Most Childhood Interventionism is Job Protection

[Anonymous]

I have three average, healthy kids. I keep running into doctors and school administrators intervening “in an abundance of caution“. One child is short, so a doctor ran blood tests, bone scans and several ped visits “just to be safe”. One child was an ounce short of regaining the recommended weight at the hospital breastfeeding, so they had to return to the doctor twice, “just to be safe”. The third was evaluated for torticollis and assigned 6 PTs because their head was “slightly tilted, just to be safe”. I went to one visit, copied whatever the PT showed me (I could have YouTube’d this) and never returned, the kid grew out of it within weeks. Recently, one child’s (age 7) teacher approached me about their handwriting and set a meeting between me, her and an OT to “discuss and evaluate strategies to address child’s handwriting”. The entire hour I sat in this meeting, I felt it was a waste of all our time. My kid knows how to write, they aren’t great at it and they are super lazy. There is nothing wrong with this kid that more practice won’t fix entirely.

Is this normal? Does everything a kid do need to evaluated by a professional? Or - if you get paid by the hour to use a hammer, will everything look like it needs nailing down?

[Anonymous]

Thank goodness you didn't post this in the Special Needs Forum, where some of us have real issues, and need to fight to get prompt medical care, services and accommodations.

[Anonymous]

Maybe there's just stuff wrong with your kids

[Anonymous]

I had the opposite issue. My child struggled with R’s past the age where it’s considered “normal” and still we couldn’t get speech covered because it wasn’t bad enough I guess. We paid cash for the services.

[Anonymous]

You are amazing, OP, in that your knowledge in all of these different areas exceeds that of experts in the field who have seen hundreds if not thousands of such cases. Very impressive!

[Anonymous]

Are you practicing handwriting at home?

[Anonymous]

Anonymous wrote:
Thank goodness you didn't post this in the Special Needs Forum, where some of us have real issues, and need to fight to get prompt medical care, services and accommodations.

Well … I’m a SN regular and I get what OP is saying. There’s a weird dynamic where medical assessments really get pushed and therapists are more than happy to take your money. It’s much different for the harder stuff, like getting an IEP that works and is implemented correctly. My kid has SN and sometimes I do have to fend off stuff both related and unrelated to his disability. If I wanted I could spend all my time and money on OT, ABA, floortime, play therapy, and on and on …

[Anonymous]

I'll top you. Sent a kid to a day camp. A week later the kid gets lice and comes home with a note saying that in order to come back, they need a note from a certified lice specialist (not even a pediatrician!).

This is kid #3, and by now I know how to deal with lice without paying hundreds of $ to the "specialists". But the camp wouldn't budge.

[Anonymous]

I noticed this too. I feel like my child with scoliosis is having an excessive amount of x rays. After 2 years of this the curve stayed the same despite every 4 months x Ray.

My oldest is a late grower. At the last appointment they pushed seeing an endocrinologist. I said wait another year first.

[Anonymous]

Malpractice and suing culture, plus recruiting business from high stress parents obsessed with their kids being “the best” at everything, including health.

[Anonymous]

Anonymous wrote:
Thank goodness you didn't post this in the Special Needs Forum, where some of us have real issues, and need to fight to get prompt medical care, services and accommodations.

Trust me, I think all of these interventions could have better served children who actually needed them. The last one was the weirdest: three grown adults, sitting around a table, discussing PT strategies and supports for a 7 year old whose handwriting is “messy”. Between two professionals and I, this was hours of planning, reviewing, e-mails and assessments, for one child’s lowercase letters to look…neater? I guess.

[Anonymous]

It’s great that you know everything and have so many areas of expertise!
As a parent I have actually never had any interventions. One of my kids flagged something in the system for speech evaluation, but no one ever followed up. Same kid is a very picky eater and appears to have inherited my ADHD - but we can’t get him evaluated because he stays on his growth curve and is exceptionally well behaved at school. We are a white UMC family in an affluent school district - so if specialists were looking for money I’d think we (or any of our neighbors and friends) would be easy targets. We live in a neighborhood where people pay over $100/hr for reading tutors for 7 yr olds or pay $40 per 30 min swim lesson.

I think if people are approaching you with concern, perhaps you should listen or get a 2nd opinion. Most parents have to beg and plead to get evaluated - and then wait months to be seen - even when they are full-pay. I don’t think most people suggesting assessments or interventions are working to fill their rosters with kids that don’t need any help.

[Anonymous]

I think we lucked out with a pediatric practice that is not like this. They will recommend interventions/services but anytime something is off by a little at one appointment, they always say "let's keep an eye on it and check back in at the next appointment." This saved us a lot of grief over our child who started speaking on the late side (but within range of normal) as well as our super picky eater who wasn't gaining weight on track (switching back to whole milk from 2% and emphasizing fattier foods in general got her back on track). I'm grateful that they flagged these issues for us because there were things we could do to address them. But I'm also grateful they didn't jump right to sending us to a specialist. I do think sometimes people go straight to intervention when a child is on the low end of the bell curve (meaning within the range of normal, just on the low end). OP is right that a lot of this stuff is easily resolved or sorts itself out without significant intervention, and I'm glad we didn't run around to appointments and freak ourselves out about it.

On the other hand, we did have to see a specialist for a behavioral issue that was not within the range of normal, and when when we raised the issue with our pediatrician, she gave us a list of people to contact and a recommendation for someone who wound up being amazing right away.

I wonder it this is just something some doctors are better at than others. Our ped is older and extremely experienced. She never seems alarmed by anything -- she's seen it all and our kids are pretty middle of the road medically and developmentally. I feel like less experienced doctors might refer to specialists more often because they are less likely to have seen many kids with the same issue and might wish to err on the side of caution. Of course, if you get in the habit of always referring kids for intervention, it also means you are unlikely to see how often these things resolve on their own. I think this is especially true with speech -- I think it's become really common to refer for a therapist at the 18 mo appointment if the child doesn't have a certain number of words yet, but if you read the developmental literature, you'll see it's actually not uncommon for normally developing kids to get an avalanche of words just before 2. That's what happened with our kid who is now incredibly verbal with an impressive vocabulary for her age. I think many pediatricians would have suggested therapy and it's very clear it was not necessary in her case.

[Anonymous]

My husband is a doctor (doing clinical research right now), and has never noticed any overly frivolous testing and other unnecessary things from our prescribing doctors. But then you also need to interpret what they're saying. When the doctor says "I am prescribing/referring you to X, Y and Z and this is why it's important you follow up", it's usually a good idea to do it! If the doctor says "Have you considered such and such?", maybe it's not necessary, and maybe you can push and ask whether it's really important.

Never be afraid of asking why your doctors suggest things, and what might happen if you let the issue run its course a little bit.

[Anonymous]

This is what happens when communities have excessive resources.