The importance of early intervention

In my line of work I come into contact with many parents and children. When a parent first contacts me, I can already tell a lot about them, their parenting style and how they feel about being referred to therapy. I have had a lot of unwilling, disbelieving parents contact me over the years. I empathize with all these parents, hearing that your child may need additional support is worrying and disconcerting.

Some parents, overly concerned at the news, will look for information and phone a therapist the same day wanting to book an immediate appointment (that one is me!). Other parents may shrug it off and blame the teacher for not doing their work. Some parents identify with what their children are struggling with in themselves – reasoning that they coped with the difficulty and never went for therapy, so their child will also manage. Or that it is just a stage that their child is going through.

Then I also work with parents that were never informed that their children struggled early on although the signs were there, and are now seeking help when their children have academical difficulties and are struggling to keep up with schoolwork in higher grades. Parents who wish that their children’s pre-school teachers picked up these difficulties earlier, so that it could have been addressed before leading to several secondary problems.

So why is early referral and intervention so important?

To understand the power of early intervention you need to understand basic neurology. Our brains have plasticity and can change. You might have heard the phrase ‘neurons that fire together, wire together’. Well, in children their brains are developing at a very rapid rate and because of this, it can change more readily. Before skills are consolidated, or pathways are set, we can do a lot to change the brain’s function and structure. A lot of studies have proven this over the years.

The second reason is that a child of 3 years old, is not expected to do what a 10 year old should do. A 3 year old still needs to develop a lot of skills that a 10 year old have already developed. Because skills build upon one another, a lack in one area will affect the development of many skills. A 3 year old might need to work on gross motor skills, where-as a 10 year old will have to work on gross motor skills, fine motor skills, handwriting and quite possibly anxiety or a lack of self-esteem because they have been struggling to keep up all these years. See the difference? If you catch and remediate a problem area early on, you get the development of subsequent skills back on track. The brain is so integrated, nothing happens in isolation so one system will affect the development of many others.

What always concerns me is the emotional sequelae of a child that is struggling in a specific area. Children are keen observers, and quick to realize if they can’t finish a task as quickly or as effortlessly as their peers. This can lead to avoidance and anxiety or a lack of self-esteem which then permeates through various occupational areas. Suddenly they don’t feel good enough socially, or they don’t want to participate in sport any more, or they become clingy and don’t want to separate from parents. Nobody can master everything equally well, we all have strengths and weaknesses. But a persistent struggle in a developmental area without understanding and support can become too much for some children.

I recently walked this road myself. My son was diagnosed with glue ears at the age of one which then cleared up without intervention. Unaware that this was recurring I became frustrated with his change in behaviour at times -not following instructions, bumping into everything, having massive meltdowns and falling to the ground, being emotionally labile, anxious and demanding. Other times he seemed fine and I would see his skills progress. I never put two and two together until his speech therapist referred me to an ENT. At age 4 he had recently had a tonsillectomy, adenoidectomy and grommets inserted. When the doctor examined him he had glue ears and very limited hearing. I ask myself – on and off for four years he felt as if he was under water – his hearing was affected, his balance was affected, how scary the world must have been! It must have felt horrible to have constant pressure in his ears and not being able to do anything about it. Do I wish we intervened earlier?– yes, with all my heart. Now we need to remediate four years of faulty neuronal wiring – not only in his auditory system, but in his visual system, postural system and emotional system. He needs to learn that his body is safe and his environment is safe. His postural system and balance reactions need to develop. His visual system needs to integrate with his changed auditory and movement system. If we intervened at age 1, he probably would not have all these secondary challenges. Luckily his neuronal wiring can change, but we will have to put in the work.

Nowadays I am one of those parents that look for red flags so that I can intervene early on. I applaud teachers that can pick up challenges and intervene before they become obstacles. The world has changed a lot since we were children and the demands are much higher. My wish for all children is that they can get the support they need so that they can flourish in their environments, even in the face of increased demands.

The early years remain one of the most effective times for intervention. It is a window period of golden opportunity that we should embrace, welcome and not disregard.