Re: USA today Article about Well Child visits (My Vent; Sorry So Long)

[Guest guest]

> The American Academy of Pediatrics published its latest policy in July. It

> calls for pediatricians to:

> .Ask parents questions about their children's development and look for

> signs

> of trouble at every well-child visit up to age 3.

> .Use formal, proven developmental screening tests at 9 months, 18

> months and

> again at either 24 or 30 months (the group favors the later check but says

> children aren't always seen at that age).

> .Screen every child for autism at 18 months (a first-time call for formal

> autism screening).

> .Offer additional, formal screening any time a parent or doctor becomes

> concerned about a child.

> .Refer children who fail screening tests to public early-intervention

> programs and to specialists who can evaluate the child fully, both for

> developmental disorders and related medical problems.

It is so disappointing to say that my son's Ped. did done of this. But

she did say, " We can always wait and see. " I think this lady is a warm,

caring, and skilled physician. But I am so disappointed that she didn't

suggest some of these screenings. I should have listened to my gut

feeling and went ahead with something formal when he was a 1 yr. old.

But I didn't. I waited until he was 2 to pursue a formal screening

through the Children's Hospital. And only after a staffer casually

mentioned a government funded program called " Help Me Grow " was I able

to get some real, productive help. My Ped. had never even mentioned

Help Me Grow. So after months of intervention, assessments, etc. he was

evaluated by my local school district (at the request of Help Me Grow)

and qualified for special preschool for his expressive/receptive

disorder at 3 yrs. old (which I now believe to be apraxia).

So things are going a lot better now, but I wonder how many other

parents are out there who don't know about programs like " Help Me

Grow. " Maybe I should've been more " with it " in knowing about such

things. At least I can share info. with other parents facing situations

likened to mine.

Thanks for listening!

Tricia wrote:

> 'Well child' visits revisited

> Updated 8/6/2006 6:38 PM ET

> Pediatricians are busy. Parents are, too. So fitting one more thing into a

> " well child " visit - in addition to the weighing, measuring, poking and

> prodding - is tough.

>

> But when that one thing is assessing an infant's or toddler's

> development -

> all the outward signs that his brain, mind and body are working

> together as

> they should - it's worthwhile. That's because catching the early signs of

> problems ranging from mild speech delays to mental retardation can make a

> huge difference in the lives of children and families.

> " We just know that if we get kids in early, they do so much better, " says

> Frances Glascoe, an adjunct professor of pediatrics at Vanderbilt

> University

> in Nashville.

> The problem: making routine developmental screening happen in a world

> where

> a well-child visit lasts less than 15 minutes and insurers don't pay

> doctors

> to indulge in long chats with worried parents.

> The American Academy of Pediatrics published its latest policy in July. It

> calls for pediatricians to:

> .Ask parents questions about their children's development and look for

> signs

> of trouble at every well-child visit up to age 3.

> .Use formal, proven developmental screening tests at 9 months, 18

> months and

> again at either 24 or 30 months (the group favors the later check but says

> children aren't always seen at that age).

> .Screen every child for autism at 18 months (a first-time call for formal

> autism screening).

> .Offer additional, formal screening any time a parent or doctor becomes

> concerned about a child.

> .Refer children who fail screening tests to public early-intervention

> programs and to specialists who can evaluate the child fully, both for

> developmental disorders and related medical problems.

> The mix of periodic formal screening, less formal checks in between and

> prompt responses to parents' concerns should work for time-pressed doctors

> but minimize chances that children in trouble will go months or years

> without help, says Lipkin, director of the Center for Development and

> Learning at the Kennedy Krieger Institute in Baltimore and head of the

> panel

> that wrote the policy. " Once a parent expresses a concern around a child's

> development, that in and of itself is significant, " he says. " We'd like to

> get 'wait and see' taken out of the vocabulary of the well-child visit. "

> Wiseman of Merrimac, Mass., would like that, too. Doctors told

> her to

> " wait and see " when she first expressed concerns about her toddler

> daughter's poor language, communication and play skills - warning signs of

> an autism-related disorder that was diagnosed months later. Today, her

> daughter is 10 and doing well, but Wiseman says too many doctors still

> fail

> to respond when a child falls behind.

> " I'd like to see screening at every visit, " says Wiseman, founder of First

> Signs, which promotes early diagnosis and treatment of developmental

> disorders and author of Could It Be Autism? A Parent's Guide to the First

> Signs and Next Steps. (Full disclosure: I was a paid contributor to that

> book.)

> The warning signs of many disorders, including autism, can be seen in the

> first two years of life. Yet the federal Centers for Disease Control and

> Prevention says children with autism are diagnosed at an average age of 5.

> Meanwhile, about 2% of children under 3 are enrolled in federally mandated

> early-intervention programs for children with developmental delays,

> Glascoe

> says. But, she says, 8% likely qualify.

>

> D. Wiseman

> Founder and President

> First Signs, Inc.

> Dedicated to early identification and intervention

> of children with autism and other developmental disorders

> Phone: (978) 346-4380

> Fax: (978) 346-4638

> Email: <mailto:nwiseman@...

> <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> <mailto:nwiseman%40firstsigns.org>

> www.firstsigns.org <http://www.firstsigns.org/

> <http://www.firstsigns.org/>>

>

>

[Guest guest]

> The American Academy of Pediatrics published its latest policy in July. It

> calls for pediatricians to:

> .Ask parents questions about their children's development and look for

> signs

> of trouble at every well-child visit up to age 3.

> .Use formal, proven developmental screening tests at 9 months, 18

> months and

> again at either 24 or 30 months (the group favors the later check but says

> children aren't always seen at that age).

> .Screen every child for autism at 18 months (a first-time call for formal

> autism screening).

> .Offer additional, formal screening any time a parent or doctor becomes

> concerned about a child.

> .Refer children who fail screening tests to public early-intervention

> programs and to specialists who can evaluate the child fully, both for

> developmental disorders and related medical problems.

It is so disappointing to say that my son's Ped. did done of this. But

she did say, " We can always wait and see. " I think this lady is a warm,

caring, and skilled physician. But I am so disappointed that she didn't

suggest some of these screenings. I should have listened to my gut

feeling and went ahead with something formal when he was a 1 yr. old.

But I didn't. I waited until he was 2 to pursue a formal screening

through the Children's Hospital. And only after a staffer casually

mentioned a government funded program called " Help Me Grow " was I able

to get some real, productive help. My Ped. had never even mentioned

Help Me Grow. So after months of intervention, assessments, etc. he was

evaluated by my local school district (at the request of Help Me Grow)

and qualified for special preschool for his expressive/receptive

disorder at 3 yrs. old (which I now believe to be apraxia).

So things are going a lot better now, but I wonder how many other

parents are out there who don't know about programs like " Help Me

Grow. " Maybe I should've been more " with it " in knowing about such

things. At least I can share info. with other parents facing situations

likened to mine.

Thanks for listening!

Tricia wrote:

> 'Well child' visits revisited

> Updated 8/6/2006 6:38 PM ET

> Pediatricians are busy. Parents are, too. So fitting one more thing into a

> " well child " visit - in addition to the weighing, measuring, poking and

> prodding - is tough.

>

> But when that one thing is assessing an infant's or toddler's

> development -

> all the outward signs that his brain, mind and body are working

> together as

> they should - it's worthwhile. That's because catching the early signs of

> problems ranging from mild speech delays to mental retardation can make a

> huge difference in the lives of children and families.

> " We just know that if we get kids in early, they do so much better, " says

> Frances Glascoe, an adjunct professor of pediatrics at Vanderbilt

> University

> in Nashville.

> The problem: making routine developmental screening happen in a world

> where

> a well-child visit lasts less than 15 minutes and insurers don't pay

> doctors

> to indulge in long chats with worried parents.

> The American Academy of Pediatrics published its latest policy in July. It

> calls for pediatricians to:

> .Ask parents questions about their children's development and look for

> signs

> of trouble at every well-child visit up to age 3.

> .Use formal, proven developmental screening tests at 9 months, 18

> months and

> again at either 24 or 30 months (the group favors the later check but says

> children aren't always seen at that age).

> .Screen every child for autism at 18 months (a first-time call for formal

> autism screening).

> .Offer additional, formal screening any time a parent or doctor becomes

> concerned about a child.

> .Refer children who fail screening tests to public early-intervention

> programs and to specialists who can evaluate the child fully, both for

> developmental disorders and related medical problems.

> The mix of periodic formal screening, less formal checks in between and

> prompt responses to parents' concerns should work for time-pressed doctors

> but minimize chances that children in trouble will go months or years

> without help, says Lipkin, director of the Center for Development and

> Learning at the Kennedy Krieger Institute in Baltimore and head of the

> panel

> that wrote the policy. " Once a parent expresses a concern around a child's

> development, that in and of itself is significant, " he says. " We'd like to

> get 'wait and see' taken out of the vocabulary of the well-child visit. "

> Wiseman of Merrimac, Mass., would like that, too. Doctors told

> her to

> " wait and see " when she first expressed concerns about her toddler

> daughter's poor language, communication and play skills - warning signs of

> an autism-related disorder that was diagnosed months later. Today, her

> daughter is 10 and doing well, but Wiseman says too many doctors still

> fail

> to respond when a child falls behind.

> " I'd like to see screening at every visit, " says Wiseman, founder of First

> Signs, which promotes early diagnosis and treatment of developmental

> disorders and author of Could It Be Autism? A Parent's Guide to the First

> Signs and Next Steps. (Full disclosure: I was a paid contributor to that

> book.)

> The warning signs of many disorders, including autism, can be seen in the

> first two years of life. Yet the federal Centers for Disease Control and

> Prevention says children with autism are diagnosed at an average age of 5.

> Meanwhile, about 2% of children under 3 are enrolled in federally mandated

> early-intervention programs for children with developmental delays,

> Glascoe

> says. But, she says, 8% likely qualify.

>

> D. Wiseman

> Founder and President

> First Signs, Inc.

> Dedicated to early identification and intervention

> of children with autism and other developmental disorders

> Phone: (978) 346-4380

> Fax: (978) 346-4638

> Email: <mailto:nwiseman@...

> <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> <mailto:nwiseman%40firstsigns.org>

> www.firstsigns.org <http://www.firstsigns.org/

> <http://www.firstsigns.org/>>

>

>

[Guest guest]

Well, I have a copy of my daughter's 2-year checkup chart, and our

pediatrician DOES screen for developmental problems. However, my

daughter got two big nos for both speech-related questions (over 50

words and putting two words together), I expressed concern about it

and yet we were still given the wait and see. Three months later I

called the office for a referral and got a great referral for

private services but no mention of EI. Due to long waiting lists at

the private office and my not knowing about EI until several months

later, Meg didn't start any therapy until she was 33 months. In

those 9 months she didn't learn to say a single new word so finally

my concerns were not just dismissed.

I have to think that our experience is probably pretty typical, at

least in this area (western PA).

As a side note, when my second daughter was not crawling at her 9

month checkup we were promptly referred to a physical therapist for

an evaluation by another doctor at the same practice (she crawled a

week later and we cancelled).

Kerri

>

> > 'Well child' visits revisited

> > Updated 8/6/2006 6:38 PM ET

> > Pediatricians are busy. Parents are, too. So fitting one more

thing into a

> > " well child " visit - in addition to the weighing, measuring,

poking and

> > prodding - is tough.

> >

> > But when that one thing is assessing an infant's or toddler's

> > development -

> > all the outward signs that his brain, mind and body are working

> > together as

> > they should - it's worthwhile. That's because catching the early

signs of

> > problems ranging from mild speech delays to mental retardation

can make a

> > huge difference in the lives of children and families.

> > " We just know that if we get kids in early, they do so much

better, " says

> > Frances Glascoe, an adjunct professor of pediatrics at

Vanderbilt

> > University

> > in Nashville.

> > The problem: making routine developmental screening happen in a

world

> > where

> > a well-child visit lasts less than 15 minutes and insurers don't

pay

> > doctors

> > to indulge in long chats with worried parents.

> > The American Academy of Pediatrics published its latest policy

in July. It

> > calls for pediatricians to:

> > .Ask parents questions about their children's development and

look for

> > signs

> > of trouble at every well-child visit up to age 3.

> > .Use formal, proven developmental screening tests at 9 months,

18

> > months and

> > again at either 24 or 30 months (the group favors the later

check but says

> > children aren't always seen at that age).

> > .Screen every child for autism at 18 months (a first-time call

for formal

> > autism screening).

> > .Offer additional, formal screening any time a parent or doctor

becomes

> > concerned about a child.

> > .Refer children who fail screening tests to public early-

intervention

> > programs and to specialists who can evaluate the child fully,

both for

> > developmental disorders and related medical problems.

> > The mix of periodic formal screening, less formal checks in

between and

> > prompt responses to parents' concerns should work for time-

pressed doctors

> > but minimize chances that children in trouble will go months or

years

> > without help, says Lipkin, director of the Center for

Development and

> > Learning at the Kennedy Krieger Institute in Baltimore and head

of the

> > panel

> > that wrote the policy. " Once a parent expresses a concern around

a child's

> > development, that in and of itself is significant, " he

says. " We'd like to

> > get 'wait and see' taken out of the vocabulary of the well-child

visit. "

> > Wiseman of Merrimac, Mass., would like that, too. Doctors

told

> > her to

> > " wait and see " when she first expressed concerns about her

toddler

> > daughter's poor language, communication and play skills -

warning signs of

> > an autism-related disorder that was diagnosed months later.

Today, her

> > daughter is 10 and doing well, but Wiseman says too many doctors

still

> > fail

> > to respond when a child falls behind.

> > " I'd like to see screening at every visit, " says Wiseman,

founder of First

> > Signs, which promotes early diagnosis and treatment of

developmental

> > disorders and author of Could It Be Autism? A Parent's Guide to

the First

> > Signs and Next Steps. (Full disclosure: I was a paid contributor

to that

> > book.)

> > The warning signs of many disorders, including autism, can be

seen in the

> > first two years of life. Yet the federal Centers for Disease

Control and

> > Prevention says children with autism are diagnosed at an average

age of 5.

> > Meanwhile, about 2% of children under 3 are enrolled in

federally mandated

> > early-intervention programs for children with developmental

delays,

> > Glascoe

> > says. But, she says, 8% likely qualify.

> >

> > D. Wiseman

> > Founder and President

> > First Signs, Inc.

> > Dedicated to early identification and intervention

> > of children with autism and other developmental disorders

> > Phone: (978) 346-4380

> > Fax: (978) 346-4638

> > Email: <mailto:nwiseman@...

> > <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> > <mailto:nwiseman%40firstsigns.org>

> > www.firstsigns.org <http://www.firstsigns.org/

> > <http://www.firstsigns.org/>>

> >

> >

>

[Guest guest]

On the physical form that your pediatrician uses there often is a

little developmental screen on the side column. That screening is done

mainly through observation and conversation with you as a parent.

There isn't a time during the physical when the pediatrician would say

" now let's do the developmental screen " . Not all pediatricians use the

same form but many do. If your pediatrician is a medicaid provider he

is required to have a developmental screen on that physical form.

If you want to know if your pediatrician was doing these little

screenings and what they saw, ask for a copy of your records. If the

screening is on the side column (it may be somewhere else but that is

where I've usually seen them) then you can see what he/she thought

about your child's progress at that time. Again, not all pediatricians

have this screening on their physical forms but many do. The physical

forms from the American Academy of Pediatrics are written for specific

stages of infancy/childhood and the developmental screen is geared

toward that age.

The real issue is what do they do with the information they collect

through the screening. I applaud the AAP for addressing the issue of

screening but I do think they need to clarify their standing on early

intervention, when to refer and avoiding a " wait and see " approach.

Kris

Mom to Grace age 29 mos

Pediatric Nurse Practitioner (temporarily retired due to motherhood)

On Aug 8, 2006, at 6:49 AM, Jeff wrote:

> Well, I have a copy of my daughter's 2-year checkup chart, and our

> pediatrician DOES screen for developmental problems. However, my

> daughter got two big nos for both speech-related questions (over 50

> words and putting two words together), I expressed concern about it

> and yet we were still given the wait and see. Three months later I

> called the office for a referral and got a great referral for

> private services but no mention of EI. Due to long waiting lists at

> the private office and my not knowing about EI until several months

> later, Meg didn't start any therapy until she was 33 months. In

> those 9 months she didn't learn to say a single new word so finally

> my concerns were not just dismissed.

>

> I have to think that our experience is probably pretty typical, at

> least in this area (western PA).

>

> As a side note, when my second daughter was not crawling at her 9

> month checkup we were promptly referred to a physical therapist for

> an evaluation by another doctor at the same practice (she crawled a

> week later and we cancelled).

>

> Kerri

>

>

> >

> > > 'Well child' visits revisited

> > > Updated 8/6/2006 6:38 PM ET

> > > Pediatricians are busy. Parents are, too. So fitting one more

> thing into a

> > > " well child " visit - in addition to the weighing, measuring,

> poking and

> > > prodding - is tough.

> > >

> > > But when that one thing is assessing an infant's or toddler's

> > > development -

> > > all the outward signs that his brain, mind and body are working

> > > together as

> > > they should - it's worthwhile. That's because catching the early

> signs of

> > > problems ranging from mild speech delays to mental retardation

> can make a

> > > huge difference in the lives of children and families.

> > > " We just know that if we get kids in early, they do so much

> better, " says

> > > Frances Glascoe, an adjunct professor of pediatrics at

> Vanderbilt

> > > University

> > > in Nashville.

> > > The problem: making routine developmental screening happen in a

> world

> > > where

> > > a well-child visit lasts less than 15 minutes and insurers don't

> pay

> > > doctors

> > > to indulge in long chats with worried parents.

> > > The American Academy of Pediatrics published its latest policy

> in July. It

> > > calls for pediatricians to:

> > > .Ask parents questions about their children's development and

> look for

> > > signs

> > > of trouble at every well-child visit up to age 3.

> > > .Use formal, proven developmental screening tests at 9 months,

> 18

> > > months and

> > > again at either 24 or 30 months (the group favors the later

> check but says

> > > children aren't always seen at that age).

> > > .Screen every child for autism at 18 months (a first-time call

> for formal

> > > autism screening).

> > > .Offer additional, formal screening any time a parent or doctor

> becomes

> > > concerned about a child.

> > > .Refer children who fail screening tests to public early-

> intervention

> > > programs and to specialists who can evaluate the child fully,

> both for

> > > developmental disorders and related medical problems.

> > > The mix of periodic formal screening, less formal checks in

> between and

> > > prompt responses to parents' concerns should work for time-

> pressed doctors

> > > but minimize chances that children in trouble will go months or

> years

> > > without help, says Lipkin, director of the Center for

> Development and

> > > Learning at the Kennedy Krieger Institute in Baltimore and head

> of the

> > > panel

> > > that wrote the policy. " Once a parent expresses a concern around

> a child's

> > > development, that in and of itself is significant, " he

> says. " We'd like to

> > > get 'wait and see' taken out of the vocabulary of the well-child

> visit. "

> > > Wiseman of Merrimac, Mass., would like that, too. Doctors

> told

> > > her to

> > > " wait and see " when she first expressed concerns about her

> toddler

> > > daughter's poor language, communication and play skills -

> warning signs of

> > > an autism-related disorder that was diagnosed months later.

> Today, her

> > > daughter is 10 and doing well, but Wiseman says too many doctors

> still

> > > fail

> > > to respond when a child falls behind.

> > > " I'd like to see screening at every visit, " says Wiseman,

> founder of First

> > > Signs, which promotes early diagnosis and treatment of

> developmental

> > > disorders and author of Could It Be Autism? A Parent's Guide to

> the First

> > > Signs and Next Steps. (Full disclosure: I was a paid contributor

> to that

> > > book.)

> > > The warning signs of many disorders, including autism, can be

> seen in the

> > > first two years of life. Yet the federal Centers for Disease

> Control and

> > > Prevention says children with autism are diagnosed at an average

> age of 5.

> > > Meanwhile, about 2% of children under 3 are enrolled in

> federally mandated

> > > early-intervention programs for children with developmental

> delays,

> > > Glascoe

> > > says. But, she says, 8% likely qualify.

> > >

> > > D. Wiseman

> > > Founder and President

> > > First Signs, Inc.

> > > Dedicated to early identification and intervention

> > > of children with autism and other developmental disorders

> > > Phone: (978) 346-4380

> > > Fax: (978) 346-4638

> > > Email: <mailto:nwiseman@...

> > > <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> > > <mailto:nwiseman%40firstsigns.org>

> > > www.firstsigns.org <http://www.firstsigns.org/

> > > <http://www.firstsigns.org/>>

> > >

> > >

> >

>

>

[Guest guest]

I can totally relate. I saw developmental delays in my child early on

(not rolling over, not walking....etc..). And my ped said oh it's

ok, he's not delayed. Also with his hearing and fluid in ears. It

wasn't until 20 months we discovered a hearing loss(at my demand for

hearing testing), 23 months PE tubes and during that time I self

reffered my child to EI. All this time I knew something wasn't right

but the docs refused to listen to me. Thank goodness I listened to

my intuition, because mamma's intutition is always right in my case!

Janel

>

> It is so disappointing to say that my son's Ped. did done of

this. But

> she did say, " We can always wait and see. " I think this lady is a

warm,

> caring, and skilled physician. But I am so disappointed that she

didn't

> suggest some of these screenings. I should have listened to my

gut

> feeling and went ahead with something formal when he was a 1 yr.

old.

> But I didn't. I waited until he was 2 to pursue a formal

screening

> through the Children's Hospital. And only after a staffer

casually

> mentioned a government funded program called " Help Me Grow " was I

able

> to get some real, productive help. My Ped. had never even

mentioned

> Help Me Grow. So after months of intervention, assessments, etc.

he was

> evaluated by my local school district (at the request of Help Me

Grow)

> and qualified for special preschool for his expressive/receptive

> disorder at 3 yrs. old (which I now believe to be apraxia).

>

> So things are going a lot better now, but I wonder how many other

> parents are out there who don't know about programs like " Help Me

> Grow. " Maybe I should've been more " with it " in knowing about

such

> things. At least I can share info. with other parents facing

situations

> likened to mine.

>

> Thanks for listening!

>

>

>

>

[Guest guest]

Well, I have a copy of my daughter's 2-year checkup chart, and our

pediatrician DOES screen for developmental problems. However, my

daughter got two big nos for both speech-related questions (over 50

words and putting two words together), I expressed concern about it

and yet we were still given the wait and see. Three months later I

called the office for a referral and got a great referral for

private services but no mention of EI. Due to long waiting lists at

the private office and my not knowing about EI until several months

later, Meg didn't start any therapy until she was 33 months. In

those 9 months she didn't learn to say a single new word so finally

my concerns were not just dismissed.

I have to think that our experience is probably pretty typical, at

least in this area (western PA).

As a side note, when my second daughter was not crawling at her 9

month checkup we were promptly referred to a physical therapist for

an evaluation by another doctor at the same practice (she crawled a

week later and we cancelled).

Kerri

>

> > 'Well child' visits revisited

> > Updated 8/6/2006 6:38 PM ET

> > Pediatricians are busy. Parents are, too. So fitting one more

thing into a

> > " well child " visit - in addition to the weighing, measuring,

poking and

> > prodding - is tough.

> >

> > But when that one thing is assessing an infant's or toddler's

> > development -

> > all the outward signs that his brain, mind and body are working

> > together as

> > they should - it's worthwhile. That's because catching the early

signs of

> > problems ranging from mild speech delays to mental retardation

can make a

> > huge difference in the lives of children and families.

> > " We just know that if we get kids in early, they do so much

better, " says

> > Frances Glascoe, an adjunct professor of pediatrics at

Vanderbilt

> > University

> > in Nashville.

> > The problem: making routine developmental screening happen in a

world

> > where

> > a well-child visit lasts less than 15 minutes and insurers don't

pay

> > doctors

> > to indulge in long chats with worried parents.

> > The American Academy of Pediatrics published its latest policy

in July. It

> > calls for pediatricians to:

> > .Ask parents questions about their children's development and

look for

> > signs

> > of trouble at every well-child visit up to age 3.

> > .Use formal, proven developmental screening tests at 9 months,

18

> > months and

> > again at either 24 or 30 months (the group favors the later

check but says

> > children aren't always seen at that age).

> > .Screen every child for autism at 18 months (a first-time call

for formal

> > autism screening).

> > .Offer additional, formal screening any time a parent or doctor

becomes

> > concerned about a child.

> > .Refer children who fail screening tests to public early-

intervention

> > programs and to specialists who can evaluate the child fully,

both for

> > developmental disorders and related medical problems.

> > The mix of periodic formal screening, less formal checks in

between and

> > prompt responses to parents' concerns should work for time-

pressed doctors

> > but minimize chances that children in trouble will go months or

years

> > without help, says Lipkin, director of the Center for

Development and

> > Learning at the Kennedy Krieger Institute in Baltimore and head

of the

> > panel

> > that wrote the policy. " Once a parent expresses a concern around

a child's

> > development, that in and of itself is significant, " he

says. " We'd like to

> > get 'wait and see' taken out of the vocabulary of the well-child

visit. "

> > Wiseman of Merrimac, Mass., would like that, too. Doctors

told

> > her to

> > " wait and see " when she first expressed concerns about her

toddler

> > daughter's poor language, communication and play skills -

warning signs of

> > an autism-related disorder that was diagnosed months later.

Today, her

> > daughter is 10 and doing well, but Wiseman says too many doctors

still

> > fail

> > to respond when a child falls behind.

> > " I'd like to see screening at every visit, " says Wiseman,

founder of First

> > Signs, which promotes early diagnosis and treatment of

developmental

> > disorders and author of Could It Be Autism? A Parent's Guide to

the First

> > Signs and Next Steps. (Full disclosure: I was a paid contributor

to that

> > book.)

> > The warning signs of many disorders, including autism, can be

seen in the

> > first two years of life. Yet the federal Centers for Disease

Control and

> > Prevention says children with autism are diagnosed at an average

age of 5.

> > Meanwhile, about 2% of children under 3 are enrolled in

federally mandated

> > early-intervention programs for children with developmental

delays,

> > Glascoe

> > says. But, she says, 8% likely qualify.

> >

> > D. Wiseman

> > Founder and President

> > First Signs, Inc.

> > Dedicated to early identification and intervention

> > of children with autism and other developmental disorders

> > Phone: (978) 346-4380

> > Fax: (978) 346-4638

> > Email: <mailto:nwiseman@...

> > <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> > <mailto:nwiseman%40firstsigns.org>

> > www.firstsigns.org <http://www.firstsigns.org/

> > <http://www.firstsigns.org/>>

> >

> >

>

[Guest guest]

On the physical form that your pediatrician uses there often is a

little developmental screen on the side column. That screening is done

mainly through observation and conversation with you as a parent.

There isn't a time during the physical when the pediatrician would say

" now let's do the developmental screen " . Not all pediatricians use the

same form but many do. If your pediatrician is a medicaid provider he

is required to have a developmental screen on that physical form.

If you want to know if your pediatrician was doing these little

screenings and what they saw, ask for a copy of your records. If the

screening is on the side column (it may be somewhere else but that is

where I've usually seen them) then you can see what he/she thought

about your child's progress at that time. Again, not all pediatricians

have this screening on their physical forms but many do. The physical

forms from the American Academy of Pediatrics are written for specific

stages of infancy/childhood and the developmental screen is geared

toward that age.

The real issue is what do they do with the information they collect

through the screening. I applaud the AAP for addressing the issue of

screening but I do think they need to clarify their standing on early

intervention, when to refer and avoiding a " wait and see " approach.

Kris

Mom to Grace age 29 mos

Pediatric Nurse Practitioner (temporarily retired due to motherhood)

On Aug 8, 2006, at 6:49 AM, Jeff wrote:

> Well, I have a copy of my daughter's 2-year checkup chart, and our

> pediatrician DOES screen for developmental problems. However, my

> daughter got two big nos for both speech-related questions (over 50

> words and putting two words together), I expressed concern about it

> and yet we were still given the wait and see. Three months later I

> called the office for a referral and got a great referral for

> private services but no mention of EI. Due to long waiting lists at

> the private office and my not knowing about EI until several months

> later, Meg didn't start any therapy until she was 33 months. In

> those 9 months she didn't learn to say a single new word so finally

> my concerns were not just dismissed.

>

> I have to think that our experience is probably pretty typical, at

> least in this area (western PA).

>

> As a side note, when my second daughter was not crawling at her 9

> month checkup we were promptly referred to a physical therapist for

> an evaluation by another doctor at the same practice (she crawled a

> week later and we cancelled).

>

> Kerri

>

>

> >

> > > 'Well child' visits revisited

> > > Updated 8/6/2006 6:38 PM ET

> > > Pediatricians are busy. Parents are, too. So fitting one more

> thing into a

> > > " well child " visit - in addition to the weighing, measuring,

> poking and

> > > prodding - is tough.

> > >

> > > But when that one thing is assessing an infant's or toddler's

> > > development -

> > > all the outward signs that his brain, mind and body are working

> > > together as

> > > they should - it's worthwhile. That's because catching the early

> signs of

> > > problems ranging from mild speech delays to mental retardation

> can make a

> > > huge difference in the lives of children and families.

> > > " We just know that if we get kids in early, they do so much

> better, " says

> > > Frances Glascoe, an adjunct professor of pediatrics at

> Vanderbilt

> > > University

> > > in Nashville.

> > > The problem: making routine developmental screening happen in a

> world

> > > where

> > > a well-child visit lasts less than 15 minutes and insurers don't

> pay

> > > doctors

> > > to indulge in long chats with worried parents.

> > > The American Academy of Pediatrics published its latest policy

> in July. It

> > > calls for pediatricians to:

> > > .Ask parents questions about their children's development and

> look for

> > > signs

> > > of trouble at every well-child visit up to age 3.

> > > .Use formal, proven developmental screening tests at 9 months,

> 18

> > > months and

> > > again at either 24 or 30 months (the group favors the later

> check but says

> > > children aren't always seen at that age).

> > > .Screen every child for autism at 18 months (a first-time call

> for formal

> > > autism screening).

> > > .Offer additional, formal screening any time a parent or doctor

> becomes

> > > concerned about a child.

> > > .Refer children who fail screening tests to public early-

> intervention

> > > programs and to specialists who can evaluate the child fully,

> both for

> > > developmental disorders and related medical problems.

> > > The mix of periodic formal screening, less formal checks in

> between and

> > > prompt responses to parents' concerns should work for time-

> pressed doctors

> > > but minimize chances that children in trouble will go months or

> years

> > > without help, says Lipkin, director of the Center for

> Development and

> > > Learning at the Kennedy Krieger Institute in Baltimore and head

> of the

> > > panel

> > > that wrote the policy. " Once a parent expresses a concern around

> a child's

> > > development, that in and of itself is significant, " he

> says. " We'd like to

> > > get 'wait and see' taken out of the vocabulary of the well-child

> visit. "

> > > Wiseman of Merrimac, Mass., would like that, too. Doctors

> told

> > > her to

> > > " wait and see " when she first expressed concerns about her

> toddler

> > > daughter's poor language, communication and play skills -

> warning signs of

> > > an autism-related disorder that was diagnosed months later.

> Today, her

> > > daughter is 10 and doing well, but Wiseman says too many doctors

> still

> > > fail

> > > to respond when a child falls behind.

> > > " I'd like to see screening at every visit, " says Wiseman,

> founder of First

> > > Signs, which promotes early diagnosis and treatment of

> developmental

> > > disorders and author of Could It Be Autism? A Parent's Guide to

> the First

> > > Signs and Next Steps. (Full disclosure: I was a paid contributor

> to that

> > > book.)

> > > The warning signs of many disorders, including autism, can be

> seen in the

> > > first two years of life. Yet the federal Centers for Disease

> Control and

> > > Prevention says children with autism are diagnosed at an average

> age of 5.

> > > Meanwhile, about 2% of children under 3 are enrolled in

> federally mandated

> > > early-intervention programs for children with developmental

> delays,

> > > Glascoe

> > > says. But, she says, 8% likely qualify.

> > >

> > > D. Wiseman

> > > Founder and President

> > > First Signs, Inc.

> > > Dedicated to early identification and intervention

> > > of children with autism and other developmental disorders

> > > Phone: (978) 346-4380

> > > Fax: (978) 346-4638

> > > Email: <mailto:nwiseman@...

> > > <mailto:nwiseman%40firstsigns.org>> nwiseman@...

> > > <mailto:nwiseman%40firstsigns.org>

> > > www.firstsigns.org <http://www.firstsigns.org/

> > > <http://www.firstsigns.org/>>

> > >

> > >

> >

>

>

[Guest guest]

I can totally relate. I saw developmental delays in my child early on

(not rolling over, not walking....etc..). And my ped said oh it's

ok, he's not delayed. Also with his hearing and fluid in ears. It

wasn't until 20 months we discovered a hearing loss(at my demand for

hearing testing), 23 months PE tubes and during that time I self

reffered my child to EI. All this time I knew something wasn't right

but the docs refused to listen to me. Thank goodness I listened to

my intuition, because mamma's intutition is always right in my case!

Janel

>

> It is so disappointing to say that my son's Ped. did done of

this. But

> she did say, " We can always wait and see. " I think this lady is a

warm,

> caring, and skilled physician. But I am so disappointed that she

didn't

> suggest some of these screenings. I should have listened to my

gut

> feeling and went ahead with something formal when he was a 1 yr.

old.

> But I didn't. I waited until he was 2 to pursue a formal

screening

> through the Children's Hospital. And only after a staffer

casually

> mentioned a government funded program called " Help Me Grow " was I

able

> to get some real, productive help. My Ped. had never even

mentioned

> Help Me Grow. So after months of intervention, assessments, etc.

he was

> evaluated by my local school district (at the request of Help Me

Grow)

> and qualified for special preschool for his expressive/receptive

> disorder at 3 yrs. old (which I now believe to be apraxia).

>

> So things are going a lot better now, but I wonder how many other

> parents are out there who don't know about programs like " Help Me

> Grow. " Maybe I should've been more " with it " in knowing about

such

> things. At least I can share info. with other parents facing

situations

> likened to mine.

>

> Thanks for listening!

>

>

>

>