MANCHESTER, N.H. — Since Jennifer Lambert’s son Carter was a few months old and she noticed he was having trouble rolling over, he and Lambert have been meeting with early childhood intervention specialists to address developmental delays.

Physical therapists and speech specialists have visited Lambert’s home in Windham, first in person and now via video, coaching her in ways to play with Carter, now almost 2, to improve his physical development and communication skills. Lambert learned how to teach him to speak and show him simple hand signs to express his needs.

“He’s come a long way,” Lambert said.

Through a state-funded program run by local nonprofits called Family-Centered Early Supports and Services, all children in New Hampshire up to age 3 are eligible for similar services to help with developmental delays — such as having trouble learning to speak, walk or with fine motor skills — and with disabilities.

But since the beginning of the pandemic, the number of children who are being referred to these services has plummeted.

Across the state, 400 fewer children were referred to early intervention services in 2020 than in 2019, said Nancy Lucci, who runs the early intervention program in the Exeter area through Waypoint. Lucci said in almost 15 years, she has never seen the number of referrals drop.

“We’re concerned that there are children out there we could be helping that are not coming to us in the usual ways,” Lucci said. “What starts out as a slight delay could end up being a more long-term delay and or disability.”

Losing valuable time

“We are waiting, and ready, and happy to evaluate and see any child,” said Maribeth Rathburn, who runs early intervention services across southern New Hampshire with the Children’s Pyramid. Parents do not pay out-of-pocket for initial evaluations or any services, and if a child does not need services, there is no downside to having an evaluation, Rathburn said.

Pediatricians are the most common source of referrals, said Diane Bolduc of the Moore Center, who works with the early childhood education program in Manchester. Doctors either postponed visits last year, or used videoconferencing to see children and might have missed subtler signs of delays or disabilities, Bolduc said.

Fewer children are in day care too, she said, and the parents who are still using day care have fewer opportunities to observe their children with others, to see how their children stack up — which is one way parents might pick up on a developmental delay.

“You see your kids interacting with other kids and notice, ‘Gee my child isn’t doing what those other children are doing. I wonder why that is?'”

The earlier a child showing signs of delay or disability gets therapy, the more beneficial, Bolduc said.

Rathburn urged families who think their children might have a developmental delay or disability to seek help right away.

“We’re losing valuable time,” Rathburn said. “There’s a very real chance that they’re missing out on some helpful support.”

Rathburn said it’s helpful for children who need support in early childhood to get help, so they have the skills they need to go to school when the time comes. If children are still behind developmentally when they start school, she said, it gets harder to catch up.

“It presents another set of challenges for them to participate in their education and access their education in the way that they need to,” Rathburn said.

“For some children and families, they receive our services, they catch up and they’re fine, and they never need help again,” Lucci said.

Others may need therapies or special education services as they start school, but the need could be less than it was without the early intervention, she said.

“A child who really needed some assistance and didn’t get it? It could really be a life-long effect,” Lucci said. “The early years are such a foundation of learning.”

More broadly, if more children need more special education services for delays or disabilities that could have been addressed earlier, Lucci said, it will end up costing school districts.

For the Lamberts, the therapies have reassured the family that they can work through Carter’s delays.

“Now we’re pretty confident everything’s fine, and he’s going to catch up,” she said.

Therapy via Zoom

The focus of the therapies is on teaching parents and caregivers ways to play and interact with their children that will help the child’s development.

Andrew Scott, a Hollis father whose son has been getting services since he was a few months old, remembered one game they played with a therapist.

He and his son were stacking blocks. A therapist showed Scott how to help his son line up three blocks and stack a fourth on top of a block on the end, to make a shape that looks like a train engine — and then push it around, making a “choo-choo” train sound.

“Now he does that all the time,” Scott said. “They just know stuff, that as a parent you just don’t see it,” Scott said of the therapists.

That kind of “coaching,” Lucci, Rathburn and Bolduc said, has translated pretty well to videoconferencing now that therapists rarely go on home visits, to limit potential COVID-19 spread.

“The therapists, they say things you just don’t see,” Scott said. “Even via Zoom, they can pick up things that he’s doing that aren’t even obvious to me.”

Scott said it probably helps that he and his son knew the therapists from in-person visits before they started the Zoom sessions, but said the videoconference therapy seems to be working.

Scott is glad his son hasn’t had to miss out on a year of services because of the pandemic.

Once children turn 3, they are no longer eligible for the early intervention program, and responsibility falls on the local school district.

“Everything about their development is happening so quickly,” Bolduc said.

A developmental delay of even three or four months can lead to long-term losses, Bolduc said, meaning the child will have to work even harder to catch up. A child’s development is not paused during the pandemic, though it can seem the rest of the world is.

“We’re still here,” Bolduc said,” and kids still need us.”

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