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Warning Signs That Your Child Might Need Special Instruction


Special instruction is a broad category of care available from Happy Hearts. This month we’ll dive into ways a special instructor can help and the warning signs that a child should be referred to a special instructor. These services are provided at no charge in the state of Pennsylvania for qualifying children from birth to age three through the early intervention program. If your child struggles with growth and development, it’s important to get them a free evaluation so they can receive the assistance they need as soon as possible to help them live their life to the fullest.


What is Special Instruction?


Special instruction addresses a child’s overall growth and development, particularly in a few key areas. A special instructor may work with a family to improve their child’s play skills, cognitive development, social interactions, or motor and language development. Happy Hearts also employs special instructors who specialize in behavior management or hearing loss. We’ll discuss these specialties in more detail in future posts.


Special Instruction as a Prelude to Speech Therapy


Special instructors are often assigned to a case when there is a language delay so they can work on the prerequisite skills needed before a child learns to talk.


According to Teach Me To Talk, those skills are:

  1. Reacting to their environment

  2. Responding to people

  3. Taking turns with someone while interacting

  4. Developing a longer attention span

  5. Shifting attention between a person and an object

  6. Playing with toys appropriately

  7. Understanding words and following simple directions

  8. Vocalizing or purposefully making sounds

  9. Copying what others say and do

  10. Communicating nonverbally with gestures

  11. Seeking attention when they need something or want to play

Warning Signs That Your Child Should be Evaluated By a Special Instructor


Every child develops differently. This makes it hard to know what’s normal, especially when you’re flooded with opinions on social media. But according to the CDC’s Developmental Milestones, if your child misses more than a couple of the following benchmarks you should consider having them evaluated.


By 2 months:

  • Child doesn’t watch when you move

  • Child won’t look at a toy for several seconds

  • Child doesn’t makes any sounds other than crying

  • Child doesn’t react to loud sounds

By 4 months:

  • Child doesn’t open their mouth when they see breast or bottle, even if hungry

  • Child doesn’t look at their hands with interest

  • Child doesn’t make “oooo” or “aahh” cooing sounds

  • Child doesn’t make sounds back when you talk to them

  • Child doesn’t turns their head towards the sound of your voice

By 6 months:

  • Child doesn’t put things in their mouth to explore them

  • Child doesn’t reach for a toy they want

  • Child doesn’t close lips to show they don’t want more food

  • Child doesn’t take turns making sounds with you

  • Child doesn’t stick tongue out and blow

  • Child doesn’t make squealing noises

By 9 months:

  • Child doesn’t look for objects (like toys) that have dropped out of sight

  • Child doesn’t bang two things together

  • Child can’t get into a sitting position by themself

  • Child can’t sit without support

  • Child doesn’t make a lot of different sounds like “mamamama” or “bababababa”

  • Child doesn’t lift arms to be picked up

By 12 months (1 year):

  • Child never puts anything in a container, like a block in a cup

  • Child doesn’t look for things they see you hide, like a toy under a blanket

  • Child doesn’t pull themselves up to stand

  • Child doesn’t walk while holding on to furniture

  • Child doesn’t wave goodbye

  • Child doesn’t call their parent “mama” or “dada” or another special name

  • Child doesn’t seem to understand “no” (doesn’t pause or stop when you say it)

By 15 months:

  • Child doesn’t try to use things the right way, like a phone, cup, or book

  • Child won’t stack at least two blocks or other small objects

  • Child hasn’t taken at least a few steps on their own

  • Child hasn’t tried to say one or two words besides “mama” or “dada”

  • Child doesn’t look at a familiar object when you name it

  • Child doesn’t follow directions given with both a gesture and words

  • Child doesn’t point to ask for something or to get help

By 18 months:

  • Child doesn’t copy you doing chores, like sweeping with a broom

  • Child won’t push a toy car or play with simple toys

  • Child doesn’t walk without holding on to something

  • Child won’t climb on and off a couch or chair without help

  • Child doesn’t try to say three or more words besides “mama” or “dada”

  • Child doesn’t follow one-step directions without any gestures

By 24 months (2 years):

  • Child doesn’t notice when others are hurt or upset

  • Child doesn’t look at your face to see how to react in a new situation

  • Child never holds something in one hand while using the other hand

  • Child doesn’t try to use switches, knobs, or buttons on a toy

  • Child never plays with more than one toy at the same time

  • Child won’t point to things in a book when you ask

  • Child doesn’t say at least two words together, like “more milk”

  • Child can’t point to at least two body parts when you ask them to show you

  • Child doesn’t use more gestures than just waving and pointing, like blowing a kiss or nodding yes

By 30 months:

  • Child doesn’t use things to pretend, like feeding a block to a doll as if it were food

  • Child doesn’t show simple problem-solving skills, like standing on a small stool to reach something

  • Child doesn’t follow two-step instructions like “put the toy down and close the door”

  • Child doesn’t know at least one color

  • Child says fewer than 50 words

  • Child can’t name things that you point to in a book

  • Child doesn’t say words like “I,” “me,” or “we”

By 36 months (3 years):

  • Child won’t draw a circle after you show them how

  • Child ignores your warnings, such as not to touch a hot stove

  • Child won’t talk with you in conversation using at least two back-and-forth exchanges

  • Child doesn’t ask “who,” “what,” “where,” or “why” questions

  • Child can’t identify what action is happening in a picture when asked, like “running,” “eating,” or “playing”

  • Child won’t say first name when asked

  • Child doesn’t talk well enough most of the time for others to understand them

What To Do If Your Child Exhibits These Warning Signs


If you recognize any of these warning signs in your child, it’s likely they'll qualify for free special instruction through the early intervention program. Early intervention helps children develop the skills they need to thrive throughout their lives, and trains and equips parents to be part of this important process.


A doctor’s referral ISN'T necessary to seek early intervention services. If you’re located in Berks, Schuylkill, Lebanon, Tioga, or Wayne counties, please email JTofany@HappyHeartsLLC.com or call 570-573-3293 to schedule a no cost evaluation.



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