Nivera Child Development Centre > Early Intervention for Speech Delay and Behavior Regulation in a Young Child
Early identification and intervention play a crucial role in supporting children with developmental delays. At Nivera Child Development Centre, our multidisciplinary team works closely with families to understand each child’s unique strengths and challenges, and to provide individualized therapy plans that promote meaningful developmental progress.
This case study highlights the journey of Abi, a 3-year-old child who was brought to the centre due to concerns about speech delay, behavioural tantrums, and attention difficulties. Through structured intervention involving behaviour therapy, occupational therapy, and speech therapy, Abi demonstrated noticeable improvements in communication, attention, and participation in daily activities.
Her progress illustrates how early therapy, consistent intervention, and family involvement can support children in developing essential communication and functional skills.
Behavior Therapist
Speech Language Pathologist
Occupational Therapis
Name: Abi Mariyam (Name changed for privacy)
Age: 3 Years 3 Months
Gender: Female
Location: Ernakulam
Therapies Provided
Behaviour Therapy
Occupational Therapy
Speech and Language Therapy
Abi, a 3-year-3-month-old child, was brought to Nivera Child Development Centre by her parents with concerns regarding speech delay, behavioural tantrums, and excessive screen exposure.
She was born through full-term normal delivery with no significant prenatal or perinatal complications. Medical history included chickenpox at 1 year 3 months and pneumonia six months prior to assessment.
Parents reported that Abi had 2–3 hours of daily screen exposure for nearly a year, which may have contributed to delays in speech and communication development.
Motor milestones were achieved, though slightly delayed. However, speech and language development were delayed, and the child relied mainly on gestures and pointing to communicate.
A multidisciplinary assessment was conducted by the therapy team at Nivera Child Development Centre to evaluate Abi’s developmental, behavioural, and communication abilities
Vineland Social Maturity Scale (VSMS)
Indian Scale for Assessment of Autism (ISAA)
Childhood Autism Rating Scale (CARS)
Behavioural observation sessions were conducted to evaluate Abi’s attention span, behaviour regulation, social interaction, and emotional responses during structured activities.
The behavioural assessment revealed the following:
Restlessness during structured activities
Behavioural tantrums when task demands were placed
Occasional self-injurious behaviour such as pulling hair
Occasional hitting others when frustrated
Difficulty sustaining attention during tasks
Reduced self-regulation during transitions
Despite these challenges, several positive strengths were observed:
Good eye contact
Ability to imitate actions
Recognition of familiar people
Attempts to communicate through gestures and single words
No features suggestive of Autism Spectrum Disorder were observed in ISSA and CARS.
A detailed speech and language evaluation was conducted to assess Abi’s receptive and expressive communication abilities.
At the time of evaluation:
Communication was mainly through pointing, gestures, and dragging adults toward desired objects
Limited spontaneous speech was observed
Vocabulary for common objects and actions was restricted
Difficulty expressing needs verbally
Standardized language assessments showed developmental delays:
Receptive Language Age (RLA): 20–22 months
Expressive Language Age (ELA): 18–20 months
Additional language evaluation showed:
Receptive language abilities below expected age level
Expressive language skills significantly delayed
These findings indicated Spoken Language Disorder with delayed communication development.
Based on multidisciplinary assessments, individualized therapy goals were developed.
Improve attention and task engagement
Reduce behavioural tantrums
Improve emotional regulation
Increase participation in structured activities
Encourage appropriate behavioural responses
Improve fine motor skills and eye-hand coordination
Increase independence in dressing and self-feeding
Develop toileting skills and daily living independence
Improve sitting tolerance during activities
Address sensory sensitivities through sensory integration therapy
Improve functional communication
Increase expressive vocabulary
Develop two-word and three-word phrases
Improve comprehension of instructions
Encourage answering simple questions
Improve pre-writing and early academic skills
Develop ability to follow instructions
Improve attention during structured learning activities
Enhance cognitive skills such as matching, sorting, and concept identification
Abi participated in a multidisciplinary therapy program designed to address her communication, behavioural, and developmental needs.
Behaviour therapy focused on improving behaviour regulation and attention.
Interventions included:
structured play activities
positive reinforcement techniques
attention-building tasks
behaviour regulation strategies
guided peer interaction activities
These interventions helped the child gradually improve cooperation during therapy sessions.
Occupational therapy targeted sensory processing, fine motor development, and participation in structured tasks.
Therapy activities included:
fine motor strengthening activities
visual-motor integration tasks
play-based therapy
sensory regulation activities
ADL training for toileting independence
These interventions improved Abi’s attention span and participation in activities.
Speech therapy sessions focused on developing communication skills and vocabulary.
Therapeutic strategies included:
joint attention activities
vocabulary development
modelling and imitation techniques
structured communication exercises
functional communication training
Over time, therapy progressed to sentence formation and expressive language expansion.
Special education sessions focused on early learning skills and school readiness.
Activities included:
pre-writing exercises
matching and sorting tasks
concept development activities
instruction-following tasks
structured learning routines
These sessions helped improve attention and cognitive engagement during structured learning tasks.
Follow-up language assessments were conducted to evaluate progress.
Receptive Language Age: 24–27 months
Expressive Language Age: 20–22 months
Further language evaluation indicated improvement in both receptive and expressive communication abilities.
After consistent therapy sessions, several positive developmental changes were observed.
Improved cooperation during therapy sessions
Reduced tantrums during structured tasks
Better attention and engagement
Increased expressive vocabulary
Use of two- to three-word phrases
Improved ability to follow one- and two-step instructions
Improved response to simple “wh” questions
Improved spatial and cognitive skills
Better attention during activities
Increased participation in structured learning tasks
Abi’s developmental journey demonstrates that early therapy intervention can significantly improve communication and behavioural skills in young children with speech delays.
With continued therapy, parental involvement, and structured developmental support, children can build stronger communication skills, improved attention, and better participation in daily activities.
Akash’s developmental journey demonstrates how structured and early therapeutic intervention can support children with autism in achieving meaningful improvements in communication, behaviour, and independence.
With continued therapy and supportive home environments, children with developmental challenges can build essential life skills and participate more confidently in everyday activities.
If you are noticing signs such as speech delay, reduced eye contact, hyperactivity, or difficulty interacting with others, early assessment can help.
