How to Know When Your Child Needs Help


As an independent educational consultant, I speak with hundreds of parents every year. Most of them have typically developing children and simply want assistance exploring area schools. Sometimes, however, parents have questions about their children’s development and specifically want to know when it’s just normal differences in how kids grow and when to seek help. Parents can’t help but compare their own children to those at the playground, preschool, and social events and sometimes worry that their kid is falling behind.

Different rates of development, even within a single child, are normal. Some kids are speaking in full sentences before they’re walking confidently, while others are running across fields but still using single words to communicate their needs. Similarly, some preschoolers march off into the classroom with barely a look behind them, while others cry as if they’re being left at the orphanage. Other kids seem fine earlier on but can start to manifest issues later as they start more formal schooling or approach higher levels of education.

So when is it just normal child development and when should you seek professional assistance? For guidance on this issue, I turned to the experts.

Speak With The Teachers

All of the experts I consulted urge parents to speak to the child’s teachers, whether in daycare, preschool, elementary, middle, or high. These people have seen hundreds, even thousands of kids your child’s age and can usually parse out what is typical and what might be a problem. Schedule a meeting with the teacher to discuss your concerns. The teacher may suggest formal testing, but even if this isn’t yet necessary, you have raised your concerns and the teacher can watch your child more carefully with these thoughts in mind.

But Don’t Necessarily Take Their Word For It

Sometimes teachers don’t pick up on the problems, though. As one DCPS special educator laments, “The simple answer should be: ask your child’s teacher. But that is so hard because, for example, some parents have said that they have had concerns for a few years and asked teachers and were told things were fine. And they were not fine.” So even if the teacher dismisses your concerns, that doesn’t mean you shouldn’t move forward with an evaluation.

One mother, who is also an Occupational Therapist in DCPS, went ahead and did private testing for two of her elementary-age children even though they were on grade level and the teachers weren’t concerned with their performance. “Yes, they were always on grade level, but they also had attention issues and hyperactivity. I didn’t want to wait until they were falling behind in school to get help.” They were both diagnosed with ADHD and with therapy, and medication, have been making even greater strides both academically and socially.

Test or Wait and See?

Teachers and experts often disagree on whether you should pursue testing as soon as you detect a lag in development or take a wait-and-see approach. Dr. Cheryl Shapiro, a psychologist who conducts educational testing, says she considers a variety of factors when making such recommendations. “Some of it depends on age,” she says. “With kids who are in kindergarten, I always talk about how there’s a push/pull. In the past we didn’t expect kids to read in kindergarten so there’s something to be said for giving development some time. However, if there’s a history of a speech delay and/or the teachers are concerned, it may make sense to test sooner because we know that early intervention is important. For older kids,” she continues, “I always want to hear teacher feedback and any patterns. If the child has been struggling for a year or two, then it may make sense to test, especially if the child is falling further behind rather than gaining ground and closing gaps.”

Maintaining a positive attitude about school is also important. As Dr. Shapiro notes, “We want kids to enjoy school and be excited about learning, especially in elementary school. If I hear that a child is starting to develop a negative attitude toward school or is feeling down about themselves, then it’s time to consider testing to see about getting them extra support. Even if there’s no diagnosis, the family gets a lot of information about their child’s strengths and weaknesses and there are recommendations for how to support them.”

Private occupational therapist Kristen Masci recommends testing right away rather than waiting. “If a parent identifies their child as beginning to experience challenges, it is best to obtain comprehensive testing early on,” she says. “Determining the underlying skill deficits can provide a specific roadmap for educators to follow when selecting alternative teaching methods and allow appropriate compensatory strategies to be put in place. This prevents repeated trial-and-error methods from being used that can waste time and lead to the student experiencing ongoing frustration, emotional, or even behavior issues.”

Even before formal evaluations, if the school agrees to begin some interventions, it can be useful to observe a student’s response to such assistance. “You develop a better understanding of them as a learner, which can inform an evaluation beyond the standard cognitive and educational assessments,” explains one DCPS special education teacher. “When you go into an evaluation with questions or theories deeper than ‘why is reading hard for them right now?,’ you can get more out of an evaluation because the provider has questions to probe.”

What Do You Do If You Think There Is A Problem?

Once you have flagged problems you have a few different routes to follow for testing. Free, public evaluations are available to all residents of the District. If your child is under the age of three, the city will evaluate under a program called Strong Start. Starting at age three, Early Stages takes over. If your child is in kindergarten or above, regardless of what type of school they attend (or even if they’re home-schooled), your in-bounds public school has the responsibility for conducting such evaluations. Please note that that does not mean that they will do a full battery of testing. They will start with a review, to determine if such testing is warranted. Sometimes, even when there does turn out to be a diagnosis, the public system does not get to the point of that diagnosis, either because they never do the full testing or because the full testing produces a negative result.

In these cases, and/or to speed along getting answers for your struggling child, parents might want to seek out private testing. If you have insurance it will probably cover at least some of the costs, but often the fees must be paid up front and then you get reimbursement from your insurance company. In most cases there are minimal to substantial copays involved. Pro tip: some offices have pro bono slots that you can apply for. You can also ask for a discount if your insurance isn’t going to pay for the evaluations.

What Happens If You Get A Diagnosis?

A lot of people think a diagnosis automatically means intervention – an individualized educational plan and/or accommodations at school, therapies, medications – and this does often happen. However, just because your child’s issues might be causing them to struggle, if it’s not impacting their actual school performance, the school might not implement any assistance. Many families have to seek private therapies in order to support their children. You may want to pursue such therapies in addition to what the school offers, since more is often needed. Parents may also want to explore medication to help their children’s functioning.

You’ll Never Regret Finding Out That Nothing Is Wrong

Regardless of what interventions end up being put in place, it is always helpful to understand your child better and support their strengths and weaknesses. And remember, you will never regret finding out that there’s nothing wrong and that your kid is just experiencing normal leaps and lags in childhood development.

E.V. Downey is an educational consultant based on Capitol Hill. In addition to helping families navigate the school system, she is co-director of Busy Bees Camps. She also teaches flute at Music on the Hill and tutors elementary and middle school students.