Early Intervention for Babies and Toddlers
Earlier is kinder — not because a window slams shut, but because looking, requesting and recovering from a no are cheaper to teach at two than at eight. Two or three skills in meals and play. Not five therapies stacked into a toddler’s week.
Written by the Inclusive Developmental and Therapy Center therapy team — our Speech & Language Therapist, psychology and ABA staff. This page is awaiting its clinical review.
About Early Intervention
Early intervention at Inclusive Developmental and Therapy Center in Model Town, Multan is the work of the first years: looking when you say a name, requesting with a reach or a sound, recovering from a no, and play that goes back and forth. Contact owner Muhammad Salman Afzal first; faculty includes Mahnoor Baloch. How she frames this: early intervention with Mahnoor. A consultation is Rs 1,500 and lasts up to 50 minutes.
It is not five therapies stacked into a toddler’s week until nobody has a home left. It is two or three skills, practised in meals and play, with the parent in the room. Mahnoor’s 4Dots practicum (May–July 2024) used that shape with young autistic children. It is listed as a practicum, not a published trial.
You do not need a diagnosis. A worry and a few examples are enough. Lost skills at any age is same-week, not “wait and see”. Age-by-age lists: milestones. Red-flag guides: one year, two years, three years.
Who this is for
- No pointing or response to name by 12 months (hearing checked first)
- Few or no words by 18 months
- No two-word combinations by two
- Play that does not go back and forth — the adult acts, the child does not answer
- Toddlers who have lost skills they used to have
- Parents who want to know what to do in meals and play this week, not a waiting list
What early intervention is, and what it is not
It is teaching looking, requesting and recovering from a no inside the routines you already have — breakfast, the bath, a two-minute floor game. The parent is the therapist between sessions. That is why parent coaching sits next to this programme, not as an extra.
It is not a promise that a child “catches the window or misses it forever”. Brains keep learning well past three. Earlier is kinder because the same skill is cheaper to teach at two than at eight, and because a toddler’s week still has room for play. It is not five appointments a week. If a centre offers that as the only honest plan, ask what the parent is supposed to do at home.
What we actually practise in the first month
Two or three skills, not twenty. Speech and requesting often share the same first month: speech therapy, communication.
- A look when you say their name — after hearing has been checked, not before
- A reach, a sound or a picture to request something they already want
- Recovering from a no without the whole morning collapsing
- A two-minute play that goes back and forth: you act, they answer, you wait
- One routine (snack, bath, outdoor shoes) that becomes the daily practice
When to come, rather than wait and see
Ask now if there is no babbling or pointing around 12 months, no clear words by 18 months, no two-word combinations by two, or if skills that were there have gone. One late milestone on its own is often nothing. A cluster, or a loss, is not nothing.
Assessment is the first hour: developmental assessment. Hearing is asked about at every first look, because glue ear can look like a late talker for months. If a medical opinion is needed, we say so that day.
How it joins the rest of the plan
Under-3s who are autistic often sit in both this programme and autism support. School is later — school readiness is for sitting and a classroom, not for a one-year-old. Related cluster pages: a session, at home, under 3s.
What a parent can try at breakfast tomorrow
None of this needs a toy catalogue. The skill lives in the pause, not in the equipment.
- Hold the cup for two extra seconds before you hand it over. Wait for a look, a reach or a sound. Then give it. That is requesting.
- Sit on the floor and copy what they are already doing with one toy of your own. Then wait. A look back at you is a turn.
- Say their name once, from the side, not in their face. If they do not turn, move closer and try again. Do not stack the name six times.
- Warn before a no: “one more, then finished.” Then stop. Recovering from a no is a skill, not a test of toughness.
- Count words across Urdu and English. Paani and water are both words. Mixing two languages in one sentence is typical, not confusion — bilingualism does not cause delay.
Bacha bolta nahi — talking this through in Urdu
Say it however it comes out. Bacha bolta nahi. Naam lene par nahi mudta. Apni hi dunya mein rehta hai. Early intervention here sits alongside speech and, where the picture is autism, the joined-up autism programme. A child who is late to talk has not been spoiled, and nobody here will tell you to wait another year on a hunch.
How this programme works, in more depth
Each of these pages is one slice of the work — a session, who it is for, or what to try at home — linked back to this service.
What a session actually looks like
- 1You tell us what you have noticed, in the words you actually use at home.
- 2We watch play, looking, requesting — not a test the toddler has to pass.
- 3We pick two skills for this month, practised in one routine.
- 4You leave with what to do at breakfast or bath, not a sheet of twenty games.
Take a worksheet home
Print one sheet. Fill it in this week. Bring it to the consultation — a consultation is Rs 1,500 and lasts up to 50 minutes.
First-words picture cards
Cut-out cards for late talkers. Name, wait, celebrate any try.
Requesting cards
Help, more, finished, stop, my turn, can I play — a faster ask than screaming.
Home practice log
One skill, a few minutes, one line of what happened. Bring it next time.
Talking home program (PDF)
Pauses at snack and bath.
Book a consultation
Contact owner Muhammad Salman Afzal first. No referral needed. A consultation is Rs 1,500 and lasts up to 50 minutes.
The idea behind the work (in the books)
The first years are taught as joint attention and requesting inside real play, not as a stack of clinic hours. We use these books as teaching ideas. We do not run a certified Early Start Denver Model, Hanen or ESDM programme.
Bruner — scaffolding and formats
Jerome Bruner described scaffolding: the adult holds just enough of the task that the child can take the next step, then quietly takes the props away. A “format” is a tiny repeated game (peekaboo, ready-steady-go) that gives the child a slot to fill. That is why we practise one routine, not twenty new games.
Rogers and Dawson — Early Start Denver Model for Young Children with Autism
Sally Rogers and Geraldine Dawson’s ESDM book puts play, parent coaching and ABA-style teaching in the same hour: follow the child’s lead, then stretch one more turn. The 2010 Pediatrics trial is real; the 2019 multi-site replication was only partial. We borrow the shape — play, parent in the room, two skills — not the certified programme or the intensity those trials used.
Mundy — joint attention
Peter Mundy’s work treats a shared look (“did you see that?”) as the floor under first words. A child who will not look when you point has nothing to hang a word on yet. We teach the look and the point before we drill vocabulary lists.
Hanen — Observe, Wait, Listen
The Hanen Centre’s OWL (Observe, Wait, Listen) is a parent pause so there is a slot to fill. We coach that pause live. We are not a certified Hanen centre and we will not print “It Takes Two to Talk graduate” on a page we have not earned.
What the research tells us
This isn’t just our opinion — it’s grounded in published research. Here are a few findings from trusted, independent sources:
NICE guidance on autism in under-19s (CG170) recommends considering a specific social-communication intervention that uses play-based strategies with parents, adjusted to the child’s developmental level, to increase joint attention, engagement and reciprocal communication. For pre-school children it recommends parent mediation. That is the shape of this programme: play, the parent in the room, two or three skills.
— NICE Clinical Guideline CG170 — Autism spectrum disorder in under 19s: support and management. View sourceA Cochrane review of parent-mediated early intervention for young autistic children (17 trials, 919 children) found strong evidence that the way parent and child interact changes — more shared attention, more parent synchrony. Evidence that the child’s own language and adaptive skills change was smaller and less certain. That is why we measure looking and requesting first, and why we do not promise words by a date.
— Cochrane Database of Systematic Reviews — Oono, Honey and McConachie (2013), CD009774. View sourceDawson, Rogers and colleagues (Pediatrics, 2010) ran a 48-child randomised trial of the Early Start Denver Model. After two years the ESDM group gained 17.6 IQ points on average versus 7.0 in community care. A 2019 multi-site replication (Rogers et al., 118 children) only partly reproduced the language finding and did not reproduce the IQ, autism-severity or adaptive-behaviour differences. We print both results. Inclusive does not run certified ESDM.
— Dawson et al., Pediatrics (2010), PMID 19948568; Rogers et al., JAACAP (2019), PMID 30768394. View source
Other ways we can help
Speech Therapy
Help for late talkers, unclear speech, stammering and language delay, through play your child enjoys.
Motor & Daily Skills
Motor, handwriting and self-care skills, built up through purposeful play.
ABA Therapy
ABA and positive-behaviour support for autism, ADHD and hard-to-manage behaviour.
Early Intervention: your questions answered
Is it too late if my child is already three?
No. Three is still early. The plan simply starts to look more like sitting, requesting and play that will have to survive a classroom. See school readiness if the next door is nursery.
Do they have to sit on a chair?
No. Floor play is the session. Sitting is a later school-readiness skill.
Is this instead of an assessment?
No. Contact owner Muhammad Salman Afzal first. The first look is still the start. This programme is the hours that follow, with you in the room. See developmental assessment.
My child is not pointing and does not turn to their name. Is that autism?
It is a reason to look, not a diagnosis. Hearing comes first. Then we watch looking, requesting and play. A formal autism diagnosis sits with a developmental paediatrician or psychiatrist. Therapy can start on the strength of what we see. Not responding to their name walks through the first checks.
How many sessions a week does a toddler need?
Most toddlers here come once a week, with the parent in the room, and practise two skills in one home routine every day. We will not stack five clinic hours into a week that then has no home left. If a child needs more intensity than we can honestly staff, we say so.
Can this be done online?
Parent coaching for under-3s works well on video because we watch you, not the toddler on camera. Hands-on looking and play is more accurate in the room. We will say which parts transfer. See parent coaching and online therapy.
Worried about your child? Let’s talk.
A short, friendly conversation is the best first step. Call, text or WhatsApp us — we’ll listen and guide you, with no pressure.
MPS Road, Block A Model Town, Multan (near Bloomfield Hall School, Street No. 2) · Mon–Fri, 2 PM – 6 PM