Developmental Delays and Special Needs
When we observe that young children do not seem to be following the generally expected path of development in one or more domains, evaluation may be indicated to determine whether the child has a special need. Special needs include any kind of needphysical, emotional, or cognitivethat differs substantially from the normal range of abilities. The child could have a developmental delay, or she could be gifted.
While it is not unusual, as discussed earlier, for an individual child’s growth and development to be uneven, at some point it may become apparent that the child is either not meeting or exceeding expected benchmarks or milestones. Sometimes special needs are apparent at birth, as in a child with a cleft palate. But in many instances it takes months or years for such needs to be recognized. You wouldn’t know, for example, if a child had speech articulation problems until that child was expected to be speaking clearly, between ages 3 and 4.
Sometimes delayed progress, a physical condition, or atypical behavior is due to factors that can be addressed with the expectation that a child will “catch up.” For instance, a toddler with frequent ear infections may experience a hearing impairment resulting in delayed language fluency. While medical intervention and natural growth of the structures of the inner ear will eventually resolve the frequency of infections, speech therapy and hearing accommodations may be indicated for a period of time until the child has regained normal functioning. A child born with a congenital physical condition like club feet (abnormally rotated inward) may experience many surgeries to correct the condition. The child’s orthopedic disability may require adaptations to the arrangement of the classroom to accommodate leg braces or a wheelchair, with the expectation that the condition will eventually be corrected.
But other developmental disabilities will require long-term support to address learning and emotional needs throughout the early childhood period and beyond. For example, a child who displays distinctive physical behavior such as hand-flapping, inability to make eye contact, or repeating the same words over and over again should be referred for evaluation to determine if the child has autism spectrum disorder (ASD). Once diagnosed with ASD, the child may be offered occupational, speech, and cognitive therapies. Other cases of physiological, biological, or genetically inherited conditions, such as cerebral palsy or Down syndrome, constitute special needs that require active intervention and support on a long-term basis. Table 4.1 describes various special needs conditions (Cook & Cook, 2005).
Inclusion
Federal lawthe Individuals with Disabilities Education Act (IDEA)requires that children with disabilities be included in regular classroom or care settings to the maximum extent possible and provides funding for resources to meet their special needs. (IDEA does not provide funds to address the special needs of gifted children; programs and funding for these children are localized.)
Inclusion of children with disabilities serves several important purposes. First, typically developing young children who grow up within a diverse environment learn and internalize acceptance of their differently abled peers, which leads to higher levels of self-esteem among children who might otherwise feel marginalized or stigmatized. Second, separating children with disabilities and categorizing them by a single factor they may have in common (such as ADHD) risks grouping those who are otherwise very different from one another in many respects (Greenspan, Wieder, & Simons, 1998). Third, keeping children with delays or special needs isolated from their peers almost guarantees that they will be labeled for life in spite of the fact that except for their identified special need, they are like typically developing children in many other ways.