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Cayman Parent | Articles | Expert Advice | Identifying Learning, Behavioural or Cognitive Issues

Identifying Learning, Behavioural or Cognitive Issues

There is nothing more unsettling for a parent than the thought that their child may not be developing typically. You may notice that your child is not meeting milestones as quickly as another child. Your child may also engage in strange behaviours or do odd things that just don’t seem right. But what should you do next? − Faith Gealey MS CCC-SLP, a Speech and Language Pathologist at the Cayman Islands Health Services Authority

Seeking Diagnosis

When your instinct tells you that things are not going the way they should, be guided by it. While a million questions may run through your mind, following these steps should result in a smoother journey through the assesment and/or diagnosis process:


1. Talk to anyone who helps you care for your child: A teacher, nanny, carer or grandparent. Check whether they have any concerns about your child’s development.



2. Document your concerns: Make a list of your concerns about your child’s development with specific examples of their behaviour. It will be easier for you to discuss these concerns once they are written down, and you won’t have to worry about forgetting any key areas you want to discuss with your paediatrician.



3. See your child’s paediatrician: Paediatricians are not only there for when your child is feeling sick. Your child’s healthcare providers are also there to assist you with tracking your child’s development. Discuss your concerns with them so that an action plan can be developed. These are individuals who see children on a daily basis and are familiar with what the range of normal development looks like. Allow them to assist you in this process with securing the appropriate referrals and to ease any concerns you may have.



4. Follow through with referrals: Your paediatrician may recommend that your child see one or more service providers on-Island. Please do not wait! Proceed with making the necessary appointments for your child based on your paediatrician’s recommendations. Keep in mind that for some services, there may be a short waiting period between when the appointment is made and when your child is seen.



5. Report back to your paediatrician: After following through with your child’s referrals, it will be best to forward these results to your child’s paediatrician. Not only will they be able to decipher any of the technical aspects of the report but they can also make subsequent referrals for any therapy that is required. Many insurance companies will not cover services without a physician’s referral, so having your paediatrician as an integral part of your team is vital.



Next Steps


If your child is under the age of five, enrol them in the Early Intervention Programme (EIP). This programme involves a group of early childhood teachers and therapists who specialise in providing services to children under the age of five. These professionals can assess your child’s overall development and provide additional support and services if your child demonstrates a need for them. Their goal is to have your child ready for school.


Work with your child’s school
If your child is over the age of five or enrolled in school, seek school-based guidance. For children already enrolled in primary or secondary school, seeking help will be varied based on the school setting. Most public and private schools have a Special Educational Needs Coordinator (SENCO), or an equivalent position. Discuss your concerns regarding your child’s classroom teacher and the SENCO for your child’s school. The SENCO will coordinate a meeting with all of the stakeholders so that all concerns can be discussed and can assist you with getting the necessary referrals.

For children who attend government schools, many services such as Speech and Language Therapy, Occupational Therapy, Music Therapy and Education Psychology are offered within the school system. For children who attend private schools, parents may need to seek support through the Health Services Authority or through one of the privately owned medical service providers on-Island.


This is a plan that outlines in writing what services will be provided to your child and what accommodations can be offered to him or her in their academic setting. It also includes short term and long term goals that your child’s therapy team and teachers will focus on. Establishing an Individualised Education Plan (IEP) will assist your child’s therapy team with planning and implementing goals that will enhance your child’s academic success. IEPs are often written by a school’s SENCO (or equivalent) in consultation with all stakeholders included. As a result, it encourages an open dialogue between you, your child’s teacher and your child’s service providers. IEPs are updated annually, however, these can be updated more or less frequently, depending on your child’s unique academic needs.


If your child has been diagnosed with a special need, it can be overwhelming and it is quite natural for you as a parent to go through periods of grief, denial, sadness, anger or anxiety as you try to wrap your head around their diagnosis and the way forward. Seeking support from other parents who have gone through similar experiences can help you come to terms with your child’s diagnosis. Additionally, there are non-profit agencies on-Island, such as the Special Needs Foundation of Cayman (SNFC), that are available as a resource to families to provide access to trainings, guidance and general support as you and your family goes through this difficult period.

Remember that the diagnosis of a special needs child does not change who your child is to you or their role in your family. They are still the little child that you are madly in love with. As you go through the therapy process, take time to appreciate the small gains your child will make. The small changes eventually add up to greater transformations over time – and these are worthy of celebration – no matter how small!


To learn about the most common behavioural disorders in Cayman refer to this article.

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