Developmental asssessment at Children's with Nurse Practitioner

[Anonymous]

I called to get an assessment in the Developmental Neurology Dept at Children's. They set me up with an appointment in April. After I got off the phone, i googled who the appointment is with, and it's a nurse practitioner.

I'm not convinced my son has anything going on -- he's got some quirks at age 3, had some hearing issues for the last couple years which we are in the process of resolving with tubes and speech therapy, is very high energy, and has some sensory-seeking behaviors in loud settings. My guess (looking into a crystal ball) is we'll end up with a push by his school for an ADHD diagnosis in 3 years or so (whether or not he actually is ADHD), but the rest will be resolved through the tubes/speech therapy, and otherwise aging out of it. But nonetheless, we've had enough red flags that I think it's worth having him checked out to cover our bases.

Is it okay if the eval is with a nurse practitioner? They didn't ask whether i wanted to see an MD or not.

[Anonymous]

The basic developmental assessments (i.e. she'll flash a picture and ask him to name what's there, check his motor skills, etc.) aren't hard to administer and I'm sure any nurse practitioner can handle this. In fact, I think a lot of the people doing the assessments for ChildFind for the counties/DC are also nurses or have a similar background.

If she finds any red flags I'm sure you could ask for a referral for an MD for a follow up.

We've been at Children's for years and DD has been seen at many departments but we have never seen a NP so I'm wondering if this is something new?

[Anonymous]

You should also call and check to make sure the NP isn't somehow working with a doc who will come in part way through or something.

[Anonymous]

Is this at Children's in Rockville? I don't have a lot of faith in her abilities. We had a 30 minute appointment, she asked a few questions, barely interacted with DS, and sent us on our way telling us to find an OT and read about SPD. 3 months later we met with a Developmental Pediatrician who did several evals, asked many more questions, and spent 2 hours with us. DS fully met the DSM criteria for autism and ADHD. It was missed entirely by the NP at Children's- she had told us that DS didn't seem to have any ASD traits at all.

[Anonymous]

We saw a NP there, and it was fine in terms of getting a diagnosis. It was that, or wait a horribly long time to see anyone, but we figured it was a good start. She was able to point out some things we weren't aware were problems (speech and fine motor issues -- we were going in for an ADHD eval). She was accessible after the appointment by email and phone for questions. There was a bit of a disconnect, where she was telling us what to request from the county, but those were services never offered directly by the county -- confusing for parents dealing with this for the first time. But, we'd probably have had similar problems with a doctor as well. We did have some differences of opinion over medicinal options, and have since started to see someone else, but it was a good start and the diagnosis seems to hold.

[Anonymous]

Get an appointment with the person you want. It is not worth it to see someone else sooner. I have done this with other doctors and regretted it later. NPs have a small fraction of the training doctors do and I actually find it offensive that they did not tell you it's a NP.

[Anonymous]

Anonymous wrote:Get an appointment with the person you want. It is not worth it to see someone else sooner. I have done this with other doctors and regretted it later. NPs have a small fraction of the training doctors do and I actually find it offensive that they did not tell you it's a NP.

+1

NPs aren't specialists in the same way a developmental pediatrician (or a child psychologist) is, and you want a specialist. Particularly in a case where what's going on isn't obvious--and your gut may well be right, OP--you want someone with the expertise and sense of context to really help. As much as you don't want someone minimizing any problems, you also don't want someone to exaggerate them, either. Good luck.