Developmental Pediatrician - What’s the point?
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Anonymous
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We saw a developmental for our first child beginning when he was 18 months. All she did at appointments (every 6 months) was developmental assessments (stack blocks, copy lines on paper, etc), tell us he was delayed (we already knew - I was the one who self referred to infants and toddlers when he was 11 months), and then she would ask us how we thought he was doing (I thought we were there so she could tell us?!). Then, she would tell us to “keep doing what you’re doing”, since he was in infants and toddlers and we also had him in private therapy. She never made a diagnosis beyond global developmental delay. We got a full neuropsych exam done when our son was 6, and we were asked for the data from Kennedy Krieger. When I reached out to the developmental ped, she said there wasn’t any. We had nothing to give the neuropsychologist from KKI. She seemed very surprised by this.
Fast forward, and our second son (18 months) has a speech delay. The ped who did his 18 month appointment (unfortunately not his regular ped), suggested we see a developmental pediatrician. Which brings me to the title of this post - what is the point? I already have him in infants and toddlers and private therapy. What else is a developmental pediatrician going to do? I know he’s delayed. Did we just hav a really bad developmental ped with our first child? If there is a “point” to a developmental pediatrician that we missed with our diet child, how can I make sure we are getting what we should be this time around? |
Anonymous
| Point is keeping your toe in the door. 10 years ago, it took months to get a 1st appointment. Just keep going. We never went, but did OT, BT, ST, PT anyway. |
Anonymous
But…get my toe in the door for what? What are they supposed to do? They offered nothing of value with our first child. My mind boggles thinking about how she would ask “How do you think he’s doing?” WTF? Wasn’t her job to tell me how he’s doing?! It was obvious to me he was behind his peers which is why I had him in all the therapies. It’s now been suggested for my second, but it was such a waste of time with my first. However, I don’t want to deprive my second of this if there is any actual value to be had from seeing a developmental pediatrician. |
Anonymous
| Our insurance required it to pay for services but otherwise it was pointless like you are saying. |
Anonymous
| Ours was great when my oldest had a speech delay + insurance required a developmental ped dx for coverage. |
Anonymous
Doctors are supposed to elicit a history, symptoms, any concerns. They aren't at home with you observing your kids. You are. Imagine you book a neurologist for migraines. Is he supposed to instantly see the migraines? No - you report what you are experiencing, then doc might do tests, then diagnose. Some things can't be seen in an examining room in 5 minutes. Don't lose faith. Just go to the appointments, unless you find yourself with a completely normal, average kid hitting all the normal milestones. |
Anonymous
| We also found those appointments pretty useless. Especially if you have a medically healthy kid. The only time I found it beneficial was when we had one who also did regular peds so we saw her for well visits which were more thorough than normal ones. |
Anonymous
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They are most appropriate for medically complex kids where there are more factors impacting development - like a genetic condition or cerebral palsy. We have never seen one ourselves but the “dev ped” has or used to have a totemic status on DCUM, since replaced by the “neuropsych.”
Blah. There is no single professional that holds the answers. The most important ones we have had are those that are addressing very specific, obvious challenges: OT for when DS needed basic gross motor skills to do things like climb a slide; behavioral psychologist to address aggression; educational consultant to get and implement the IEP. |
Anonymous
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My Dad's a developmentalist and neurologist. In more complex cases he does a lot of testing and then is involved in medication management. He sees some very seriously ill kids as well. He also spends a lot of time coordinating various care providers such as speech and occupational therapy.
I mean you'd also be surprised for how many parents "make sure you regularly talk to your kid" is new advice. |
Anonymous
| Mine did genetic testing for us. |
Anonymous
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Our developmental pediatrician was the one who gave us an ADHD diagnosis. Our pediatrician wasn’t sure (i now realize how much difficulty there is in diagnosing ADHD if girls AND gifted children and feel grateful that my child who is both those things was still diagnosed very very early) and we didn’t need a full neuropsych especially because of how young my child was. There was good guidance on what kind of support to pursue for that and for another much less common disorder. So for us yes it was very helpful in terms of making a plan but then you implement the plan with other people (therapists etc). He also was willing to provide back up with the school and gave us letters with his recommendations for support. We also have records of the evaluation for ADHD that we have passed on to other providers.
So, your experience doesn’t sound great. I do ask a lot of questions and probably come across as very pushy. I do think you have to be very clear about your concerns and specific observations to help them help you. I’d make sure you know exactly why you are being told to go to dev Ped (typically not just for speech delay, right?) and then be very clear on wanting to hear their thoughts about how to approach each concern and and what if anything else you should be looking for. And there should be notes for each visit/ I review them each time and once asked for written clarification through the patient portal. I keep all of that together and it’s been helpful in the IEP process and when talking to other providers |
Anonymous
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For an ADHD/HFA kid, our experience was the same as OP's. We did our first assessment when DS was 3 at KKI with a dev ped - and i guess that was helpful. But it was never proposed by anyone that we have an ongoing relationship, so we didn't, and have never missed it. Psychiatrist and psychologist, plus ongoing support from our regular ped, has met our need well enough.
Agree with others that dev peds are probably tremendously helpful for complex matters like genetic abnormalities. And also for people who are clueless. But for your average parent of a ADHD kid on dcum with a graduate degree and the internet at their fingers, I don't think it's helpful. |
Anonymous
| We found it useless too. They literally talked to me about the importance of sunscreen. Such a waste of time. |
Anonymous
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In my son’s case he was evaluated for asd at 4.5, and in addition to getting the dx needed for ABA, she also noticed he had a peculiar way of staring into space for 3 secs. Looked normal to me! But he soon after got a mild epilepsy diagnosis too.  we had no family history and he was otherwise medically healthy! so maybe our experience is extreme, but I do think they are trained to see some things that therapists and normal peds might miss.
We got a very detailed visit summary (our dev ped was at Kennedy Krieger too). I always find evaluator’s observations interesting. |
Anonymous
^ I should add that he had already been evaluated by our ped, early intervention, multiple OTs, STs, and we are close friends with several medical specialists who had spent time casually observing him. My husband and I have fancy degrees, run in educated circles, etc., but the dev ped just saw the epilepsy (and other subtle things pertaining to his ASD) that no one else had. |