Infants are constantly developing, learning new skills, growing, and changing. Each of these changes typically happen incrementally with one change opening the opportunity for another to occur. Sometimes it feels like a ton of changes happen at once and then there is a slowing down during which the new skills are solidified. Other times, it feels like the changes are just coming one after another. Regardless of where you feel like you are, these developmental changes, the quality of them and the order in which they come, are important to your baby’s overall development.
This isn’t meant to scare you or make you think you need to be your baby’s drill sergeant ensuring that they meet each developmental milestone in record time (please don’t do that). There is a wide range of normal, and we want to allow for that, but we also don’t want to miss early signs that baby could use a little help to get or stay on the right track. This is where “wait and see” steals those early opportunities and allows atypical or non-ideal movement patterns to solidify, persist, and disrupt what is supposed to come next.
What ‘Wait and See’ Means
If you’re unfamiliar – the ‘wait and see’ approach is when a parent identifies a question or concern related to their baby’s development and a provider (typically the pediatrician) recommends that the family just ‘wait and see’ how things play out. My observation is that the pediatrician gives this recommendation because they aren’t sure whether there is anything going awry or not. The majority of pediatricians only get a few hours of education in typical infant/child development, so if they haven’t done more of their own education on the topic, they likely aren’t attuned enough to these early signs that baby is heading down a different trajectory and need to wait, themselves, until a delay is more obvious to be sure there is one there. Because of the lack of education they receive on infant/child development, pediatricians typically rely on developmental checklists to help them assess if an infant is on track with their development.
The problem with checklists is that they assess whether or not an infant has attained a skill but they don’t assess the quality of how they perform the skill. An example: an infant should be rolling back to front and front to back by about 5 months of age. If a parent checks off that the infant is doing this, then the pediatrician doesn’t identify a problem. However, if the infant rolls using extension patterns (so pushing their heels into the ground, lifting there hips and arching back to roll onto their stomach) as opposed to using flexion patterns (so bringing their legs bent up and then rolling to their stomach), then they will likely have difficulty learning to sit and crawl. But if neither the parent nor the pediatrician understands this distinction, the issue won’t be picked up for a few more months when the infant is having difficulty with these next skills.
The reason this ‘wait and see’ approach is no good, is because intervening early on, when parents first verbalized a concern, typically results in faster resolution of the issue and allows baby to continue on their best developmental trajectory. Whereas intervening later, when the issue is obvious, and also likely more embedded in the child’s development, leads to a longer course of intervention before the issue is resolved and baby is back on a more ideal developmental trajectory.
What To Do Instead
So while most pediatricians may not be able to identify these more subtle, early signs, there are plenty of pediatric providers who are. First and foremost are the therapists who treat infants and children with difficulty developing – namely occupational therapists, physical therapists, and speech language pathologists. Additionally, all states provide early intervention services. Typically, you can self-refer your infant to this program and get a developmental evaluation. Each state has different qualifying diagnosis for services but through the evaluation process you can learn more about how your infant is developing and if there are any supports needed to optimize this development. So if you have a concern and your pediatrician recommends you ‘wait and see,’ I would suggest requesting a referral to a therapist or an early intervention program. This will then allow you to get an assessment from someone who specializes in infant development.
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