We live in a world today where we get packages delivered in same day / next day services, where we click on a button for instant gratification, where we, as a society, do not have to wait any more. It is all about getting what we want when we want it. It has been quite interesting to listen to our friends complaining how Covid19 has slowed down production of certain things and we now have to wait longer before we receive it. Another feature of life today is that we overschedule ourselves so we hear many people note that they are “soooo busy”(Myself included, lol)! There is always something we have to do. In the midst of all of this, we have children who may struggle with a developmental delay with or without a diagnosis. Developmental delay is defined by the understanding that development is occurring at a slower speed. This does not mean that the child’s intelligence is slower, simply that the nervous system is operating at a slower rate to accomplish the massive amount of development that needs to occur especially in the first 7 years of a child’s life.
A developmental delay is not a life sentence and it is not a brain injury. Our brain is neuroplastic and has the capability to change, to cope, to adapt to every stage of our lives. Somewhere though, a notion has started for families that the child has to “catch up”. One wonders what this means for different families. And also, who is responsible for leading families into this state of perpetual worry if their child is going to “catch up” or not. Though it is not the only consideration, there is a strong indicator that we as professionals do carry some of this blame. We do evaluations comparing and contrasting children according to their peers across the nation in standardized tests. We spend much time explaining what and why the child cannot accomplish certain goals at a certain time. We introduce the idea of therapy to support the child through the stages. There is nothing wrong with this process, it has to be done, but it is also “how” we do this that matters. What do parents feel when they leave our consultation rooms? How did they receive this information on their child? What type of action did we spur them to consider as they leave us?
Even as we live in this faster paced world today, development is still running its course since the beginning of time. We are still carried 9 months in utero, if all goes well, we are still born the same way, and we still spend the first 18 years of our lives in dependency of our parents in different shapes through the developmental stages. The reality is that no one has the power to force development to go faster in natural environments where there are no disasters. Our notion to get the child to “catch up” is one that is fraught with anxiety and fear inside our parents and they do what every good parent will do: They go to work! They involve their child in therapy, additional tutoring, fight for Individualized Educational Plans (IEP) at school and work harder to provide more funding to pay for these services. Again, there is nothing wrong with this as this would all be necessary to support the child.
But in the midst of all of this, we have to consider how the child with developmental delay is receiving this? How would it feel to have a perpetual round of therapists working and playing with you, also within the safe space of your home, your inner sanctuary? How does it feel when relationships come and go? How does trust develop in relationships? How does the child understand the constant pressure of needing to “prove” they need to “catch up”? Even as we do not talk to the child about our needs for them, they pick it up in every nuance and overture as they note what types of things we would comment on and which things we ignore. They do pick up these intersubjective messages from their perception, not from the well-intended notions of the adult, increasing the pressure and anxiety they are already experiencing.
What do we do?
- It is good to have evaluations completed and to know the strengths and vulnerabilities of a child’s profile
- It is good to use intensity and frequency in a therapy program as neuroplasticity research requires this in order to change nervous system pathways
- It is good for adults to have goals in mind and to work towards it, but it is not good if the child picks up that they are being pushed and prodded towards skills and activities of which they do not understand the meaning of. Natural development comes from having the intrinsic motivation and wiring to grow, not from external pressure. This has not changed and it never will.
- Therapy should meet the child where the child is at, not somewhere in the future. It is the moment now that counts, the current ideathat needs to be mobilized to support the unfoldingof the next sequence.
- If play and playfulness was good enough for the typical child to grow and develop, it has to be good enough for the atypically developing child. It simply does not make sense that the child with developmental delay is developing at a slower pace, but is expected to work (catch up) at a faster pace than their peers.
How then? What do we do?
- Put the therapy team of choice in place and arrange the village of support around the family.
- Decide on a course of action and create consistency and stability in the child by sticking to it, so they can feel safe and secure.
- Every moment counts, but not in the expectation of tomorrow, just focus on this moment in time to support growth and development in the now, just like every other child does.
- It is not about not having a plan, but about executing the plan in playfulness, acceptance, conveying safety and security, decreasing anxiety to increase the intrinsic motivation to want to communicate more, to want to please more, to want to achieve, to want to take the risks to gain new learning.
- Look for signs if the child is avoiding tasks more than they are tackling them. Therein lies a message. How can the “village” support the child to rather mobilize that same energy into channels of growth and necessary risk-taking behavior which will result in problem solving and positive social emotional behavior.
- Most importantly, slow down the moment to meet the child’s processing speed so the child is motivated to remain in the moment, supporting themselves to go forward. When we use this “go slow”, the child relaxes and natural development drives the child to do the necessary exploration, knowing they will be kept safe and supported by the adults, and not risk disappointing the important people in their lives.
The real truth is that when we “go slow” in the moment, we reach our goals for the child faster! Waiting, watching, and wondering what next to do to mobilize the child’s mind is the single most powerful technique to have the child trust that the adult will be a safe and secure base, enabling them to do what the moment is asking of them to do. And so doing, natural and spontaneous development will also be available for the child with an atypical developmental profile.