child does not do this, it’s reason to consider an evaluation.
12-14 MONTHS: EARLY PROBLEM SOLVING Next look and see if your child is developing early problem solving capacity at around 12-14 months. Your little toddler should be able to use back-and-forth communication to solve problems. For example taking your hand and walking you to the fridge and telling you what he/she wants. It’s back-and-forth communication in order to problem solve.
18-20 MONTHS: PRETENDING After 18-20 months you should be looking to see if your child is pretending. Look for the beginning of pretending — kissing dolls, pretending in play.
HOW IMPORTANT ARE THESE MILESTONES? These milestones — we call them functional developing milestones — bring together all of the child’s abilities. They are much more revealing and they’re very important because if your child is lagging in any of these areas it can be an early indicator of a problem. You want to have this taken care of as quickly as possible. We are doing this to help the child get extra practice, to have a full evaluation if he or she needs it. It should be a full evaluation. It should be comprehensive, relating to movement, communication, relationship and thinking skills. This can help parents to start developing a comprehensive early intervention program if necessary.
COMPREHENSIVE EVALUATION BY YOUR DOCTOR: What do you do if you suspect there’s a problem? Get your child an evaluation that assesses all of these (mentioned above) areas. And then develop an intervention program. Make sure it has the following elements: 1. Address all the areas we discussed (relationship, movement, communication and thinking skills) 2. It needs to involve the family and needs to empower the family to be a co-leader. 3. It needs to work through the family to improve child’s skills, using the family relationship. 4. And it needs to have a very intensive home program. Your child has 12-14 waking hours and if you or a professional only works with a child for three hours a week, it is not enough. Most programs aren’t intensive and don’t give parents enough work to do at home. And the program needs to be tailored to the individual child. Every child is different; tailor an approach to the child. This is not a one-size-fits-all situation.
DON’T LET PROFESSIONALS OFF THE HOOK: There are a lot of complaints from families of special needs children about how they are told their child has problems. What’s the proper way to break the news and what should you do as a parent when you hear the diagnosis? As parents, once you are told, you need to ask questions like: What are the challenges in each of these areas? What do I do, as a parent, to help promote development in each area? Because you want to know specifics and if you don’t ask, some doctors might not tell you. Most doctors will just tell you the diagnosis and then just send you to contact early intervention. That’s not terribly helpful to parents who have just heard this devastating news. You, as parents, need to get your doctor to be more specific. This is an area that is lacking, and it’s up to the parents to change the system. Parents should not let the doctors or educators or psychologists off the hook. Don’t let professionals off the hook. If they can’t provide the answers find someone who can. I find most parents want specific answers that empower them to make the next step. Again, the questions are: What are the challenges my child faces, and what do I do about it at home or with other professionals?
SHOULD PARENTS BE WEARY OF LABELS? Until a child stops making progress you shouldn’t be eager to apply labels that establish some permanency until the child’s progress levels off for a couple of years.
MOVING BEYOND THE LABEL A label is really only a ticket to services. You need to know where the challenges are in every step. You need programs at each phase of your child’s development. The earlier on you get a child with special needs help, the better. You need to start in the early years to school years and continue to adolescent and adult years.
GUILT AND DEALING WITH THE PROBLEM EMOTIONALLY How should parents deal with guilt, anger and grief? Once you hear your child has special needs it can be very hard on families. Yet a lot of growth can occur in families when they meet these challenges. But we, as a medical community, and with other parents of special needs, have to supply growth and tools to meet these challenges. Parents need respect and support.
WHAT CAN YOU EXPECT AS A PARENT OF SPECIAL NEEDS CHILD? What you should expect and remember is that a vast majority of cases will have continuous progress with ambitious programs where parents are full partners in the school program and a home program. Parents need to be very involved in helping their child along — at home and at school.
Dr. Stanley Greenspan is a child psychiatrist and the author of many books on child development including, “The Child with Special Needs.” For more information you can visit his Web site at: www.stanleygreenspan.com ..