By Dr. Regina Granados
Licensed Clinical Psychologist & Fellow Special Needs Parent

Is it a hearing impairment, or autism? Is your baby just a late-bloomer or developmentally delayed? Could it be dyslexia… or something else? Pediatricians base their recommendations on the information parents give them, but when it comes to our children’s development, it can be very difficult to express our concerns. Here, to the rescue, are five important tips every parent should follow when talking with a pediatrician:

1. Prepare in advance for your appointment.
Make a list of your questions, and place it in your purse or diaper bag the night before your appointment. More importantly, make a list of the concerns you have about your child’s development. Be prepared to give examples to help your pediatrician fully understand your perspective.

2. Offer full and complete answers.
Pediatricians rely on parents to accurately describe a child’s development and behavior. If parents don’t give enough information to spot a problem, a pediatrician may not be able to recognize that a problem exists. Avoid rushed or simple “yes”/“no” answers in response to the pediatrician’s questions; instead, try to give descriptive details in your answers, and don’t be afraid to ask questions if the pediatrician is unclear. To illustrate this point, let’s compare the following two scenarios in which a pediatrician is holding a routine check-up for a 2-year-old:

Scenario # 1
Pediatrician: Is he using two words?
Mother 1: Yes. (The child can say 40 words but doesn’t put two word phrases together. Mom misunderstood the question.)
Pediatrician: Does he point to show you things?
Mother 1: Yes. (The child points but only when he wants something. He doesn’t point to share his interests. He also doesn’t look at this mother when he points.)
Pediatrician: Is he playing with toys?
Mother 1: Yes. (The child plays with toys in a unique way that mom doesn’t mention. He also isn’t doing any pretend play.)
Pediatrician: Does he respond to his name?
Mother 1: Yes. (Mom doesn’t mention that she turns his face to get his attention in order for him to respond.)
Pediatrician: Things sound good.

Scenario # 2
Pediatrician: Is he using two words?
Mother 2: What do you mean, “two words”?
Pediatrician: Is he using phrases with at least 2 words when he speaks?
Mother 2: No. He can say 40 words, but he’s not putting phrases together.
Pediatrician: Is he pointing to things?
Mother 2: He leads me by my hand to things he wants. Sometimes he uses my hand to point.
Pediatrician: Does he look at your face when he leads you by the hand or uses your hand to point?
Mother 2: No.
Pediatrician: Is he pointing out things that he finds interesting, not necessarily to request something?
Mother 2: No, he only tries to communicate when he wants something.
Pediatrician: Is he playing with toys?
Mother 2: Yes, but not like his cousins the same age do.
Pediatrician: What do you mean?
Mother 2: He plays differently. Sometimes he likes to lie down and stare at them. Other times he tries to line them up. It’s just the way he likes to play.
Pediatrician: Is he doing any pretend play yet?
Mother 2: No, not yet. I try to teach him but he’s not interested.
Pediatrician: Does he respond to his name?
Mother 2: Yes, if you turn his face and get his attention, of course.
Pediatrician: If I were to call his name, would he turn and look at me?
Mother 2: Hmmm, probably not. He doesn’t really pay attention when people call his name.
Pediatrician: Mom, I’m concerned about his development….

As we can see from the example above, being short and concise is not always in your child’s best interest. In scenario number one, the pediatrician has no idea that the child’s development may need further evaluation. The pediatrician assumes that the parent is providing complete information. Yet, critical information was not shared because the first mother was brief in her responses. In the second scenario, the mother provided complete thoughts and helpful examples. Accordingly, the pediatrician had the information needed to identify a potential developmental concern.

3. Do your homework and learn about early warning signs for special needs.
Many parents erroneously believe that having a healthy baby at delivery precludes that baby from ever having a developmental delay, but even healthy babies need to be closely monitored for the first three years to track their development. Every child’s development is unique; however, there are certain skills that most children develop by certain ages. When key skills are absent, the likelihood increases that a child may have special needs. Parents won’t know what to track unless they become familiar with skills that are expected at certain ages. For more information on tracking your child’s development, visit www.firstsigns.org.

4. Be prepared to take a stand.
If you strongly feel that your child may have a developmental delay, don’t accept a “let’s wait and see” approach. In some cases the problems may resolve spontaneously without the need for further testing or treatment, but your child’s development is too important to risk losing precious time. A pediatrician has a wealth of information concerning your child’s health and medical needs. Depending on his (or her) training, the pediatrician may or may not be experienced in identifying developmental delays. Your child needs you to be his advocate and take a stand when needed.

5. Don’t be afraid to get second opinions.
If you suspect that your child under 3 years of age has a speech delay, physical delay, cognitive delay or autism, you can contact the Alta California Regional Center: (916) 978-6400. If your child is over 3 years of age, you should request a special education evaluation in writing through your local school district. The evaluation process can take several weeks to months. If you would like to shorten the time-line, you may choose to seek a private pay evaluation through a Developmental Pediatrician, Clinical Psychologist, or a Speech Language Pathologist.

Dr. Regina Granados, is a Licensed Psychologist with a private practice in Folsom. She is the parent of two children with special needs. Dr. Granados has practiced for 10 years in the field of Autism and Developmental Disabilities. Her website (www.folsompsychologist.com) has additional links on Early Warning Signs of Autism.