When parents of young children have a concern about their child’s development they often go first to their pediatrician.
Parent concerns might include: “Our child does not turn his head when I call him.” or “ Our child does not make much eye contact or smile.” “He does not play with toys like other children.”
If the pediatrician thinks that more assessment is needed, when MD’s refer out they often refer to to other physicians at large hospitals — such as Stanford Hospital (LPCH), Children’s Health Council and U.C. San Francisco. Physicians know other physicians and often do not know local resources, e.g., licensed psychologists trained in psychological assessment.
When parents are referred to large hospital complexes such as Stanford Hospital, Kaiser Permanente and U.C. San Francisco, parents can help get the best possible assessment by finding out ahead of time:
Will their child’s pediatrician MD automatically send along the child’s medical records as part of the referral process? If not, then the parent needs to request a complete set of medical records and bring the medical records to the appointment.
Who knows the child best besides the parent? Does the child go to a nursery school or day care? Is the child taken care of by a grandparent or neighbor?
Write down the name, address, telephone number and e-mail address for all persons who know your child best. Let those people know that the child will be assessed and that someone from that institution may call to gather information. Bring the list of people who know your child best to the appointment.
Can the parent take a video of the behaviors that concern them? For example, does the child insist on lining up all his toys? Does the child have a melt-down whenever the normal routine changes? If possible, get out your ‘smart phone’ or camera and take a video of those behaviors. Bring the video with you to show whoever does the assessment.
Call ahead of time to the institution where the assessment will be done and find out (and write it down) exactly who will do the assessment? Will it be a team assessment of various areas of functioning or will the assessment be done by only one specialist?
Know that it is Best Practice in the assessment of young children to examine several areas of functioning (e.g., speech, non-verbal communication, gross and fine motor) and that the assessment be done by appropriate specialists.
Depending on the concerns, some times one person doing the assessment is sufficient and sometimes not.
Know that it is Best Practice that records and information be obtained from various sources (MD, school, day care provider, parent, grandparent) over a period of time.
It is often the case that young children do not perform as they typically do when driven several hours to an appointment and then required to do certain activities with persons they do not know.
Summary: Parents can greatly assist in the accurate assessment of young children with possible developmental delays by 1) gathering all medical records and bringing them to the appointment; 2)making a list of all persons who know your child best including email and telephone numbers; 3)inquiring ahead as to exactly who will do the assessment and what areas will be assessed.
And do not be afraid to press the professionals for understandable answers. If they cannot say it so you can understand,they are useless to you and your child.
Any questions or comments? Contact Dr. Cameron Jackson DrCameronJackson@gmail.com 831-216-6002