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The "Wait and See" Approach is Hurting our Children




This last week I had 4 patients who parents said, "the doctor said we should just wait and see if they will catch up."

Why is this an issue? We all know that intervention is key to helping a child to develop their speech and feeding skills. Children are developing and learning so much between birth and 3 years of age. These are critical years that will impact them for the rest of their lives. The thought that we should "wait and see" goes against what we know about development.

We need to change our thought process to be "how about we get them signed up for an evaluation and go from there?" That way the parents can finally get the much-needed support they need while the physician has them on their radar to check in and see how the child is progressing.

I know that our early intervention providers are bogged down, and it can take months to get into services. This is even more reason so get our children on these lists sooner than later.

Another reason why the "wait and see" approach can be detrimental is what if the child has something structural going on that is impacting their speech or feeding?

A few months ago, a mom come to our clinic because she could not understand anything her 2 year-old was saying. This particular child had been assessed by early intervention but did not qualify for services. Mom knew there was more going on with her child and she needed to be further assessed.

I always start my evaluation to second the parent and child walk into my office. I notice that this child appeared to possibly have some gross motor delays. I noticed that she was very social and appeared to have a strong bond to her mother. I noticed that she was "talking" quite a bit but I had not idea what she was saying. As I got her medical history, I started to get an overall picture of this child and her development.

This child had issues nursing as an infant, so the mother switched to bottle feeding.

This child had a history of spitting up frequently.

This child did not like having their teeth brushed.

This child had a strong gag reflex.


These were all signs of a possible tongue tie.


I completed my oral mechanism exam and took measurements of the mouth opening, where her lingual frenulum attached to her tongue, her total range of motion of her tongue, the shape of her hard and soft palate and lip strength and range of motion, etc. I noted that the lingual frenulum appeared to be tight and limited her tongue range of motion. This child was talking but all of her sounds were neutralized because she had limited range of motion of her tongue.


We need to get rid of the "wait and see" approach to speech and feeding development


I told mom my observations and she started crying. At first, I was concerned that I had offended her or frustrated her in some way. Mom finally said, "I knew there was more going on here but no one would listen to me."


Two weeks later this little one had a tongue tie release and within a month she was starting to finally say all those sounds she was struggling with before. Her mother could finally understand her.


This is why we do what we do. These moments are what keep us going in the field of speech language pathology, especially during a worldwide pandemic.


If you are concerned about your child's speech, feeding skills or oral motor skills, we might be a good for you! Please contact us to learn more.

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