Reply to Most Childhood Interventionism is Job Protection

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[quote=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.[/quote]

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