At first, 2-year-old Gianni Szott tries to use a rolling pin with just one hand to flatten out some clay.
"Oh, Gianni, honey, do it this way with two hands, it's more fun," Nora David says as she sits on the floor next to the little boy who is developmentally delayed.
Melissa Szott gets down on the floor and helps her son give it try, holding his tiny hands in hers.
It's early Wednesday morning at the Szott's home in Las Vegas, and Easter Seals child development specialist David is engaged in serious play in their living room -- activities designed to help Gianni with his motor skills.
"Wow! Gianni, that's great!" David says, clapping as the pin slowly rolls over the clay.
MEETING SPECIAL NEEDS
A year has passed since Jim and Melissa Szott, both managers with Sprint, had Gianni enrolled in the early intervention program run by Easter Seals Nevada, a nonprofit agency that serves more than 6,000 people with disabilities in Southern Nevada.
Therapists in the early intervention program work with special needs children from birth up to 3 years old.
The Szotts are thrilled with the progress therapists have made with Gianni. Now the little one who couldn't crawl or play with blocks or pull himself up or walk or talk does so.
"I only wish we could have gotten him into the program sooner "Melissa Szott said. "The sooner you get a child help who's developmentally delayed, the quicker you can bring him into the mainstream."
Szott said she's sure she would have gotten help earlier for Gianni if she had access to a developmental screening tool that Easter Seals is now making available nationwide to the public for free through a grant from the CVS Caremark Charitable Trust.
The tool, used by many clinicians for children up to age 5, is called the Ages and Stages Questionnaire and is online at www.makethefirstfivecount.org. Taking about 30 minutes, it provides parents insight into whether their child is developing on track -- or whether he could benefit from early intervention services and where to go for help.
Parents send answers to the questions in over the Internet, and about two weeks later receive an assessment from a child development specialist.
Questions on the 27-month questionnaire include: "Does your child correctly use at least two words like 'me,' 'I,' 'mine,' and 'you'? " ... "Does your child jump with both feet leaving the floor at the same time? " ... "Does your child flip switches off and on?" "If your child wants something she cannot reach, does she find a chair or box to stand on to reach it?" ... "Does your child put on a coat, jacket or shirt by himself?"
NATIONAL NEED FOR SCREENING
Brian Patchett, CEO of Easter Seals Nevada, said leaders of his national organization decided to push for a screening tool that could be widely used after they became concerned by research that found many children with special needs weren't receiving screenings that could serve as a catalyst for early intervention therapies that enable children to often overcome developmental delays.
The 2007 National Survey of Children's Health bears that out: One in five households with children has a child with a special health care need and could benefit from screening and services, yet less than 20 percent of children younger than 5 receive a developmental screening.
"If we don't get the help for children early, they end with problems in school that often make them drop out," Patchett said.
A recent Easter Seals report -- "Our Nation's Children at Risk: A State-by-State Report on Early Intervention" -- found that each year the nation fails to identify more than 1 million children younger than 5 who have a disability or who are at risk for a development delay.
"Kids who start school behind their peers may never catch up," Easter Seals researchers said. "We can give every child an equal opportunity to learn and grow, but we need to get kids the help they need in the critical years before they turn 5."
The same report found that there are 122,929 children in Nevada younger than 3, yet less than 20 percent of them -- or approximately 24,585 children -- are properly screened to identify their special need.
Patchett noted that the Nevada State Health Division contracts with Easter Seals, which serves 200 children, and several other agencies to provide early intervention programs. After the child reaches age 3, the early intervention program helps the family with transitioning into the school district.
This service is free to the parents, regardless of the child's level of disability or the family income if the child qualifies for help.
NOT ENOUGH TIME
The doctors you would normally expect to find problems in children -- pediatricians -- often don't because of the volume of patients and low reimbursements from insurance companies, Las Vegas pediatrician Dr. Sterling Tanner said.
"Many of them are only taking 10 to 15 minutes per patient," said Tanner, an Easter Seals board member and a big supporter of the new screening tool. "You can't find out much in that time."
By the time a pediatrician sees that a child gets his or her shots and takes care of an immediate problem, there's never the time to do anything more than a cursory development assessment, he said.
"It's hard for parents to even get their questions answered," Tanner said.
Low reimbursement from insurance companies for child visits, said Tanner, has forced pediatricians today to see almost double the number of patients in an hour that he and other pediatricians saw in the 1970s.
"Pediatricians are at the bottom of the barrel when it comes to reimbursement," he said.
But Tanner conceded that pediatricians could see fewer patients if they thought they could live with less money.
The median salary for a pediatrician in the Summerlin area is about $171,000 a year, according to salary.com.
"Parents can and should use the questionnaire to share with their doctors," Tanner said. "It's one of the most proactive things they can do."
Tanner said there are "quite a large number" of developmentally delayed children "who can catch up" with the early intervention of physical, speech and occupational therapists.
ANSWERS TO QUESTIONS
Jan Crandy, a Las Vegan who was recently named a public member of the national Interagency Autism Coordinating Committee by Health and Human Services Secretary Kathleen Sebelius, said she strongly supports Easter Seals' online development tool for parents.
"The sooner kids are found to have autism, the more we can do for them," she said. "It should help parents who have questions."
Chad Zyniecki, district manager for CVS pharmacies, said that in the coming months he expects that some of his stores to help hold screenings for youngsters.
"Early intervention for kids with some development problems is key," he said.
Melissa Szott said it is critical that parents not rely solely on their pediatricians when they suspect something is wrong with their children.
"The first two pediatricians I had for Gianni would each see him for only 10 minutes at a time and say there was nothing to worry about -- that he was just premature and he'd catch up."
A third doctor found that Gianni, born five months early by emergency cesarean section, has Dandy-Walker Variant, a brain malformation. Some children with the condition end up with normal cognition.
"That's why I wish we had caught it earlier," she said. "These therapists we have are like angels from God."
She said that if she had access to the Easter Seals questionnaire when Gianni was 2 months old, she's sure her concerns would have been confirmed and she could have received help for her son much sooner.
Questions, she said, that she would have then had to answer "no" to on the questionnaire would have included: "Does your baby make cooing sounds such as 'ooh,' 'gah,' and 'aah'? " "While your baby is on his back, does his wave his arms and legs, wiggle and squirm?"
"I'm sure I would have been told to get expert help right away," Szott said. "And believe me, we would have gotten it."
Contact reporter Paul Harasim at email@example.com or 702-387-2908.