How Does Early Intervention Work?

Updated on February 02, 2012
M.M. asks from Chicago, IL
21 answers

Hi all,
My DD is about to turn 18mos, and mostly, she's not talking. She uses Mama, Dada and Kitty regularly.
Apart from that, nothing. She HAS words. I have heard her say blanket, cup, bink (ba ba), Uh-oh!, and banana (nana)...but she won't use them. She prefers to walk over to something and grunt and point at it when she wants it.
I've tried making her say it by witholding what she wants...she wins that fight with a screaming fit each time.
I've tried walking away, and she'll get mad, and then just go find something else to do.

She understands my very well, and quite a bit. She follows basic orders quite well ("put this in the trash", "Go get your cup", etc...). She's just not talking, seeminly, becuase she doens't want to.

I'm guessing that the ped is going to want us to do early intervention when we go for her 18mos apt. So I'm just curious what that involves?

What can I do next?

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answers from Minneapolis on

speech therapy and working with her a lot at home. No magic pills :( My cousins baby was speech delayed at 18 months. It was mostly just going in to a speech therapist weekly.

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answers from San Francisco on

My nephew was exactly the same. He would not talk for anything. My sister lived with my mom and my mom ran the roost so sis didn't have much to say when mom put her foot down and absolutely FORBADE anyone giving my nephew anything unless he at least made an attempt to speak. My sister was heartbroken for days watching her little one cry, but it worked. It didn't take long for him to realize that no one was going to cave and if he wanted something, he was going to have to at least try to say it.

So, while I agree you should look into early intervention, don't be surprised if they tell you there is nothing wrong, she is just bein stubborn and lazy. You will do her a world of good if you stop giving in to the tantrums.

3 moms found this helpful


answers from Los Angeles on

I am an early childhood interventionist, and I have seen the therapy work very well for a lot of kids. Even if your pediatrician is not concerned, I would push for the therapy if you can. Someone said 18 months is too young, but by the time you actually get someone coming to your house she might be 2 already, so you don't want to wait. I have worked with kids as young as 10 months so it's never too early! We really force the language to come out and help stop the behaviors. It's not a miracle but the younger you start and the more on board YOU are with it (i.e. using the methods outside of the sessions) the better it works.

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answers from Chicago on

My son did not say a word when he turned 2. We contacted early intervention. They did an evaluation & started speech therapy for him. It did wonders.
He is in kindergarten now & is talks as well as his peers.
I couldn't have made a better decision.

2 moms found this helpful


answers from Jacksonville on

My son at 18 months didn't have any words and didn't even point or grunt to let us know what he wanted, so I don't know if this will work for you. Our specialist has us use sign language. The thought being that you can't force a child to talk but you can move their hands. This helps them to understand that words have meanings and if they ask for things, they will be given to them. We started with eat. Whenever we would sit down to eat, would have him sign eat. We would just put a little on his plate. If he wanted more he had to sign more or eat. We had to help him at first by moving his hands. He was resistant at first, but he did catch on and started asking for things,
My son really liked the signing times and baby signing times dvds. You can check them out at the library.
My son started with EI at 18 months. He just turned 3 and is doing really well with talking. We don't use sign language anymore.

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answers from Chicago on

You call the early intervention phone number, they set up an appointment time for you and the child to come in, or they may do it at your house. They will tell you if the child qualifies for any services. If they do qualify then they usually come right to your house (or daycare) and do whatever services you qualified for. It's that easy.

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answers from Dallas on

I think your expectations are too high. My oldest son barely said anything understandable until he was 3. He graduated high school with honors and does public speaking since graduating college.

I know that your question was about early intervention, but I think you may be putting too much pressure on your little girl. I doubt she needs anything.

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answers from Dallas on

I think she sounds pretty normal and I doubt your doctor will be concerned. You can continue to help her develop her skills by reading to her, doing rhymes/poems/nursery rhymes with her, singing/ music in the car, and by modeling the language. If she wants a drink and walks over and grunts at your, Say "Oh, I think you mean that you want a drink. Say "Drink, please" and then hand her the drink. Even if she does not say it. When she DOES say the words, go wild with excitement!

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answers from New York on

Even if your pediatrician doesn't recommend it, I'd call early intervention. It will take a little while to get scheduled, have a meeting and get started. It is only available till age three and it's much harder to get help after three. They evaluated my son for free in my home, and the intervention he got was VERY inexpensive and convenient. Your daughter might not be that far behind but it sounds like she will not progress as she has decided to scream, not talk -bad sign that she finds speech frustrating. In the meantime, teach her the word and the sign language for "Please" and insist she use it when she wants something, it is easier for her than coming up with the correct label for what she wants but teaches her she must use words to ask for and receive something. For the next week use the word and the sign for her, then push her to say it. Then start walking away from tantrums without giving in! Put yourself in a nice quiet time out and know that screaming will not hurt her as much as rewarding and reinforcing screaming will hurt her.

1 mom found this helpful


answers from Richmond on

Usually 18 months is when pediatrician's begin talking about EI. Do you have any other children? They take their milestone's into consideration as well.

My pediatrician got me in touch with EI just after my son's 18 month check up. Once you're in touch with them, it takes quite a while (I'm assuming depending on your state), usually 3-5 months to review applications. My son was accepted within a week, because his case is considered 'severe'.

He had to undergo a full developmental evaluation and go to an ENT before you could even apply. After that, they sent a team out to my home to evaluate him (they like to do this at home, since it's within the child's comfort zone). After that, he was either accepted or denied (like I said, in his case, he was accepted immediately.)

Then you come up with a game plan and create 'goals'... and after that, you begin speech therapy (and/or OT therapy, and/or group therapy)... and that's when the real work begins ;)

GOOD LUCK!! My son is 2 and has the vocabulary of a 12 month old, but EI has worked WONDERS and he's definitely improving! He still has a ways to go, but he's getting there :)

Like your kiddo, my son understands *everything*... he just doesn't speak. He grunts and growls and gets mad (well, that's all he was doing in the beginning)... but now he can say a few more words and even put two words together, like 'bye dada!'...

We also figured out that, as a younger baby, he never put things in his mouth (which is how babies explore their environment and it's important because that's how they learn to work their tongue muscles)... because he skipped that step, he's a picky eater, and it's directly related to his not speaking. We're getting there! You'd be surprised, in hind sight, how much contributes to the issues she's having now!! PM me if you'd like more info :)

Good luck with your daughter!!

ETA: Stick with your mommy gut. If you truly feel like there's an issue, keep bringing it up with her doctor. Everyone told me my son was on track, that he's normal for that age, his big sisters must be speaking for him, etc, etc... and it turned out to be a SEVERE speech delay. Trust that instinct mama!!

1 mom found this helpful


answers from Rockford on

I actually just started this with my son. He wasn't speaking so we had him evaluated at 17 months (he's 19 months now). Like you, I knew he had words, he just refused to use them, and would grunt and scream more than try to use words. Our pediatrician referred us to Child and Family Connections. They actually sent someone out to our house, to ask about my worries and what types of things he was and wasn't saying. They do a basic question and answer with you about your child, to get a feel for what is going on. After that we had an appointment with two developmental therapists, who came to our house and, basically, played with my son on the floor with a few toys to see where he was in development. That lasted for 45 minutes, then I talked with them for 45 minutes. They recommended I have his hearing tested and that he have speech therapy once a week. The speech therapist comes out to the house once a week and works with him. He's already started saying more words and expressing himself verbally more!
That was my experience with early intervention. Child and Family Connections has a web site too, that might give you more information.

Best wishes!

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answers from Washington DC on

Your daughter sounds just like my daughter. She is 18 months and in the same boat. She has been part of an Early Intervention (EI) program since she was a year old. She originally was an automatic participate because she has a heart murmur but once she was evaluated they recommended speech, EI and physical therapy (she was a LATE walker). Now we have dropped the PT but picked up Occupational Therapy. I once asked the speech therapist when I should be ‘worried’ that she doesn’t talk much…she replied ‘when do I worry or when does a pediatrician worry’ apparently they differ. 18 months is when therapists would like to see them start but most start at around 2 years at the recommendation of the pediatrician. We also taught her simple signs to help with her frustration.

EI can only HELP your daughter and do no harm, so why not just get her evaluated? Then go from there. Good luck!!!

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answers from Washington DC on

hon, i think you might need the intervention!
she sounds like an awesomely strong-willed little person, a trait that will serve her well as she grows up. and she is training you very well indeed.
for starters, i wouldn't try to *make* her talk, it'll just get her back up. setting it up as a competition that she 'wins' by melting down is a losing proposition. but you can make it easier and more comfortable for her to meet you (not lose to you) by setting it up so that she 'wins' by opening up her communication. i'd start by being very opportunistic about her talking. when you do hear her say 'blanket', don't go all nuts with praise, but use the occasion to open the door to a simple dialogue. 'yes, honey, blanket's on the floor! pick her up, please.' or when you know she wants a banana but won't ask, dance around the kitchen singing a banana song, make the word irresistably fun to her. play with words and concepts, don't allow them to become forces of opposition.
sorry, i know that's not what your question was about. i'm just thinking that what this strong little girl needs is for you to decline the battle, not necessarily to ramp it up with intervention.

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answers from Dallas on

18 months is still too young for early intervention, IMO, and according to our pedi. My daughter had the same problem, she only said a handful of words by her 2-year checkup. The pedi said they do most of their verbal developing between 2-3 years, so we did nothing and sure enough, right around her 3rd birthday, she just opened up and started talking. She learned oodles of words daily, and she hasn't had a single problem since.

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answers from Houston on

Neither of my boys were saying much more than what you described until they were about 24+ months. Just like your daughter, they could follow directions, knew a few words and would communicate by pointing and following directions. I was also told by friends/family to have them evaluated/ have their hearing checked, but my pedi said they were totally fine so I never worried about it. Sure enough, one day they just started talking in 2 and 3 word sentences.

But, for eci, they typically come and make an evaluation, then proceed with setting up therapy if needed.

You can help with the word development and encouraging the use of words yourself though in the meantime, by story play, exploring, word games, reading, flash card games.... Also, don't give in to her screaming fights when she won't use her words... walk away.

Here are warning signs... it doesn't sound like your child has any of them, except for maybe not saying 15 words, but that doesn't have to mean consistently. If you look back it may surprise you how many words she does know:

However, getting evaluated and some therapy to help her progress never hurts either, so if you are really concerned, then you can always go that route if they determine it is needed.

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answers from Kalamazoo on

We used EI through the state of IL for my now almost 3yo. I highly recommend it. Call the department for your county and they will put you in touch with a case worker who will organize and schedule all the evaluations. They came to our home and did all of the evaluations for free. They will do them every three months at your request too. If she needs it, great you can take advantage. If she doesn't, at the very least they can give you some pointers. Go ahead an try it, it's not going to hurt.

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answers from Chicago on

When we used it, I began by calling the office where we are located (Kane County) and requesting an evaluation. After being evaluated, my daughter qualified for physical therapy as well as speech/developmental therapy. The therapists came to our house for the sessions and continued until the appropriate progess was achieved. The sessions were billed through our insurance company.

I'm attaching a link that will explain the process in Illinois. If you have any specific questions, please feel free to send me an email.


answers from Chicago on

Wow, it is dissapointing to read that many found they had to wait for EI services, in Tx I called and with in a week they did an evaluation and began services, maybe it was because of his age (30 months) and they only had 6 months to do anything with him, either way it saddens me. Your pedi does not have to send a reccomendation or anything you can contact them, they will contact your pedi and keep your pedi up to date on services and what is going on. I liked that my pedi would call periodically to discuss some of the reccomendations made by the therepists, mostly OT and he seemed to be involved and invested in my son's development. My son grunted and pointed as well and what we did in the begining was
Child grunts/points
Parent Oh what do you see?
Child grunts/points
Parent is that a banana?
Child grunts/points/squeels
Parent Can you say banana please?
Child grunts/points/squeels/screams
Parent can you say Ba Pa? (asking for first sounds only now)
Child screams - remove child from situation, calm child down, say "Sarah, can you say Ba Pa? (while holding the banana)" if they make an attempt you cheer give a small bite and ask her to try again.
My son's issue was caused by one huge ear infection that kept flaring up from 3months until 2.5 y/o when we got him tubes. Each time we followed up after the round of meds it appeared to be gone, it was only "gone" enough to LOOK like it cleared up and would slowly make its comeback! Either way the day he got his tubes in it was an explosion of words - now we had to teach him HOW to use them correctly since he could understand and be understood! EI works wonders if you utilize their services correctly and to the fullest. I will reccomend that if they offer a service TAKE IT! We were offered Speech, OT, Developmental Play Therepy and a Family Councilor - Each were a blessing in their own and my son LOVED their visits. I will also reccomend that if your child does have multiple therepists that at least once amonth they overlap their visits or have a longer group visit so EVEYONE is on the same page. We did this frequently because Speech did not want to counter what OT suggested or what DPT suggested and often that was when our BEST solutions came because we could come up with a plan/activity that addressed all the concerns at once! The Family Councilor - she was all MINE, she would visit with my son a bit based on his desire to interact with her but we would sit on the couch and drink coffee and talk about what was going on each week and discuss me and how I was doing since the others were there for my son. I tell you - a blessing EI was just a blessing to have.



answers from New York on

She sounds Ok, to me, but I am always a fan of getting an evaluation. You can call them now because it takes several weeks to get someone out and then another few weeks to start treatment if she qualifies. You do not need a referral or anything, although when you call they may ask what your pediatrician has said. They will ask you questions on the phone like what your concerns are and how many words she has. They will then come out and do an evaluation. You may have a good or a bad team, it's usually 2 people. We had a speech therapist who was good and an occupational therapist who was not. Anyway, they will most likely score your child way lower than you thought so don't freak out. This is especially true if your child has never been evaluated and is younger. Then they will tell you if you qualify. After that someone will call you and come out and discuss your goals. Then they will assign you the therapists that the original team reccomended. They will usually start you out with once a week. You will need to provide last years taxes because the rate you pay is based on your income. Honestly, if insurance covered my son's speech therapy I would have done it at the therapists office because EI always does it at home (sometimes a park or library) and my son did not like people coming to our home someone putting a lot of demands on him. So be prepared.



answers from Dallas on

I can only speak for the ECI process for Texas but am assuming it may be similar for IL. They will come to your house and do an eval. It is free. For speech if they are found to have at least a 3 month delay then they will qualify for early intervention treatment. My daughter had speech therapy from 18 mos to 2.5 yo. They would go to her daycare and do the therapy. They base the cost on your income. For example, my cost was $100 per month. If you don't make much money, it could even be $0. If they still need help after age 3, then it goes through the school system.



answers from Pittsburgh on

She may be too young for a speech eval....not sure. Definitely check with your pediatrician and express your concerns.

BUT I can tell you this friend had a son that required EI and services. (This is in PA, but I'd assume pretty standard OP.)
He was evaluated and they determined which services from which he would benefit (ST, OT, etc.) and they set up a schedule for the therapists to come to the house & do it. I believe the process involved her applying for SSI for him, so that everything would be completely covered. (He was older than 18 mos. when this began)
This followed through to IEP's and a TSS in class when he was school aged.
So...she might be too young yet AND it might be nothing, but I think you are SO on the right track for thinking about it and getting your child any & all help/services available to her!

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