At Shores Pediatrics Wellness Center, I provide developmental screenings to babies, toddlers, and young children during their well child visit. The ASQ-3 or Ages and Stages Questionnaire is a standardized tool to assess the child's key areas of development: communication, problem solving, fine motor, gross motor, social and emotional skills. The questionnaire is completed by the parent and together we review the results. It's a quick questionnaire, taking 10 to 15 minutes max to complete.
The ASQ-3 is part of a larger goal implemented at Shores Pediatrics- early identification and early prevention of developmental delays. Based on the ASQ-3 results and my conversation with the parent, I am able to assess if the child may need a further in - depth evaluation in any of the areas of concern. This is not to say that every child who scores in a lower than average range will be referred for additional services. I believe in the strength of the child and in that every child develops at his or her own pace. So on their next visit, we will compare results with the most recent ASQ-3 and assess if the child is developing age appropriately.
Won't the child just catch up? What's all the fuss? That question is hard to answer because each child is different and each child's home environment is different. The questionnaire is a great way to discuss some at-home fun activities that can be done with the infant and parent to improve the infant's areas of development. So, if both the parent and the child/ infant practice some activities, there may be some great improvement and no need for further services. If these activities do not seem to help the child, then therapy may be necessary. A quick soap box moment - it's so important that the parent be involved in whatever type of therapy their child receives. I don't know how many parents I've spoken to- frankly the majority, that when I ask them what their child does in therapy- speech, occupational, or physical- they have no clue. It's a huge and almost unfair responsibility on this child to improve his or her development based on two or three hours of therapy a week, when the remaining 165 hours are spent at home or at a school. Remember, these are kids, the activities don't have to be tedious, the funner the better, the quicker they will learn and more they will want to practice.
Imagine a baby sitting on a couch describing to the therapist his dreams... Hmm… not quite.
I always get a perplexed look from people when I tell them that I provide services to families and their infants ages 0 to 5. People ask me - what kinds of problems can an infant have? A gas? This is bogus.
It's a pretty rational thought; we tend to look at infancy and toddlerhood as the most pristine years of a person's life. Before I go into further detail, I wanted to offer a brief definition of infant mental health and then talk about what sorts of issues are a focus of therapy.
Infant mental health (IMH) focuses on children ages 0 through 5 years of age and their caregivers. IMH refers to the child’s ability to develop their physical, intellectual, social, and emotional potential. Because infants grow in a context of nurturing environments, IMH involves the psychological balance of the infant-family system.
Infant- family system. Those are the key words that really describe IMH. Often, parents complain about their child's tantrums, difficulties with sleep, eating, and other daily routines, and plain disrespect. Some parents of newborns don't feel a bond with their infant. These issues relate to a lack of attunement in their relationship with their child. Attunement is the ability for one person to understand and accept another person, and let the other person feel understood and accepted. Basically, both being on the same page.
IMH's focus is on the relationship between the caregiver and the child. One of the major goals is for the caregiver and child to be attuned to one another- therefore each person feeling a better and easier flow in the relationship. When parents and their children get along, the usual behaviors of tantrums, not following directions, fights during mealtime, bath time, and sleep time are few and far between. When parents provide consistent limit setting based on love, their children also will behave better. These first few years of life are crucial for brain development, social development, and psychological health. The relationship between the infant and their caregiver during these first 5 years is the blueprint for future relationships with teachers, friends, and their spouse or significant other.
So... how does it work? Weekly psychotherapy sessions help the parent and child become attuned to one another with the assistance of the psychologist trained in IMH.
Dr. Eva Benmeleh
I am a licensed clinical child psychologist in Miami . I hope you enjoy the site!
221 West Hallandale Beach Blvd., Suite 202
Hallandale, FL 33009