Toddler Development: When To Seek Therapy

You'll have a lively household during the toddler stage in your child's life. Still, even though your toddler may be moving around, yelling and telling you about a cool toy from a friend like any other child, you may notice some milestones that they haven't reached yet. Your concerns may make you wonder when they'll reach those developmental milestones and if it's time to seek professional help.

Drew Haverstock, a pediatric physical therapist at Franciscan Health, explains your toddler's development milestones and how therapy can get them on the right track.

When Is My Child Considered A Toddler?

"The toddler stage, in most cases, starts around age one and runs up to around age three," Haverstock said. "During this time, there's just an absolute ton of rapid growth and development."

Haverstock explained that the toddler stage is when children start walking and focus on increasing their independence both intellectually, socially and emotionally.

"It's easily one of the most important stages of development without question," Haverstock said.

What Milestones Can I Expect From My Toddler?

There are several milestones that children gain over time, which help them interact with their loved ones, peers and teachers. Knowing your child's milestones can help you recognize what needs more attention.

Haverstock explained several milestone examples that you should see from your child by the time they're one year old, including:

• Sitting independently
• Making eye contact
• Mirroring words they hear
• Walking
• Climbing
• Quick waddling or running
• Jumping
• Using stairs with decreasing support
• Pulling toys
• Kicking and throwing a ball.

Toddlers should start to have an increased awareness related to cognition with examples such as:

• Imitating peers
• Imitating scribbles and lines
• Recognizing themselves in a mirror
• Discovering hidden objects
• Understanding the difference between mine, his, or hers
• Being enthusiastic with other kids
• Using their imagination to play
• Organizing, sorting and stacking items.

"And more importantly, cognitively, they should start being able to follow more than just one-step instructions," Haverstock said. "They should start being able to follow directions that have two or three steps."

Haverstock also explained that toddlers should be able to use four- and five-word sentences consistently with verbal expression.

Even though they also should be able to feed themselves, they still may need to have things cut for them, such as meat, Haverstock explained.

"At this age, the way I like to look at it is, they are the world's greatest scientists," Haverstock said. "They are banging on things to see if they're hard or soft and even putting things in their mouth to see if they're hot or they're cold or if they have a distinct taste to them."

Are There Signs That My Toddler Can Benefit From Therapy?

During toddler development, there are several signs that can show if your child can benefit from therapy.

"I always tell parents, when they have a feeling that something should be examined, they should be following up with a physician immediately," Haverstock said.

Haverstock explained that early intervention is key, as the toddler years up to age five is a significant period of growth in child development.

"When in doubt, there's a way to go about it and have your child evaluated," Haverstock said. "Nothing that warms my heart more than when a parent comes to our clinic and we're able to do an evaluation on their toddler's gross motor skills or fine motor skills with their occupational therapy needs or even speech therapy, either receptive or expressive."

Haverstock explained that in some cases, a toddler's evaluation can result in minor concerns. However, the child is still on track for normal growth like any other child.

"Yes, your child's not perfect and they may have some syllabus issues," Haverstock said. "Still, in the end, your kid's developing like a typical child. And while we've seen some of the things you're concerned about, overall, they should be good. You've had your child evaluated early by specialists who spend their entire lives only focusing on these specific aspects. It's the best possible thing you could do."

What Can I Expect From My Toddler's First Therapy Session?

"In therapy, everything that we do, especially with this age group, is play-based," Haverstock said. "We have to be able to come up with a way to connect and engage with the child."

Core strength exercises are a way for therapists to determine a patient's abilities. Keeping kids engaged in the therapy session may require a simple but effective method to assess their core strengths.

"I love doing something as simple as rolling a ball back and forth with a child," Haverstock said. "Some parents wonder why we're just rolling the ball back and forth, but there's a reason."

Haverstock explained that the first thing he looks for is if their toddler has the core strength to hold himself upright while sitting down and rolling the ball.

"If the ball goes outside his base of support, I want to see if the kid has the ability to reach outside that base and then return to center," Haverstock said. "I'm looking at his core strength."

He also explained the importance of paying attention to the toddler's hand-eye coordination.

"I'll look closely to see if he's letting that ball just hit him in the body before he goes to get it or tracking it with his eyes, anticipating its arrival and corralling the ball as it comes to him," Haverstock said. "The next step is seeing if the child is grabbing the ball, picking it up and launching it back to me. Each of these scenarios are baby step, one above the next to see where they are in their processing and gross motor control."

Haverstock explained that parents and toddlers should show up 15 minutes early to fill out paperwork and be ready to answer questions about the child's medical condition before the first session begins.

"It's always good to hear a parent tell their story face to face," Haverstock said. "You get so much more than what you would on a piece of paper when you let a parent talk about their time with their child."

Parents and toddlers can expect direct testing, indirect testing, listening and calculated professional observation along with the initial paperwork.

"Still, it's the first session," Haverstock said. "I can't immediately ask a kid to do jump down, turn around, grab a basketball, and shoot a three-pointer, right? I don't know what the kid can do yet."

He emphasizes that starting the session slowly with every child is crucial and keeps them from being overwhelmed with tasks.

Do I Need A Pediatrician Referral To Make a Therapy Appointment For My Toddler?

Parents can contact physical therapy offices directly or seek a referral from their child's doctor.

"There have been some changes in the law regarding referrals from a pediatrician, but ultimately the best practice and what we practice at the Franciscan Pediatric Therapy Center is the need to get a referral from a pediatrician for all of our patients," Haverstock said.