EARLY CHILDHOOD TO
Babies come with a lot of firsts, including moments when a small symptom feels like a big question. At Children’s HealthSM, our pediatric experts provide answers to parents’ everyday concerns, from fevers to feedings, so you can breathe easier.
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17 Potty Training Without Pressure
How to follow readiness—not deadlines—and partner with the preschool along the way 22 Early Support
From referral to in-home therapy, a guide to Texas’ Early Childhood Intervention program
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LBig Questions
ATELY, OUR HOUSE HAS BEEN POWERED BY ONE WORD: WHY.
Why is the sky blue?
Why do dogs bark?
Why can’t I have cookies for breakfast?
Why do I have to go to bed?
If you’re parenting a preschooler too, you know the phase—the endless curiosity, the rapid-fire questions, the wide-eyed wonder about how the world works.
But here’s the funny part: while our kids are busy asking why, many of us are quietly asking questions of our own. If you have a little one, chances are you’ve Googled something at 10pm recently.
Is this normal?
Should they be talking more by now?
Why is drop-off suddenly so hard?
How do we handle these big feelings?
And are we ever going to figure out potty training?
The early childhood years are filled with explosive growth. It’s when language blossoms, independence emerges and emotions run big—and loud. It’s a stage that feels both magical and messy—when our children are learning not just how to count and communicate, but how to regulate emotions, build friendships and take their first steps toward independence (sometimes literally, sometimes in the bathroom).
This annual Guide to Early Childhood is designed to meet you in that in-between space—where curiosity is constant and questions are normal. Inside, you’ll find expert insight, local resources and practical guidance on everything from developmental support and early intervention to potty training, emotional intelligence and preparing for preschool.
Because raising little kids is big work—and just like our children, we’re doing a lot of wondering, too. The good news? You don’t have to figure it out alone.
BELOW // Amanda Collins Bernier, managing editor, with her sons Max and Owen.
BALLET for EARLY LEARNERS
Dance helps young children strengthen memory, problem solving, balance, and emotional expression—and Texas Ballet Theater’s Early Learners classes put these skills in motion. Designed for ages 3–6, these playful ballet classes spark imagination while introducing technique, musicality, and classroom structure in a positive, age-appropriate way.
Year-round classes & summer
Dallas School at Preston Center 6118 Luther Lane
Dallas, TX 75225
214.251.8199
Fort Worth School 1500 Mall Circle
Fort Worth, TX 76116
817.763.0207
Richardson School 300 North Coit Road Ste. 231
Richardson, TX 75080
214.377.8576
Emotionally Equipped
Building self-awareness and empathy from the start
WORDS KATELIN WALLING
PICTURE THIS: YOUR KIDDO ASKS FOR A SUGARY SNACK BEFORE DINNER. When you say no, he’s upset—but instead of throwing a tantrum he takes a few deep breaths and calms down. Or perhaps your preschooler notices a sad classmate on the playground and stops to comfort her. These two moments may look different, but at their core, they both come down to one thing: emotional intelligence (EQ), a crucial life skill first coined in the 1990s.
But what really is emotional intelligence and how can you ensure your child develops these skills so the above scenarios become reality? Three area experts share what you need to know.
EQ 101
Simply put, emotional intelligence is the ability to recognize, understand and manage emotions—both our own and others, says Christina Kelso, Mental Matters Project Manager at Big Thought, a Dallasbased nonprofit that helps youth develop socialemotional skills—the building blocks to EQ. The organization works with Collaborative for Academic, Social, and Emotional Learning (CASEL), which breaks EQ into five core competencies: self-awareness, self-management, social awareness, relationship skills and decision-making.
Developing these competencies is critically important because they lay the foundation for your child’s mental health, academics and overall well-being,
according to Megan Rosewell, a licensed professional counselor and Director of Children’s Services at Beckloff Behavioral Health Center in Dallas. A strong EQ helps children regulate emotions, build stronger friendships, improve communication, increase selfconfidence and perform better in school. Long term, it supports healthier relationships, stronger mental health, greater career success and resilience in the face of loss, failure, change or conflict.
BUILDING EQ: AGE-BY-AGE
The most powerful way to help your children develop emotional intelligence skills? Model them—kids learn emotional skills primarily through observation. “Kids don’t just hear your lessons on emotional regulation. They absorb them through every calm breath,
repair conversation and moment of patience parents and caregivers model,” says Rosewell. Beyond modeling, how can we ensure our little ones build these ever-important skills? Rosewell, Kelso and Dr. Priscilla Soliman, a clinical pediatric psychologist at Cook Children’s Healthcare System in Forth Worth, share their tips, broken down by age range.
TODDLERS
Build your little one’s emotional vocabulary. This may seem small, but learning how to recognize and name emotions are the building blocks of other emotional intelligence skills, according to Soliman. When she’s upset because you said no to screen time, say, “I can see by your frown that you’re upset.” A visual aid or feelings chart to help children identify emotions can be a helpful tool here.
SHELF HELP
Provide a safe space to express emotions. When your young child is feeling a big emotion, assure him it’s OK to feel mad, sad or scared. Just don’t validate bad behaviors that may come with those feelings, reminds Rosewell. You can say, it’s OK to be mad, but it’s not OK to hit others.
Read books about feelings. It can be helpful for children to see images to identify and relate to different emotions. You can even do this with books already in your home library, Kelso says. Take what you’re seeing in the illustrations or reading in the text and create questions about it. How do you think that person’s feeling? Or she’s feeling angry—how can you tell by looking at the picture?
Begin teaching simple relaxation techniques. Deep breathing exercises, visualizing calm scenes, or moving her body can help your little one regulate her emotions. Just remember: “Teaching always needs to happen when kids are already regulated,” Kelso says. So the teaching and practicing needs to happen before or after, not in the middle of your kiddo experiencing big emotions.
EARLY LEARNERS
Expand your child’s emotional vocabulary. Now’s the time to start moving beyond simple feeling words like mad and sad to more complex ones like frustrated, disappointed, or nervous, recommends Rosewell.
Focus on empathy. If your little one has a conflict with a friend or gets in a squabble with a sibling, talk about how others might feel and guide her through it by asking questions like: How do you think your friend feels? Or why do you think your brother reacted the way he did? You can also build empathy by discussing characters’ perspectives when watching movies or reading books.
Build problem-solving skills. After you talk through the questions to practice empathy, guide your kiddo to think of solutions rather than jumping into problem-fixing mode. Ask questions like: What could you do if this happens again? How do you think you should react next time? Or what’s a good way to respond in the future?
Practice self-reflection. Ask your child how they felt when doing different activities or interactions throughout the day and why they think they felt
Recommended by Megan Rosewell, Director of Children’s Services at Beckloff Behavioral Health Center in Dallas, these six books for little ones introduce emotions and how they feel.
1. My Many Colored Days by Dr. Seuss: Vibrant colors and a menagerie of animals illustrate the range of moods and emotions; ages 1–4.
2. A Ball for Daisy by Chris Raschka: Watercolor illustrations show a range of emotions without words, making this a great tool to start identifying feelings based on images; ages 1–5.
3. The Rabbit Listened by Cori Doerrfeld: A moving story about how empathy, listening and kindness can help when sad things happen; ages 2+.
4. The Way I Feel by Janan Cain: Vivid art paired with simple verses helps kids learn to name how they feel; ages 2–4.
5. In My Heart: A Book of Feelings by Jo Witek: The metaphor of the heart as a house explores a full range of emotions and describes how they feel physically in your body; ages 2–5.
6. Feelings by Aliki Brandenberg: Short comics show emotions in different situations, helping kids recognize what they might feel inside; ages 3–7.
that way, Soliman recommends. And when you’re sitting down to family dinner, go around the table and have everyone share an emotional high and low from the day.
THE BOTTOM LINE
Helping your child grow emotionally takes time, patience and consistency. If you notice ongoing challenges—like big emotional reactions, withdrawal, or changes in mood or focus—reach out to your pediatrician or school counselor for guidance. With the right tools and support, kids can learn to recognize, express and manage their feelings in healthy, confident ways.
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Legacy (PS–K) (469) 573-0077
Learning in Practice
How different preschool approaches shape the daily experience
WORDS HEIDI BUTLER
STARTING PRESCHOOL IS A MAJOR MILESTONE FOR A CHILD — but for parents, choosing which one can feel like an overwhelming decision. Every school seems to use the same reassuring buzzwords: play-based, child-led, Reggio-inspired, nature-focused. Yet those terms aren’t always clearly defined. What do they actually mean in practice? How do teachers guide children within these approaches? And how can parents determine which teaching style best supports their child’s unique personality and learning needs?
This guide breaks down the most common preschool learning approaches and curriculum models, helping families better understand their options and choose the right fit with confidence.
CHILD-LED CURRICULUM
Best for children who:
• Are naturally curious and enjoy exploring topics in depth
• Feel self-motivated and comfortable making choices independently
• Thrive when given time and space to follow their own interests
May be less ideal for children who:
• Prefer frequent direction or need consistent teacher guidance to stay engaged
A child-led curriculum puts the little one at the
center of their learning, prioritizing their interests, readiness and natural pace instead of sticking to a fixed lesson plan. Kids are given real choices about what they explore and how long they stay with it, which can help build confidence, independence and a love for discovery.
“Children can sometimes be more engaged in topics they are interested in, which may help them learn more effectively,” says Dr. Candice Mills, professor of psychology at the University of Texas at Dallas, specializing in child and cognitive development. This teaching method allows your child to develop
decision-making, self-control, critical thinking and practical life skills. Teachers serve as observant guides, asking open-ended questions and prompting collaborative projects.
This type of curriculum is often used in Montessori and Reggio Emilia-style programs, where classrooms are carefully prepared with versatile materials and a multitude of learning stations. The environment is meant for children to “choose activities, explore rich materials deeply and work at their own pace,” says Agustina Piffaretti, campus director at Ivybrook Academy, a Montessori school in Frisco. “Educators carefully observe, document learning and introduce materials or questions that extend thinking.”
One potential drawback is that if learning is entirely child-led, some educational areas may get overlooked. “Children might end up neglecting some areas of learning because they aren’t immediately interested in them,” Mills explains. For this reason, some schools will blend child-led learning with intentional teacher guidance and other curriculum styles.
PLAY-BASED CURRICULUM
Best for children who:
• Learn through hands-on exploration
• Enjoy social interaction and imaginative play
• Benefit from movement and active engagement throughout the day May be less ideal for children who:
• Prefer a highly structured environment with frequent direction
• Become overstimulated in busy or lively classroom settings
This style of learning is grounded in the idea that young children learn best through play—by exploring, experimenting and interacting with others in meaningful ways. “In a play-based program, the teacher comes along with the play, joining in and asking open-ended questions and prompts. Play-based curriculums may involve the teacher selecting the specific activities, centers, or games for the children to participate in versus a child-led program where the child is selecting an activity from a variety of choices provided by the teacher,” shares Anna Lewis, Early Childhood Manager and Director of Wild Earth Preschool at the Dallas Zoo.
This approach to learning is found in the majority of early education programs, including the Wild Earth Preschool, which employs the Reggio Emilia philosophy that promotes whole child development through nature and play. Parents will also find this curriculum in Montessori, Waldorf and HighScope schools. These activities are powerful drivers of socialemotional learning and language development. Mills notes that when children are playing together, they have opportunities to cooperate, to consider another child’s perspective and work through conflicts
STRUCTURED ACTIVE LEARNING CURRICULUM
Best for children who:
• Feel secure with consistent routines
• Enjoy hands-on, small-group projects with clear goals
• Benefit from a balance of structure and choice
Curriculum philosophies can sound abstract. Ask schools to walk you through a sample day:
• How much time is spent indoors or outdoors?
• How long are children expected to sit?
• Is there dedicated small-group instruction?
• When does free play happen?
• How are transitions handled?
Seeing the rhythm of the day helps you determine if it fits your child’s temperament.
May be less ideal for children who:
• Prefer complete independence or minimal teacher guidance
Blending predictable routines with hands-on, experiential, child-driven experiences, this style of preschool curriculum lets children learn by doing, while teachers provide a consistent framework that supports safety, assessment and developmental progress. This curriculum is also sometimes called the plan-do-review process or active participatory learning.
“Parents can expect tailored small group lessons with targeted academic goals, hands-on, inquirybased science and social studies experiences, child-led project work, and integrated enrichment involving art, foreign language, music and library studies,” Piffaretti says. “These frameworks provide predictability without rigidity, allowing children to feel secure while still maintaining ownership of their learning.”
Although commonly associated with early elementary education, this approach is also used in some preschool settings, particularly HighScope and Head Start programs as well as hybrid Montessori and Reggio Emilia-inspired models.
NATURE-BASED CURRICULUM
Best for children who:
• Love being outdoors in a variety of weather conditions
• Learn best through movement and hands-on sensory experiences
• Are naturally curious about animals, plants, and the natural world
May be less ideal for children who:
• Have severe environmental allergies
• Prefer to stay indoors or are uncomfortable getting messy
The outdoors serves as the primary classroom in nature-based preschools. Learning unfolds through direct interaction with organic elements, animals,
the weather and seasonal changes. “Through engagement with living organisms and natural materials, students develop resilience, independence, and an understanding of environmental stewardship,” Lewis shares. “This approach also supports creativity, expands vocabulary and language skills, and improves focus and attention.”
In a nature-based model, children spend most of their day outdoors, engaging with dirt, sticks, plants and insects in a sensory-rich and often messy, environ ment. This makes it an especially engaging space for kinesthetic learners. Children are encouraged to participate in physical activity, practice problem-solving and risk assess ment, and work and play alongside peers in mixed-age groups.
Many preschools utilize nature play in their teachings, but programs housed within nature centers, wildlife sanctuaries or environmental education facilities, where outdoor learning is embedded into daily instruction, tend to provide the most immer sive nature experiences for littles. In addition, many Reggio Emilia–inspired schools inten tionally treat the environment as a central component of the educational experience, incorporating natural materials, outdoor inquiry and project-based exploration as foundational elements of the classroom. And some Montessori schools lean heavily into the outdoors, though that varies by campus.
LANGUAGE IMMERSION
Early childhood language immersion gives children the experience of being taught partially or entirely in a second language. This is used as an instructional lens layered onto other approaches, not a standalone curriculum. It’s also important to note that this does not dictate how children learn cognitive, motor, or social skills. Instead, it shapes the language used to support those skills.
“The easiest time for someone to learn a second language is in childhood,” Mills shares. “Children can often pick up the grammar and pronunciation more quickly from immersion during preschool than they would from taking a class for a couple hours a week at that age or waiting until secondary school to learn another language.” However, she notes that if you want your child to retain this knowledge after preschool ends, then you will need to select future programs that foster more language lessons if the second language is not regularly used at home.
OTHER MODELS TO KNOW
While child-led, play-based and nature-based models often dominate the conversation, they aren’t
the only options. Many preschools follow a more traditional, teacher-directed approach that emphasizes early academic readiness through structured lessons, clear routines and skill-building in literacy and math. These programs often appeal to families seeking strong preparation for kindergarten with measurable learning goals and consistent daily schedules. You’re most likely to find this style in private academic preschools, some faith-based programs, and campusaffiliated early childhood centers that align closely with local elementary school expectations.
Faith-based schools may blend structured academics with religious instruction and valuesbased learning, while other programs incorporate specialized focuses—such as STEM exploration, arts integration or social-emotional learning frameworks—without strictly adhering to one named philosophy. As with any model, what matters most is how intentionally and consistently the approach is implemented in the classroom.
LOOK PAST THE LABELS
Mills notes that while choosing a curriculum that complements your child’s learning style is important, it’s just one piece of the puzzle. She encourages families to ask school leaders the following questions:
• How are your teachers trained and supported?
• What is the class size and the teacher-to-child ratio for that particular age group?
• How does the school handle discipline?
• How do teachers help children resolve conflicts?
• What does a typical day look like?
• How do teachers balance play and education?
• How is nap time handled?
• How are families involved?
“Ultimately,” Mills says, “the right preschool is one that understands your child’s strengths and needs and supports their continued growth.”
Piffaretti echoes this sentiment. “We encourage families to look beyond buzzwords and focus on how schools truly bring their philosophy to life each day. Consider who your child is as a learner, friend, thinker and creator and how they will respond to a program’s environment, practices, and values.”
At the end of the day, the best preschool isn’t defined by buzzwords or labels—it’s the one where your child feels seen, supported, and inspired to explore, grow and thrive. When looking for a school, take the time to go on tours, ask thoughtful questions and reach out to other parents in your area to find the environment that will best support your child throughout their first educational experience.
“We encourage families to look beyond buzzwords and focus on how schools truly bring their philosophy to life each day.”
—AGUSTINA PIFFARETTI
Nuture a child’s confidence and it will blossom into something beautiful. Health & Safety | Active Minds | Healthy Bodies | Happy Hearts
Primrose Schools® is a national accredited private preschool that is committed to delivering a high-quality early learning experience to meet the needs of children and families.
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Potty Training Without Pressure
How to follow readiness—not deadlines—and partner with preschool along the way
WORDS AMANDA COLLINS BERNIER
THE DANIEL TIGER UNDERWEAR WERE SUPPOSED TO SEAL THE DEAL. We had the sticker chart taped to the fridge, a jar of popsicles ready for victories and a carefully rehearsed potty song. Pee? No problem. But when it came to number two, my son planted his feet—figuratively and literally.
Weeks stretched into months. Preschool was around the corner. My confidence began to wobble. I found myself wondering whether I needed to push harder, try a different method, or declare a “potty boot camp” weekend.
Instead, what I needed was patience—and a better understanding of readiness. Experts agree: when it comes to potty training, pressure is rarely productive.
“Most kids are developmentally ready sometime between age 2 and 3,” says Dr. Stevie Puckett-Perez, pediatric psychologist in gastroenterology at Children’s Health in Dallas. “If we start before kids show readiness signs because we want to potty train faster, it typically doesn’t go any faster and can take longer.”
In other words, rushing the process doesn’t speed it up. It often slows it down.
WHAT READINESS REALLY LOOKS LIKE
Potty training isn’t simply about ditching diapers. It’s a surprisingly complex developmental task. Learning to use the toilet involves “a dynamic mix of physiological cues and readiness signs, ability to integrate sensory signals, and a multi-step chain of events,” Puckett-Perez explains.
True readiness isn’t measured by age, but by skills. Signs include:
• Following basic instructions and communicating needs through words or gestures
• Having the motor skills to sit, stand and pull pants up and down
• Staying dry for a couple of hours
• Showing interest in the toilet or “big kid” underwear
• Noticing that they need to potty, or have certain pre-potty behaviors, like going behind a couch or squatting to go in their diaper, or even telling you that they are about to pee or poop
But even when the time is right, it’s important to manage expectations. Daytime control typically comes before nighttime, and mastering urine usually happens faster than stool. Even after children are potty trained, occasional accidents are common—sometimes up to age 6.
And despite the popularity of “three-day” methods, most children take longer. “Some kids will easily master toileting in a weekend,” Puckett-Perez says. “But the more typical timeline is months, not days.”
PRESSURE CAN BACKFIRE
When adults push too hard to meet a deadline, children often push back. Strong-willed children, in particular, can turn toilet learning into a control issue. Forcing the process could even lead to withholding urine or stool and fear of toileting.
Instead of ultimatums, she recommends building autonomy into the process through limited choices: “Do you want to set the timer for 2 minutes or 3?” or “Do you want the red or the blue undies?”
If a child refuses, pause rather than escalate. Neutral language protects confidence. There can also be some natural consequences to behavior that do not feel like overt punishment, Puckett-Perez says. “Such as, ‘Well, we can’t go play at the park just yet until we’ve had our potty break. Let me know when you’re ready.’”
And when the process stalls or mistakes happen, she stresses the importance of keeping your emotions in check. “The process of potty training can be immensely frustrating for parents, and sometimes that tends to show in our words, facial expressions, or body language. We want to do our best to keep that in check so that our sensitive children do not internalize a sense of shame or failure and shut down when it comes to toileting.”
POTTY TRAINING BY PERSONALITY
Temperament plays a bigger role in toileting than many parents realize. A child’s personality impacts how they learn, so try to know what big traits your child and use these to your advantage when potty training and choose a method and pace that is right for them.
POTTY WINS
Dr. Stevie Puckett-Perez shares five simple strategies to help kids master potty time.
1. Talk the talk.
Choose words that feel natural to your family—pee, poop, potty, toilet—and start using them consistently. Model bathroom routines and narrate what you’re doing. “For example, ‘I have to go potty, so I pull my pants down and sit on the potty and let the pee come out in the toilet. Now I got it all out and use some toilet paper to wipe and get clean. Now I have to pull my pants back up and flush the pee away. And now I get to wash my hands and be all done!’” says Puckett-Perez.
2. Remember size matters.
Whether you choose a child-sized potty or a seat attachment, make sure your child’s feet can rest flat on the floor or a stool. Dangling feet make it harder for kids to use their muscles effectively.
3. Make it fun.
Keep special potty-only toys in the bathroom to make practice time feel positive. Let your child pick out “big kid” underwear and turn it into a playful challenge: “Let’s see if we can keep Elmo dry!”
4. Stay potty positive.
“In GI Psychology, we tell kids all pee is good pee, all poop is good poop, as long as it gets out of your body,” says PuckettPerez. Avoid labeling pee or poop as “yucky,” “stinky” or “gross.” Instead, praise effort and progress.
5. Practice pushing.
If your child struggles with “pushing,” make it playful. Blowing bubbles or balloons while sitting on the toilet can help activate the right muscles.
Highly active children may struggle to notice internal body cues until it’s too late—or resist stopping play to take a break. In those cases, scheduled potty breaks and frequent body check-ins can help. Some are very reward driven, so using something like a visual chart where they can color in boxes when they practice sitting on the potty and earn prizes for their efforts can be effective.
Sensitive or cautious children may internalize mistakes. Even subtle frustration from a parent can feel like failure. For these children, keeping language neutral and praising effort rather than outcome can make a big difference. And kids with an independent streak respond best when they feel ownership in the process. These
Potty training isn’t simply about ditching diapers. It’s a surprisingly complex developmental task.
children tend to have a high need for control and selfagency, so choice-giving can help reduce resistance.
Remember, just like every other milestone, there’s a spectrum of normal. “Each child has their own timeline,” Puckett-Perez says. “Even bright, healthy, successful children can struggle with potty learning.”
WHAT PRESCHOOLS REALLY EXPECT
Preschool requirements are one of the biggest sources of stress around potty training. Some programs require children to be fully potty trained before enrollment or by a certain age. But policies vary widely—some schools might require complete independence, while others allow pull-ups or offer support, often depending on staffing, or if the setting is a private, public or cooperative preschool.
From the classroom perspective, independence doesn’t mean perfection, says Ana Bravo, executive director at Primrose School of Prestonwood. She defines potty trained as “the ability to remain dry during the day and independently recognizing the need to use the potty,” along with managing clothing and maintaining hygiene independently. But she’s quick to clarify that children aren’t expected to arrive flawless. “The beginning is only the beginning,” she says.
Accidents—especially early in the school year— are “very common,” she says. Teachers handle them calmly, getting on the child’s level and offering reassurance: “It’s OK!” Parents should remember these accidents are very normal, she says, and prepare by sending a few sets of extra clothes to school with their kiddo.
Developmentally, young preschoolers can usually manage the gross motor portions of toileting—pulling down elastic-waist clothing and climbing onto a preschool-height potty, but wiping thoroughly requires fine motor dexterity many children haven’t mastered yet. Some preschools won’t help with wiping, so be sure to ask about it before your child starts. Practice the skill at home with toilet paper or wet wipes so that your child has the confidence to do it at school but be realistic. “We expect that young learners will not be very thorough with their wiping and it’s normal to come home with some mild soiling or smearing, or for kids to continue needing wiping help at home,” says Puckett-Perez.
THE PRESCHOOL POTTY TRANSITION
Preschool can be a great motivator for helping kids along the path of potty training in some cases. Children this age often benefit from seeing other kids practice going to the toilet, washing hands and otherwise normalizing the experience of potty breaks
and practices. Seeing it be commonplace helps with exposure and learning for many kids
But even children who are mostly trained may regress when school begins. “Children may experience dips and setbacks in any developmental milestones as their brains and bodies adapt to a transition,” Puckett-Perez explains.
Starting preschool introduces new routines, social demands, and distractions. Other life changes— like a new sibling or move—can also trigger regression. When accidents increase, the solution isn’t shame—it’s support. Parents may need to temporarily return to scheduled potty breaks, reminders and positive reinforcement until confidence rebuilds.
THE HOME–SCHOOL PARTNERSHIP
Most preschools understand that potty training is a process, and if they know that your child is working on the learning process they are willing to work with you. But communication is key. Bravo encourages families to ask about bathroom schedules, clothing expectations and whether the school prefers pull-ups or underwear before the year begins.
And share honestly how potty training is going home, too—what’s worked and where your little one might need some help. “Consistency is key,” Bravo says. Maintaining similar schedules and language at home and school helps children feel secure.
She also recommends written communication— emails or messages—so updates and plans aren’t forgotten. And she offers reassurance for anxious parents: “It takes practice. Each child is different and will learn at their own pace.”
Most importantly, she frames toilet learning as a shared effort. “Remember that this journey is a partnership, not a solo act.”
WHEN TO PAUSE—OR SEEK HELP
If a child is intensely resistant, dysregulated or shows no readiness signs over age 3, parents may want to consider consulting their pediatrician.
Other reasons to seek guidance include:
• Pain with urination or bowel movements
• Withholding stool
• Sudden accidents after age 6
But for most families, the biggest takeaway is this: potty training is a process.
“Potty training truly is a complex process,” Puckett-Perez says. “We cannot force an arbitrary timeline on a child to have perfectly mastered all of the pieces.”
When parents focus on readiness, maintain open communication with preschool, and protect their child’s confidence, toilet learning becomes what it was meant to be: another step in growing up—not a race to win.
Early Support
From referral to in-home therapy, a guide to Texas’ Early Childhood Intervention program
WORDS KATELIN WALLING
FOR MANY PARENTS, DEVELOPMENTAL CONCERNS don’t arrive all at once. They build slowly—delay in walking, difficulty with balance, fewer words than expected. You might tell yourself to wait and see, but sometimes that quiet inner voice keeps nudging you to look a little closer.
If your gut is nudging you to pay attention, don’t ignore it. Calling your local Early Childhood Intervention (ECI) provider is an excellent first step, says Catherine Carlton, chief of staff at My Health My Resources of Tarrant County (MHMR), a nonprofit that offers community-based child and family services. Carlton knows that feeling firsthand. Her own son needed physical therapy to strengthen his legs, and he qualified for ECI services.
“It’s overwhelming. I mean, when you need help and rely on a system to help you, it is overwhelming and stressful and hard and scary and alone and all those adjectives. But what I found is that ECI provided that support and connection for me to understand the system, to get my son what he needed, to support not just me but my family. They were our cheerleaders. They were our supporters. They were our providers,” she says.
If you’re concerned about a developmental delay, Early Childhood Intervention could be exactly what your child needs. Here’s what to know.
ECI EXPLAINED
Early Childhood Intervention is a statewide program that offers services such as speech, occupational, feeding and developmental therapies to children ages 3 and younger. Little ones receive these services in their natural learning environment—whether that’s home, in a child care setting or even a grandparent’s house, says Anisha Philips, senior director of ECI at MHMR Tarrant.
Children don’t need to have a special needs diagnosis to receive ECI services. They qualify if they meet one of three criteria:
1. They have a medical diagnosis that’s likely to cause a developmental delay, such as cerebral palsy, epilepsy, Down syndrome or spina bifida. (Parents can use the ECI Qualifying Diagnosis Search Tool at diagsearch.hhsc.state.tx.us.)
2. They are deaf, hard of hearing, blind or visually impaired, as defined by the Texas Education Agency.
3. They have a delay of at least 25% in one or more areas of social/emotional, adaptive, communicative, motor or cognitive development or 33% in expressive language development.
Once a child qualifies, services continue until developmental goals are met or they transition out of the program at age 3, explains Dr. Tracy Harrington, a licensed psychologist in the Developmental Psychology department at Cook Children’s. Nationally, the Centers for Disease Control and Prevention estimates that about 1 in 6 children has a developmental delay or disability, making a need for early support more common than many parents realize.
WHEN SHOULD PARENTS CONSIDER ECI?
Your pediatrician is an important partner. Well-child visits in the first few years include developmental screenings, and doctors track progress in communication, movement and social skills. But parents don’t need to wait for a provider to raise concerns; you know your child best.
“Mom to mom, I would say, call,” Carlton says. “Calling and everything being OK is a good situation, but calling and there is a need? You want to do that sooner rather than later, so that you can get connected to the team.”
The brain develops at a rapid rate in the first few years, and research shows that early intervention is key to bridging the gap when there’s a developmental delay. As children age, the gaps continue to expand and the delays can get more profound if not addressed, Harrington says.
While every child develops at their own pace, these signs may warrant a closer look:
OVER 3?
Start Here
Early Childhood Intervention services end at age 3, but support doesn’t stop there. If you have concerns about a child who is older, you can contact your local public school district and request a free evaluation. You do not need a doctor’s referral, and your child does not have to be enrolled in the district to request an evaluation.
If eligible, your child may receive services through an Individualized Education Plan (IEP), which can include speech therapy, occupational therapy, behavioral support or classroom accommodations.
• Your 12-month-old doesn’t crawl, use gestures like waving or shaking their head, show interest in peek-a-boo, babble or sit steadily. Other things to watch for include not being able to stand when supported or eating solid foods.
• Your 1- to 2-year-old doesn’t speak or use twoword sentences, know the function of common household objects, imitate actions or words or follow one-step instructions. Not walking or developing a heel-toe walking pattern could be other red flags.
• Your 2- to 3-year-old has difficulty with the stairs, drools or has unclear speech, can’t communicate in short phrases, doesn’t understand simple instructions or has extreme difficulty separating from a primary caregiver. Other warning signs at this age relate to play: your child can’t build a tower of more than four blocks, doesn’t engage in pretend play or has little interest in other children.
GETTING STARTED
If you’re concerned about your child’s development, you—or your pediatrician, a family member, or other caregiver—can request an evaluation. You’ll fill out a referral form, which includes basic contact information and a description of your concerns. You can find this form on your local ECI provider’s website. To find the program that serves your area, visit hhs.texas.gov and search “ECI Program Search,” where you can look up services by city, county or zip code.
Once a referral is submitted, the ECI provider has 45 calendar days to complete an evaluation and write the Individualized Family Service Plan (IFSP). Within a few days, someone from your local program will reach out to schedule a first visit.
During this first visit, which typically lasts about two hours and often takes place in your home. During
“We want to make sure that those families have a lifeline to us.”
—AMY SPAWN
the visit, specialists conduct a comprehensive assessment that looks at all areas of development and ask detailed questions about your child’s history, daily routines, strengths and your family’s priorities.
If your child does not qualify, ECI providers often connect families to additional community resources and may schedule a follow-up evaluation in several months, says Amy Spawn, CEO of The Warren Center in Dallas. “We will check back in with the family in three months or six months and see how the child is doing. If the parents have concerns again, we’ll have them come back in and do another evaluation,” she says. “We want to make sure that those families have a lifeline to us.”
EIC PROVIDERS IN DFW
The following are Early Childhood Intervention programs in the DFW area that work in association with Texas Health and Human Services:
LifePath Systems
1515 Heritage Drive, McKinney 972/562-0331 lifepathsystems.org
Metrocare Services
3230 Remond Drive, Dallas 214/331-0109 metrocareservices.org
If your child does qualify, you’ll work with your team to write an IFSP. This plan is developed based on the unique needs of your child and family, and it includes goals you set together, what services are needed, how often they’ll be provided and who will be providing them. It will also include information like your service coordinator’s name, a description of your child’s strengths and needs, an explanation of how the team will measure your kiddo’s progress and any services your child needs that aren’t provided by ECI.
MHMR of Tarrant County / ECI of North Central Texas 3840 Hulen St., Suite 602, Fort Worth 817/335-3022
mhmrtc.org
The Warren Center, Inc. 320 Custer Road, Richardson 972/490-9055 thewarrencenter.org
Once you sign the IFSP, the planned services must begin within 28 calendar days.
WHAT SERVICES LOOK LIKE
Depending on your child’s needs, services may include speech therapy, occupational therapy, physical therapy, feeding support, nutrition counseling, social work or specialized skills training.
One of the distinguishing features of ECI is its family-centered approach. Providers coach caregivers on strategies and techniques that fit naturally into daily routines. With Carlton’s son, that looked like creativity on the living room floor.
“Our physical therapist—we always called her the MacGyver of physical therapy—would say, ‘OK, grab that couch cushion. Grab that pot. Let’s take
that spoon,’” Carlton says. The therapy activity was based on whatever was within arm’s reach while they were playing together.
For other children, it might mean playing with certain toys during bathtime to help with motor skills, practicing saying certain words on the drive to the grocery store or incorporating feeding techniques at mealtimes.
Providers will observe and document your child’s progress at each visit and adjust strategies as needed. The IFSP is reviewed every six months and eligibility is reassessed annually, though adjustments can be made at any time.
PAYING FOR SERVICES
The referral, evaluation and assessment, case management, IFSP development and any translation or interpreter services needed are provided to Texas families at no cost. When it comes to the services your child receives, you can either use your child’s public or private insurance or pay the Family Cost Share—a sliding scale based on your income and family size after allowable deductions. ECI staff will help you determine your monthly maximum charge.
TRANSITIONING AT AGE 3
Transition planning typically begins the child is between 27 and 33 months old, Philips says. Because ECI services end at age 3, families work with their team to explore next steps.
The most common plan is connecting you to your local school district for Early Childhood Special Education. The district must complete any additional evaluations and determine eligibility before the child’s third birthday. If eligible, the child will receive an Individualized Education Plan (IEP). Other options include charter schools, private therapy, child care or Head Start.
Whatever path families choose, Spawn says, providers work to ensure the transition feels smooth and supported. “We make sure that transition happens seamlessly for parents,” she says.
“They were our cheerleaders. They were our supporters. They were our providers.”
— CATHERINE CARLTON
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The Early Childhood Resource List
The first five years of your child’s life are crucial for development. Their experiences in these early years will help shape who they become. Learn about the local programs and institutions that help lay the foundation for learning and health for years to come.
Childcare & Preschools
BASIS Texas Charter Schools
Benbrook, Plano and Richardson enrollbasis.com
BASIS Texas Charter Schools is a public school network offering tuition-free education for grades K–12, with three locations in Dallas-Fort Worth. See ad on page 4.
Big Blue Marble Academy Allen, McKinney and Murphy bbmacademy.com
Big Blue Marble Academy preschools in Allen, McKinney and Murphy offer infant, preschool and school-age care for children ages 6 weeks–12 years in a safe and nurturing environment. Contact us to learn more!
See ad on page 13.
Challenger School
Plano
challengerschool.com/campuslocations/texas
469/642-2000
Challenger School offers uniquely fun and academic classes for preschool through eighth grade. Students learn to think for themselves and to value independence—results are unmatched at any price. Come see for yourself. Observe classes anytime. See ad on page 9.
Dallas ISD
Dallas
dallasisd.org/morechoice 972/925-3700
You’re invited to the BEST school fair in the city—Dallas ISD’s More Choice Expo! Learn about our 200+ schools that are paving your student’s path to success through excellence, innovation and tradition. See ad on back cover.
Goldberg Early Childhood Center
Dallas jccdallas.org/gecc 214/739-2737
Goldberg Early Childhood Center provides play-based early education in warm, nurturing classrooms, fostering social, emotional and academic growth within a vibrant, full-service campus that supports the entire family through wellness, enrichment and community connection. See ad on page 19.
Grace Academy of Dallas Dallas graceacademy.com 214/316-3561
Grace Academy of Dallas is Christ-centered and futurefocused. Grace Academy serves students in pre-K3 through the sixth grade and is located in Preston Hollow.
Grace Academy is expanding in the near future. Learn more online! See ad on page 16.
Lightbridge Academy
Fate, Flower Mound, Fort Worth, Mansfield and Plano lightbridgeacademy.com
Lightbridge Academy is The Solution for Working Families® and offers programs for infant, toddler and preschool age children. Our curriculum embraces every moment as another opportunity to learn and unlocks every child’s potential. See ad on page 13.
Lumin Education
Dallas lumineducation.org
214/824-8950
Lumin offers award-winning Montessori education serving children from pregnancy through third grade. Through both our classroom and Home Visiting programs, Lumin Education helps children realize their potential and unlock their love of learning. See ad on page 15.
Montessori Children’s House and School Dallas mchsdallas.org
214/348-6276
MCHS is dedicated to providing quality Montessori education to children 2–6 years of age when children are naturally enabled with the capacity to make substantial leaps in their academic, cognitive and social development. See ad on page 19.
Rigley Primrose Schools
Dallas, Frisco and Plano primroseprestonwood.com
469/791-9131
The Primrose Balanced Learning® focuses on intellectual development, creative, physical, social emotional and life skills in authentic, age-appropriate ways tailored to each child. Early education experts, insights from the latest child development modern research. See ad on page 16.
River Legacy Nature Center
Arlington riverlegacy.org/education 817/860-6752
Our Nature School, summer camps, enrichment classes and homeschool clubs offer hands-on, immersive nature education and bonding experiences tailored to various age groups, fostering curiosity and environmental stewardship for all learners. See ad on page 19.
St. Mark Catholic School Plano stmcs.net
972/578-0610
St. Mark Catholic School, serving preschool through eighth grade, sets your child up for success by building strong foundations in faith, academics and social development. Tour our distinguished three-time National Blue Ribbon School today. See ad on page 19.
St. Philip’s School and Community Center stphilips1600.org 214/421-5221
At St. Philip’s School and Community Center, students in K3 through eighth grade build unstoppable confidence, curiosity, faith, integrity and a heart for service through a holistic, faith-based education. Are you ready to be unstoppable? See ad on page 16.
Temple Shalom Early Childhood Center
Dallas templeshalomdallas.org/ecc 972/661-1810
Temple Shalom’s ECC offers nurturing early education for infants through pre-K, blending play-based learning, outdoor exploration, socialemotional growth and strong academic foundations in a warm, engaging environment that supports each child and their whole family. See ad on page 21.
The Westwood School
Addison westwoodschool.org
972/239-8598
At Westwood, we nurture a natural love of learning through the Montessori method. Starting at just 12 months old, we give students the opportunity to build their character, explore
their interests and develop their strengths. See ad on page 21.
Winters Park Academy Frisco wintersparkacademy.com 972/632-6493
Our early childhood programs immerse children in STEM with hands-on activities. They learn about physics through a sink and float exercise and explore engineering and creativity by building their own robots with our special kits.
See ad on page 21.
Classes
Texas Ballet Theater School Dallas, Fort Worth and Richardson texasballettheater.org/tbtschool 817/763-0207
Starting as early as 18 months, Texas Ballet Theater School brings dance and fitness classes to students of all ages and abilities. Browse yearround offerings and register or drop in today! See ad on page 6.
Healthcare
Children’s Health Dallas and Plano childrens.com
Children’s HealthSM is ranked as one of the top pediatric hospitals in the country. From little scrapes to big scares, our nationally recognized physicians and specialists are experts at making life better for children. See ad on page 2.
Shopping
The Pharma-C Company pharma-c.com 262/284-6600
We’re here to support you through every stage of life. Whether you’re caring for an aging loved one, small children or yourself, The Pharma-C Company provides trusted resources to guide you on your unique journey. See ad on page 15.
