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Speech and motor delays aren’t uncommon. Here’s how to get the help you need, when you need it.

When should I be concerned about my child’s development?

Dr. Sirak: You may notice that your child isn’t hitting milestones that other children are. As a general rule, by six months your baby should be able to roll from back to front and vice versa; eight month olds should be able to sit up; and by one year a child should be able to say three or four words.

With older kids, it can be harder to judge if there’s a problem. Look for things such as difficulty with clarity and articulation when it comes to speech, trouble getting dressed or self feeding, awkwardness holding a pencil, and even just keeping up with other kids athletically.

In many cases, kids may just be late bloomers. But if you don’t see any progress, or if you see any regression of any kind–such as the fact that your child used to be able to climb stairs and now can’t–that’s cause for concern.

What should I do if I think my child has a delay?

Dr. Sirak: First, talk with your pediatrician. If he or she agrees that your child may need some help, be aware that New Jersey has an early intervention program for children under age three. This program, which operates on a sliding scale payment model, sends therapists to your home to work with your child and does not require a doctor’s prescription. You also can use your health insurance or pay out of pocket to obtain rehabilitation services for your child.

For slightly older children, your local board of education can offer an evaluation of your child and, if warranted, can place your child in a free local preschool that offers rehabilitation therapy services.

What will a therapist do for my child?

Dr. Sirak: For children who need help with gross motor skills, a physical therapist will teach them how to roll over, sit, crawl or walk. An occupational therapist will help a child who has trouble with fine motor skills, teaching her to pick up small objects, work buttons and zippers, tie shoes or improve her handwriting.

A child with language issues will see a speech therapist who can help him learn to speak, or speak more clearly. Younger children can be helped to communicate with a technique known as baby sign language, which promotes speech. Kids with feeding problems will see a feeding therapist who will help develop normal eating behaviors that promote weight gain.

Does pediatric rehabilitation really work?

Dr. Sirak: Yes! Often, rehabilitation therapy allows children to catch up to their peers and continue to develop on track. The important thing is not being afraid to seek out help, especially because it’s so readily available.


Dr. Michelle Sirak is a Goryeb Children’s Hospital pediatric physiatrist focused on physical medicine, rehabilitation, restoration of function, and a return to a high quality of life. Dr. Sirak works with patients, pediatricians, and specialists to create individualized treatment plans, including home exercise programs, for children with muscle, bone, soft tissue or nervous system injuries and diseases.

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