INTERVIEW: Decoding Early Childhood Challenges: Behavioral vs. Developmental Signs in Young Children
03/21/25
In a busy child care classroom, it’s common to see little ones struggling with big feelings, social interactions, or certain skills. But how do you know if a child’s behavior is just part of growing up or if it could be a sign of a developmental challenge?
To help answer this, we sat down with Jordan Lambert, Technical Assistance Coach in Action for Children’s Village Family Child Care program, Pitty Jennings, LSW, IECMH Prevention Team Lead at Nationwide Children’s Hospital, and Patrick McKelvey, LPCC-S, Clinical Lead Supervisor at Nationwide Children’s Hospital’s Early Childhood Mental Health Program. In this Q&A, they’ll break down the differences between behavioral and developmental challenges, share what to look for in young children, and offer practical tips for child care professionals and families.
Welcome to all of you, and thank you for being here! So before we get started, behavior management, developmental delays, and early intervention are all pretty popular buzzwords in the early care and education space these days and it’s important to distinguish all three! Patrick, can you briefly explain the difference between these terms?
Patrick: That’s a great question! Developmental delay occurs when a child’s progression through typical developmental stages slows, stops or reverses. Developmental delays could affect motor, cognitive, social or emotional skills. Children develop at different rates. All children do not meet developmental milestones such as walking, crawling or talking at the same age. When a child’s development falls outside of a typical range, they may have a developmental delay. Early intervention refers to services provided to assess or treat young children who show signs of developmental delay. Early intervention is provided by a range of specialists and professionals trained to assess and provide therapies to support speech, occupational, physical and cognitive development. Adults often refer to behavior management when they are concerned about a child’s behaviors or are looking for strategies to maintain control when teaching or caring for children in group settings. Behavior management occurs through teaching children social and emotional regulation skills that equip them to manage their own feelings and behaviors. It also includes practices teachers and caregivers can use to create safe, interesting environments that encourage children to interact cooperatively and safely.
That brings us to some of the biggest challenges affecting children’s development today. Pitty, what are you seeing in your line of work?
Pitty: So many young children are still rebounding from the effects of disrupted care and education that occurred during the pandemic. Children in group care and early childhood education may also experience a lack of consistency of caregivers and teachers due to a high turnover of employees in early childhood care and education. Research tells us that increased reliance on electronics and technology has a negative impact on most areas of child development. Less opportunity for outdoor play and physical activity impedes children’s physical development and health, emotional regulation, sensory responses and some approaches to learning. Through IECMH consultation, we’re able to help early childhood professionals with understanding best practices for childhood development and think of strategies to increase healthy social development and wellbeing.
Jordan, from your perspective, what other factors are affecting children’s development in central Ohio?
Jordan: For young children, we know that having a stable and caring environment is a major key to lifelong success. But currently, many of Ohio’s families are unable to access important resources like affordable healthcare, housing, and childcare during their child’s most critical years of birth to five. Financial strain on parents mean children may miss critical wellness checks, have poor nutrition, or experience other confusing and stressful situations that impact their development. A lack of support for families can also lead to parents “pouring from an empty cup” and may reduce the amount of quality family time as parents try to juggle everything at once.
With these challenges in mind, how can educators determine whether a child is experiencing a behavioral issue or a developmental
delay?
Patrick: Screening and assessment are key. Programs should explore the use of assessment tools to help determine needs for their children at the program level. Assessments such as the Devereux Early Childhood Assessment (DECA) or Ages and Stages Questionnaire/Social Emotional (ASQ/ASQ-SE) are helpful in programming planning for children’s emotional needs and discussing potential referrals with caregivers. Partnering with early intervention programs such as Help Me Grow can also help programs determine the best supports for children.
In addition, helping families normalize that having their child screened or assessed is an additional tool in their child’s success. Once a potential concern has been identified, educators can talk with caregivers about taking that information to their child’s pediatrician. They can also recommend calling Nationwide Children’s Hospital’s Behavioral Health Intake line to be connected to programs that can help. Nationwide Children’s Hospital provides integrated multi-disciplinary assessment in their early childhood mental health program that not only assesses for behavioral concerns but also assesses for speech and occupational therapy needs. For children with significant developmental concerns, families may be linked with further evaluation in the department of Developmental and Behavioral Pediatrics or the Child Development Center or may be provided with other community resources as appropriate. Families interested can visit www.NationwideChildrens.org/BehavioralHealth for more information.
What examples have you seen of confusion between behavioral and developmental challenges in early learning? How does it impact the child when these challenges are misidentified?
Jordan: It’s definitely important to identify and address developmental concerns early, but it can be difficult to tell what behaviors are a part of typical development and what might be something to investigate. Occasional behaviors such as tantrums or biting can be stressful and concerning for adults, but they also demonstrate a young child’s developing communication skills and growing independence. Other times, a behavior is a sign of a deeper need for connection, or an underlying anxiety that can be addressed. Telling behavioral and developmental challenges apart can be tricky, but understanding the root of the challenge is the first step in addressing it. If the root cause is not identified correctly, children may miss out on important early intervention steps and strategies that help promote healthy growth. Adults also might find usual techniques aren’t working in the way they expected.
What are some successes you’ve seen when challenges are properly navigated in the early childhood classroom? What intervention strategies do you find work best?
Pitty: Through Infant and Early Childhood Mental Health Consultation services, we have seen very positive results. Consultants have been working successfully with early childhood professionals to prevent young children from being expelled from their early childhood programs. We’ve also found that intervention strategies that are implemented at various levels create the best impact. This means being able to provide strategies at the child and family; classroom and program levels to create systems change. When choosing strategies, the best ones are rooted in evidence and trauma-informed practices like Conscious Discipline or the Positive Early Childhood Education (PECE) Program. More importantly, when thinking of intervention strategies, the goal should always be to create a sense of safety and security for a child by addressing unmet needs such as physiological needs (food, shelter, water, sleep), a need for connection (attachment and attunement to other children, adults and their community) or a need for a stimulation level change (offering more or less stimulation).
Jordan mentioned this earlier too, but implementing interventions and strategies early on when there is a question about a child’s needs — not only in a crisis — yield the best success. The Helping Ohio Preschoolers Excel (HOPE) Line is an evidence-informed, statewide program that connects early learning professionals working with children ages 0 to 8 to short- and long-term support, enhancing their capacity and self-efficacy while creating nurturing learning environments. The program is totally free and offers resources like rapid response consultation, social and emotional resources, professional development and linkages to community resources. Providers, families, and licensed childcare programs can request services by calling 844-678-ABCS (2227) or visiting www.NationwideChildrens.org/ABCs. So far, the HOPE line has diverted over 94% of children from expulsion since its inception.
Jordan: We love the HOPE line! It’s such a great resource for programs. Adding on to what Patrick said about basic needs, children find the most success when they feel deeply connected to and understood by the adults in their life. The most successful educators are those with a keen understanding of each child, a strong rapport with families, deep knowledge of childhood development, and the ability to recognize and respond to challenges as they arise. Sometimes finding out what works for an individual child takes time. But in the end, it is so rewarding to see each child succeed — sometimes the child who is struggling the most when they enter program shows the most growth by kindergarten after receiving the proper supports!
A few of my favorite techniques to try are if a child is feeling very upset or energetic, it often helps to de-escalate by encouraging them to ground and connect back into their body using their senses. This could look like offering an opportunity for physical activity such as carrying gallon paint jugs, playing a jumping game, delivering a message down the hall, or going for a walk outside. If a child is feeling overwhelmed and out of control, it can sometimes help to have them slow down and focus on a quiet sensory task like a breathing technique (“blowing out the candles”) or holding a visually or physically interesting item like a sequin pillow or sensory bottle. Another one of my favorite activities is encouraging the child to help a teacher sort feathers by color while taking time to touch and observe each one.
So Jordan, assuming we’ve identified that the challenge is behavioral, what are some actionable steps you would recommend for early childhood educators to manage those issues?
Jordan: When managing difficult behavior, I really think the three main keys to success are connection, intention, and reflection. Connection means you’re collaborating with the family and incorporating that children’s home life into your program. Keeping things consistent between home and the classroom helps children to feel secure and understand what to expect. You’ll also want to make time for 1-on-1 moments with individual or small groups of children. Building a strong relationship with each child is really what helps them to feel loved, safe, and secure. When it comes to intention, you just want to be purposeful and planful in the way you run your program. Plan ahead for your day to set everyone up for success. Develop strong routines & visual aids to help support children throughout the day, and arrange or modify the physical environment as needed to support positive behavior. Incorporate children’s interests to keep help them feel included and engaged. If you’re experiencing behavioral challenges with young children, offer choices and focus on positive behaviors that you do want rather than behaviors you don’t want – and make sure families have know about available early childhood development help and resources. And last but not least, take time for reflection. Celebrate those small victories! Document the challenging moments and look for any common threads connecting them. Think about the whole context, including what happened before, what objective behaviors you saw, and what happened after or as a result of the behavior. Consider any deeper needs that a behavior may be communicating. Are they overwhelmed? Struggling with transitions? Lacking communication skills? The more you reflect, the better you’ll get and thinking ahead to potential situations and planning in advance how you can positively support each child. And of course, if you have concerns or you’re finding challenging behaviors difficult to manage, don’t be afraid to ask for help! Reach out to a program administrator, mentor, coach, or community resource like Action for Children or Nationwide Children’s Hospital for support.
Pitty: That’s a great answer, and I’ll add on by saying that if educators are experiencing difficult behaviors in the classroom, the best advice is to seek support early on. We know that the best time to support children is when we begin having a question about a child’s needs and not wait until there is a crisis. The HOPE Line I mentioned is a go-to resource. We encourage providers to call as soon as they need support.
Feeling confident and competent in your skills will also support managing difficult behaviors in the classroom. Ohio provides free high-quality professional development opportunities for early childhood professionals. For a complete listing of training sessions and organizations providing training you can visit Training — Ohio IECMH!
Parents and guardians often face similar challenges at home. What advice would you give them to help identify concerns and find support?
Jordan: Raising children and supporting their growth is hard work. Luckily, you don’t have to do it alone! The CDC’s free Milestone Tracker App or Milestone Checklists make it easy to track and understand your child’s development. You can share these results and any concerns you have with your doctor who will be able to offer their expertise and help connect you to additional resources. There also are free or low cost supports available to you with or without a doctor’s referral – for instance, for children under age 3, Help Me Grow offers free help and resources for supporting children during their earliest years. You can reach out to Help Me Grow at Action for Children or visit helpmegrow.org to get connected. For children over age 3, call your local public elementary school and tell them you have concerns about your child’s development. The school district will be able to make suggestions and connect you with the appropriate programs or resources.
Action for Children also offers programs to help support and connect parents! Parents or guardians can call us at 614-224-0222 or go online to learn more about what programs and resources are available.
Patrick: We’ve also seen many parents benefit from parenting supports and training programs. Parenting programs are for any parent or home caregiver who would like to learn new, positive approaches to raising healthy, resilient children. One option for parents in Ohio is the Positive Parenting Program, also called Triple P. It’s a free parenting program that offers a variety of trainings for parents including in person and virtual supports, and group and individual training options. For information about the free Triple P programs, parents and caregivers can check out all the offerings at www.NationwideChildrens.org/TripleP or email TripleP@NationwideChildrens.org.
In your opinion, Jordan, what’s the best way that educators can involve families and keep them informed about what’s going on with their children when there’s a suspected developmental delay or behavioral issue?
Jordan: When noticing a challenge or potential delay, educators need to make time to discuss their concerns with the family in a calm and collaborative manner. Consider scheduling a meeting where you can share your observations with the family, get feedback based on what they are seeing at home, and work together to determine next steps. Having those conversations can feel hard, but start with the positive. Emphasizing that the child is a valued part of the group and highlighting their strengths helps build a positive relationship and shows that you and the family are on the same side. Having specific observations and data to share helps explain your concerns in a clear and objective way. Consider sharing the results of the CDC’s Milestone Checklist or a screening such as the ASQ-3 (available on paper or through the Sparkler app). It also can be helpful to keep a journal with notes about specific behaviors and the context in which they occurred. You’ll always want to ask for the family’s feedback too. As a child’s best expert, the family can offer special insight or tips specific to their child. They also can give more information about what they may (or may not) be seeing at home. And we’ve said this a few times, but act early and follow up. Continue to keep an open line of communication with the family and communicate any progress.
Patrick, what are some of your favorite resources on this topic that you would recommend to families?
Patrick: Oh, I have a bunch…
And to close us out, what services or programs at AFC or Nationwide Children’s Hospital would you recommend to educators who may need more intensive coaching or case management for a child at their program?
Pitty: Nationwide Children’s Hospital provides ongoing infant and early childhood mental health consultation (IECMH) in the mid-Ohio region. Partnerships last between 18-24 months and services range from on-site coaching, goal setting, training and support with programmatic implementation of social-emotional wellness. Partnerships are limited but those interested can contact ECMH@NationwideChildrens.org. We also provide free Ohio Approved training both virtually and in-person for programs in the mid-Ohio region for people who want to strengthen their skills in meeting the needs of children on a variety of topics such as managing challenging behaviors, supporting transitions and addressing trauma. Providers can request training by filling out this form to Request an Early Childhood Training.
Jordan: Action for Children also offers a ton of professional development for early childhood educators (visit actionforchildren.org/PD) and many programs to help support teachers and administrators. Any licensed ECE program can reach out to our Step Up To Quality team where coaches are available to offer 1-on-1 help in finding a curriculum or planning activities that support all children. For Type-B and Type-A Family Childcare Professionals, The Village can connect you to 1-on-1 coaching support and help refer you to resources. And of course, look out for collaborations between AFC and organizations like Nationwide Children’s Hospital! There’s a lot there.
Thank you all for sharing your expertise with us!
About Action for Children: Action for Children is the local child care resource and referral agency for central Ohio, and is committed to assuring quality early learning experiences for all children. Our services focus on transforming the lives of children by supporting the everyday heroes who most influence our children’s early growth; care givers, educators, parents, and guardians. Learn More.
About Nationwide Children’s Hospital: Named to the Top 10 Honor Roll on U.S. News & World Report’s 2024-25 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child. More information is available at NationwideChildrens.org.