What happens at an initial consultation with a developmental pediatrician?

[Anonymous]

And. . .has anyone EVER been to one who said, hey, your kid is fine, they're just being a kid? I am so wary of this BS and feel like it is the first step down a shit spiral of my kid being labeled and medicated simply for being a kid who is still learning self-regulation and right from wrong.

BTW, posted this over in general parenting but no answers - I guess this question might be better placed here.

[Anonymous]

First of all, you do need an attitude adjustment. You are taking your child to be evaluated for a reason, you need to be open to hearing what the doctor has to say. Otherwise, why are you doing this? I'm guessing your kid is not just being a kid. You don't say how old your DC is, but the cryptic reference to knowing right and wrong tells me you've hit some kind of roadblock. You can call on resources to get over it, or you can curse at those resources and dig in. Your call.

I guess I am defensive about this because I adore our developmental pediatrician. He has made a MASSIVE difference in my DC's life and I don't know how we would be where we are today without him.

It isn't a "label" its a diagnosis. Please refer to it by its proper name and not some dismissive insult. And my DC is not in a shit spiral because he has a diagnosis. He has gotten the supports and interventions he needed and is doing amazingly well. My guess is that if you open your eyes and ears your child will do the same.

No, doctors do not give diagnoses when there isn't one to give if they are any good. And they don't prescribe medication when it isn't needed if they are any good. But my guess is that if your DC does have a diagnosis, and perhaps even could benefit from medication, that you will not be open to this possibility blaming it on BS and the like.

Here's a hint -- if you are going to insult the folks over here in Special Needs with words like shit spiral to describe our lives (and, sure, we've all had those moments when it felt that way, but that isn't what you are referring ) you won't get a lot of useful advice. Tell us more about your DC and be open to what we and especially the doctor have to say and you might learn something.

[Anonymous]

We use Dr. Dan Shapiro - Initial consultation was just for parents, an hour long meeting where we talked about our concerns and our family in general. Before this meeting we had to fill out a bunch of forms about our kid online and have DC's teacher fill out forms/questionnaires about DC at school which we brought with us to the meeting.

DC was observed at school and Dr spoke with teachers.

DC was brought to Dr's office play area where Dr "played" with child and before this observed my interaction with child.

Preliminary report is emailed to parents. Diagnosis, suggested interventions, etc.

Parents have meeting with doctor w/o child to discuss findings.

Very very helpful and has made school a great experience for DS.

I don't care about the label, DS has AS/ASD, as long as he's getting the supports and help he needs.

[Anonymous]

OP,

I think your concerns are normal. Just so you know, sometimes, you do get the kid is fine response. A friend of mine was encouraged by her son's preschool teachers to be assessed. And they told them this. Her second kids is majorly Aspergers and they waited until 6 to go to a developmental pediatrician. My guess is that sense there's a genetic component, that the older child showed similar behaviors when he was younger but not extreme enough to be considered on the spectrum.

For us our visit was fantastic b/c it confirmed all the little things I was observing and gave us a plan of action. In our case, our kid isn't on the spectrum but has other learning issues, which is a little like being on a scavenger hunt. You get your first clue, and little by little you get more clues go for additional testing as the kid gets older. GL

[Anonymous]

Anonymous wrote:First of all, you do need an attitude adjustment. You are taking your child to be evaluated for a reason, you need to be open to hearing what the doctor has to say. Otherwise, why are you doing this? I'm guessing your kid is not just being a kid. You don't say how old your DC is, but the cryptic reference to knowing right and wrong tells me you've hit some kind of roadblock. You can call on resources to get over it, or you can curse at those resources and dig in. Your call.

I guess I am defensive about this because I adore our developmental pediatrician. He has made a MASSIVE difference in my DC's life and I don't know how we would be where we are today without him.

It isn't a "label" its a diagnosis. Please refer to it by its proper name and not some dismissive insult. And my DC is not in a shit spiral because he has a diagnosis. He has gotten the supports and interventions he needed and is doing amazingly well. My guess is that if you open your eyes and ears your child will do the same.

No, doctors do not give diagnoses when there isn't one to give if they are any good. And they don't prescribe medication when it isn't needed if they are any good. But my guess is that if your DC does have a diagnosis, and perhaps even could benefit from medication, that you will not be open to this possibility blaming it on BS and the like.

Here's a hint -- if you are going to insult the folks over here in Special Needs with words like shit spiral to describe our lives (and, sure, we've all had those moments when it felt that way, but that isn't what you are referring ) you won't get a lot of useful advice. Tell us more about your DC and be open to what we and especially the doctor have to say and you might learn something.

I think you were being a bit harsh with OP. Yes, her choice of words was insensitive, but we have all been insensitive/judgmental re: other's children before realevizing that our own kid had SN, then the light bulb of empathy turns on. While I agree with the message you were trying to convey, just because she's insensitive does not mean you should be. Also, please remember that she is embarking on a scary journey, one frought with doubt, denial, shame, embarrassment (we've all felt those emotions so don't pretend you havent).

OP, relax and when on this board just try to be more sensitive. We have all been there - that moment when it is suggested that perhaps your child needs to see a specialist. It's ok to be scared, angry, resentful, fearful of his/her future, afraid of what others will think and say. Once you come to grips that your goal is to help you child, you are then better equipped to help him/her.

I don't recall from your original question but who suggested you see a Dev Ped?
How old is your DC?
What odd or "off" behaviors have you noticed? Be honest, don't pretend like there aren't any.
And finally, all depending on WHO suggested you see a Dev Ped? that makes a lot of difference.

[Anonymous]

Anonymous wrote:

Anonymous wrote:First of all, you do need an attitude adjustment. You are taking your child to be evaluated for a reason, you need to be open to hearing what the doctor has to say. Otherwise, why are you doing this? I'm guessing your kid is not just being a kid. You don't say how old your DC is, but the cryptic reference to knowing right and wrong tells me you've hit some kind of roadblock. You can call on resources to get over it, or you can curse at those resources and dig in. Your call.

I guess I am defensive about this because I adore our developmental pediatrician. He has made a MASSIVE difference in my DC's life and I don't know how we would be where we are today without him.

It isn't a "label" its a diagnosis. Please refer to it by its proper name and not some dismissive insult. And my DC is not in a shit spiral because he has a diagnosis. He has gotten the supports and interventions he needed and is doing amazingly well. My guess is that if you open your eyes and ears your child will do the same.

No, doctors do not give diagnoses when there isn't one to give if they are any good. And they don't prescribe medication when it isn't needed if they are any good. But my guess is that if your DC does have a diagnosis, and perhaps even could benefit from medication, that you will not be open to this possibility blaming it on BS and the like.

Here's a hint -- if you are going to insult the folks over here in Special Needs with words like shit spiral to describe our lives (and, sure, we've all had those moments when it felt that way, but that isn't what you are referring ) you won't get a lot of useful advice. Tell us more about your DC and be open to what we and especially the doctor have to say and you might learn something.

I think you were being a bit harsh with OP. Yes, her choice of words was insensitive, but we have all been insensitive/judgmental re: other's children before realevizing that our own kid had SN, then the light bulb of empathy turns on. While I agree with the message you were trying to convey, just because she's insensitive does not mean you should be. Also, please remember that she is embarking on a scary journey, one frought with doubt, denial, shame, embarrassment (we've all felt those emotions so don't pretend you havent).

OP, relax and when on this board just try to be more sensitive. We have all been there - that moment when it is suggested that perhaps your child needs to see a specialist. It's ok to be scared, angry, resentful, fearful of his/her future, afraid of what others will think and say. Once you come to grips that your goal is to help you child, you are then better equipped to help him/her.

I don't recall from your original question but who suggested you see a Dev Ped?
How old is your DC?
What odd or "off" behaviors have you noticed? Be honest, don't pretend like there aren't any.
And finally, all depending on WHO suggested you see a Dev Ped? that makes a lot of difference.

I do apologize for being harsh. Sometimes I have trouble with the questions that are phrased like "please, please reassure me that my DC isn't in the same shit spiral yours is." She does sound anxious and I do know that feeling. (Though I stand by everything I wrote, perhaps I should have used gentler language).

[Anonymous]

OP here. I'm sorry - I can see that my language was insensitive but with a 3.5 year old boy, a part of me can't help but feel that various people - daycare providers, teachers, etc - are just overreacting and sending us on a never-ending "scavenger hunt" as one PP put it - one that is massively time-consuming and expensive. THAT is exactly what I fear. A hunt that leads to nothing but leaves my very young son A) fearful of doctors and B) with the feeling that there is something terribly wrong with him. And yes, I do have a strong suspicion of all of these "specialists" and the frequency with which certain disorders are diagnosed and yes, medicated.

That said, here are some specifics. DS is by all accounts perfectly normal - normal height/weight, hitting nearly of his developmental milestones for motor skills, cognitive, language, etc. For the past 6-9 months we've had some behavioral challenges and minor sensory issues that have emerged, along with a near reversal in sleep habits, from a perfect sleeper to an anxious kid who can't get himself to sleep and can't stay asleep without mom or dad right there. On the behavior side, he has issues with self-regulation and aggressiveness, especially when angry but also when he is simply overexcited/overstimulated. He hits, bites (occasionally), and will generally engage in annoying habits like poking at people, licking them, etc. When he is very upset he will even hit, bite or pinch himself. He is also expressing sensitivities to sound and generally hates pants with buttons/zippers and the like complaining they are too tight.

RE: sleep we have noticed some incidents that seem like sleep-walking, restlessness, etc. He also has allegies and snores, so sleep apnea or the like could be a culprit. He recently moved to a DC PCS PS3 class and his teacher mentioned some episodes of "zoning out" as she put it.

So all of this sent us to our ped, who referred us to Children's for an EEG and neuro consult (to rule out absence seizures), a sleep specialist, and an OT specializing in SPD. The EEG was inconclusive so they are now recommending an overnight EEG and a consult with a developmental ped.

So basically, I've gone from having what I felt was a normal kid to what the docs are now making me feel is a freaking crisis situation by referring me to every specialist under the sun. My son is bright and social, and aside from a few challenges is a normal, developing kid. The shit spiral I feel is my own as all of this is making me doubt myself and wonder where exactly I went wrong here. I am, as I said, HIGHLY suspicious of all of this, right or wrong. And I appreciate what all of you are saying about labels, but I don't buy it. Society DOES label kids, and it affects them. I have nieces and nephews in these situations and I have seen it affect their self esteem - and be used as a crutch - "I have ADD, so I can't XYZ." I've watched their parents do it, too - "Well, Susie does have ADD, so XYZ is really hard for her." I fear that all of this limits kids and is potentially damaging - especially with syndromes that are so nebulous. As the neuro MD said today, "All of this could also mean he's just being his normal 3.5 year old self." WTF? So why am I here then, exactly?

There. That's my whole life story. Sorry if I offended anyone. My question about what to expect at an initial consult still stands so I can prepare my kid for what to expect. Thanks.

[Anonymous]

Trust your gut. You're his mom. If you think your kid is fine, then don't do this. If you don't think he's having absence seizures, all you've described is an anxious kid with some sensory issues. If you think his behavior is within the range of normal and there's no medical risk to waiting and seeing, just wait and see.

Signed, a mom of a kid with lots of labels who benefited a lot from lots and lots of intervention

[Anonymous]

Op: I was where you were when my seemingly normal nursery schooler was being run arnd for eegs and dietary tests and hearing tests: angry, shellshocked, pissed that this was becoming my life.

I hope it goes away for you. For me, this is my life now ; my kid is not "normal" and its not the crazy doctors fault. I'd like nothing more than to drop my kids off at school in the morning and get on w my life, like so many of my friends, but that's not my reality.. I can be pissed, I can be in disbelief, or I can deal w it.


To answer your question, the dev ped will run some diagnostics and use their expertise to evaluate your child and make next step recommendations. My dev ped has declined to put an autism dx on my kid, even though others want that

[Anonymous]

Anonymous wrote:Op: I was where you were when my seemingly normal nursery schooler was being run arnd for eegs and dietary tests and hearing tests: angry, shellshocked, pissed that this was becoming my life.

I hope it goes away for you. For me, this is my life now ; my kid is not "normal" and its not the crazy doctors fault. I'd like nothing more than to drop my kids off at school in the morning and get on w my life, like so many of my friends, but that's not my reality.. I can be pissed, I can be in disbelief, or I can deal w it.


To answer your question, the dev ped will run some diagnostics and use their expertise to evaluate your child and make next step recommendations. My dev ped has declined to put an autism dx on my kid, even though others want that

I am so sorry for you, really. What you describe is EXACTLY how I am feeling. Just once I'd like the teacher to say my kid had a great day insted of giving me the litany of every little effing thing he supposedly did wrong. I want to ask, "oh, really? And NONE of the other 3 yo's do that?" Some things I'll give her, but some of the stuff that gets brought up is just so asinine. At this point, if we keep going down this rabbit hole, I will spend more time getting my child evaluated than actually working. And I will end up on Xanax.

[Anonymous]

BTW, what are these diagnostics of which you speak?

[Anonymous]

17:06 again. It's hard for me to get upset with you, OP, b/c I was you last yr at this time with a "shit storm" from DS's school regarding what was going on at school with DS - my seemingly normal, smart, happy, sweet, well behaved, never been sick a day in his life 4 year old. Was a complete surprise but DS definitely has AS/ASD. It's better to know and deal. Not the end of the world, your child is the same kid with or without the "label."

You can choose to follow up now or not but I'll tell you my life and my son's life is a whole lot better now b/c we dealt with it last yr and can pretty much coast now. Good luck!

[Anonymous]

To answer just a couple of your questions, yes, I actually know a number of people who have received no diagnosis after evaluations or have been told that their child is a little anxious, or has some executive function challenges, but not enough of anything to receive a diagnosis. It is not my experience AT ALL that clinicians are quick to diagnose or medicate. In my own experience with psychologists and doctors, t they have been very conservative and careful. I, too, have a boy whose first three years showed no signs of any problems. He was always ahead on milestones, both physical and cognitive, and also very outgoing and social, who started to have serious problems in preschool. Believe me, I have been there: dreading the pickup and the relentlessly negative feedback from the teacher about my beloved child. It sucks. But these people really are here to help you. And again, in my experience, no one ever overstepped with a possible label. I, on the other hand, speculated about a lot of possibilities but my child didn't get the ADHD diagnosis until he was six and old enough to be given a neuropsych evaluation, which is more sophisticated and thorough than anything that can be administered at 3.

[Anonymous]

Anonymous wrote:OP here. I'm sorry - I can see that my language was insensitive but with a 3.5 year old boy, a part of me can't help but feel that various people - daycare providers, teachers, etc - are just overreacting and sending us on a never-ending "scavenger hunt" as one PP put it - one that is massively time-consuming and expensive. THAT is exactly what I fear. A hunt that leads to nothing but leaves my very young son A) fearful of doctors and B) with the feeling that there is something terribly wrong with him. And yes, I do have a strong suspicion of all of these "specialists" and the frequency with which certain disorders are diagnosed and yes, medicated.

That said, here are some specifics. DS is by all accounts perfectly normal - normal height/weight, hitting nearly of his developmental milestones for motor skills, cognitive, language, etc. For the past 6-9 months we've had some behavioral challenges and minor sensory issues that have emerged, along with a near reversal in sleep habits, from a perfect sleeper to an anxious kid who can't get himself to sleep and can't stay asleep without mom or dad right there. On the behavior side, he has issues with self-regulation and aggressiveness, especially when angry but also when he is simply overexcited/overstimulated. He hits, bites (occasionally), and will generally engage in annoying habits like poking at people, licking them, etc. When he is very upset he will even hit, bite or pinch himself. He is also expressing sensitivities to sound and generally hates pants with buttons/zippers and the like complaining they are too tight.

RE: sleep we have noticed some incidents that seem like sleep-walking, restlessness, etc. He also has allegies and snores, so sleep apnea or the like could be a culprit. He recently moved to a DC PCS PS3 class and his teacher mentioned some episodes of "zoning out" as she put it.

So all of this sent us to our ped, who referred us to Children's for an EEG and neuro consult (to rule out absence seizures), a sleep specialist, and an OT specializing in SPD. The EEG was inconclusive so they are now recommending an overnight EEG and a consult with a developmental ped.

So basically, I've gone from having what I felt was a normal kid to what the docs are now making me feel is a freaking crisis situation by referring me to every specialist under the sun. My son is bright and social, and aside from a few challenges is a normal, developing kid. The shit spiral I feel is my own as all of this is making me doubt myself and wonder where exactly I went wrong here. I am, as I said, HIGHLY suspicious of all of this, right or wrong. And I appreciate what all of you are saying about labels, but I don't buy it. Society DOES label kids, and it affects them. I have nieces and nephews in these situations and I have seen it affect their self esteem - and be used as a crutch - "I have ADD, so I can't XYZ." I've watched their parents do it, too - "Well, Susie does have ADD, so XYZ is really hard for her." I fear that all of this limits kids and is potentially damaging - especially with syndromes that are so nebulous. As the neuro MD said today, "All of this could also mean he's just being his normal 3.5 year old self." WTF? So why am I here then, exactly?

There. That's my whole life story. Sorry if I offended anyone. My question about what to expect at an initial consult still stands so I can prepare my kid for what to expect. Thanks.

My first thought when I was reading through this was absence seizures, so I'm glad they are pursuing this. Are they also doing a brain MRI? I don't mean to scare you because this is a very remote possibility, but behavior change plus blanking out would make me want to rule out a brain tumor. Again, very very unlikely, but its something they should rule out.

Honestly, your child is getting really good and attentive medical care and you should be grateful. It could be nothing or it could be something (not just developmental but maybe medical) and its great that the doctors are taking this seriously.

You had me until your last paragraph, and then you lost me. I have one child with AS and ADHD and another with ADHD and both are terrific students with NO self-esteem issues. I am sorry that your nieces and nephews were raised to think they were somehow inferior but thats not because of their diagnosis, its because of how their parents treated them. It isn't "society", I know because I live in "society" and my kids are doing terrifically. The whole label thing is just BS and leads to parents not taking care of their kids, I'm sorry. if you treat it as a diagnosis, no different from any other diagnoses, and you raise your kids to understand that this is one aspect of who they are but by no means the only defining thing -- as we have -- it isn't a burden. Rather, it becomes a useful tool for getting them what they need. Calling it a "label" and railing against all the professionals doesn't get your child what he needs.

I think you need to take a deep breath and calm down. Seriously, you are leaping ahead to all sorts of scenarios and, even more troubling, you are finding villains everywhere. There are no villains. There is just your young child who is going through a tough time and a team of doctors who are trying to help you.

[Anonymous]

Anonymous wrote:To answer just a couple of your questions, yes, I actually know a number of people who have received no diagnosis after evaluations or have been told that their child is a little anxious, or has some executive function challenges, but not enough of anything to receive a diagnosis. It is not my experience AT ALL that clinicians are quick to diagnose or medicate. In my own experience with psychologists and doctors, t they have been very conservative and careful. I, too, have a boy whose first three years showed no signs of any problems. He was always ahead on milestones, both physical and cognitive, and also very outgoing and social, who started to have serious problems in preschool. Believe me, I have been there: dreading the pickup and the relentlessly negative feedback from the teacher about my beloved child. It sucks. But these people really are here to help you. And again, in my experience, no one ever overstepped with a possible label. I, on the other hand, speculated about a lot of possibilities but my child didn't get the ADHD diagnosis until he was six and old enough to be given a neuropsych evaluation, which is more sophisticated and thorough than anything that can be administered at 3.

Thanks. Glad no one overstepped for you and I wish I could say the same. I had a daycare provider suggest my kid might have autism and I had to resist the urge to bitch slap her. When I told my ped that story she was like um, no. Other things maybe, but definitely not ASD.

How did you cope with the relentlessly negative feedback? It is so emotionally exhausting. I make my husband do pick up so I don't have to deal with it these days. On top of everything else, it is too much.