When the exam room door closes, most parents have some questions about how their child is developing or behaving. Competitive parenting abounds; everyone wants to prove or believe his or her child is above average. The he-did-what?-she’s-so-smart stories can strike fear in your heart when your child is nowhere near the same accomplishment and of similar age. These comparisons can sometimes lead to worry. A lightning bolt drove through my chest when my mom started to compare F to other children and expressed worry that he might never say, “Mama.” I waited impatiently and in unified worry until about 18 ½ months.
Even the mamas and papas who seem to brag at the supermarket, on the phone, or at book club about how much their child talks-walks-sleeps-eats worry. I mean it; they worry, too. Don’t let ‘em fool you. Worry may be just below sleep deprivation on the job description for parenthood. Being a pediatrician has proven this to me.
If you worry about what or how your child is doing, speak up. Let your pediatrician know. Don’t be intimidated by the length of the appointment, the reason for your worry (Joey is eating toe jam) or even if you’ve asked before. If you’ve previously discussed a problem, revisit your concern if worry remains in your heart. Your instincts matter.
Here’s a summary of the national study I mentioned at the end of my near-miss-Cindy-Brady-TV interview yesterday morning. The study found that pediatricians need to do a better job helping families place and follow through with referrals for developmental delays. Although most pediatricians in the national study did a good job screening, most were not good at ensuring families followed through and saw a therapist for the flagged concern.
Bottom line: early intervention is essential. Early intervention (not waiting until the problem has gone on for months to years) for many developmental delays can improve the outcome and deter long-lasting disability for children.
Like most pediatricians, I screen for developmental delay (by asking questions, doing physical exams, observing the child in the room) at all check-ups. We also do more formal standardized screening in my office at 9 months, 15 months, 18 months, and the 2-year check ups, including screening for autism. Even then, we may miss a worry a parent maintains. I need parents to tell me.
The study points out this screening isn’t enough. Over the 9 months the study went on, 14% of the children in the study were found to fail developmental screening tests alerting pediatricians to a red flag in development. Yet, pediatricians (from 17 clinics) referred those children on average only about 61% of the time. As the study went on, they referred less of these children, with only a little over half the children getting referred.
Be your child’s best advocate. Speak up if you’re got concerns. And if your concerns persist.
If you’re worried about your child’s development, check out Healthy Children’s Ages & Stages. It’s a nice place to get a sense of typical development. If something seems off or delayed for your child, talk with your pediatrician at the next check-up or schedule a visit now if you’re worried. Even if that worry seems silly as toe jam.
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Sarah Weiler says
Dr. Swanson, we are so happy to see that you have a blog! A friend of ours sent me this the other day….Mark and I are both thrilled and, even though we no longer live in Washington, we plan to keep reading! Hope all is well…
Sarah Hill says
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. In my research for an answer to this problem I have come to more closely to that idea of a lack of oxygen being that primary problem. Autism affects information processing in that brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood.
Those signs all begin before a child is three years old. Others also exhibit sensory processing deficits, as well as symptoms related to aggression, attention, hyperactivity, and speech.
– Sarah Hill
richard joachim says
We have an 18 month old little boy. He was given the initial screening and has some of the traits associated with possible Autism. Very scared What should we really be looking for?