Parents often have a difficult time sharing concerns about their child. The following outlines four crucial steps to follow with your child’s physician, and highlights the importance of a patient but persistent approach.

• Be prepared
• Express your concerns clearly
• Ask questions
• Follow up

Each well visit provides an opportunity for your child to receive a routine developmental screening; however, if you don’t ask, it may not be offered. Whether or not you have specific concerns about your child’s development, it is best to come to the doctor’s office prepared. Physicians rely on parents to provide information about their child. As a parent, you are your child’s best advocate and a “resident expert” about your child’s health and development. During a well visit, a physician usually sees a child for less than 15 minutes, even less if there has been an emergency that day. It is a challenge, for both the parent and the physician, to cover the wide range of issues related to a child’s health within a limited time.

If you have concerns about your child’s development, take the following four crucial steps: be prepared, express your concerns clearly, ask questions, and follow up.

1. Be prepared. Before you go to your next well visit, print out the checklist of developmental milestones and note whether your child has met each of the expected milestones. If you have questions or concerns, write down a few concrete examples that might assist your physician:

• “My child doesn’t respond to my voice.”
• “He spends so much time lining up his toys, he has no interest in other children.”
• “She hasn’t learned a new word in months.”
• “He doesn’t look at me—he never makes eye contact.”

Whether or not you have concerns, ask your doctor for a routine screening.

2. Express your concerns clearly. While this issue can be an emotional one, try to focus on your concrete concerns, such as developmental milestones. If your physician doesn’t want to perform a screening, or isn’t responsive to your concerns, be persistent. Ask why. And remember, “don’t worry” or “let’s wait and see” are not adequate responses. Schedule a follow up appointment, if necessary, or ask for a referral to a developmental pediatrician. Your child’s healthy development is your most important concern.

3. Ask questions. If there are terms you don’t understand, ask your physician to explain. After the screening, ask what the results show, and what they mean. Inquire about referrals to specialists. Ask what the next step will be.

4. Follow up. For most parents, routine screenings indicate that a child is following a typical development pattern. Screenings at well visits in the future will help to confirm that. For other parents, who learn from the screening that their child may be at risk of a developmental delay, follow up is crucial. Children at risk of atypical development are routinely referred to Early Intervention for a closer look by a developmental specialist. You also may want a referral to a developmental pediatrician, a psychologist, a neurologist, a psychiatrist, or a specialist for further evaluation.

Through all four steps, some parents may stumble or falter. Grief and disbelief can prove to be great hurdles. Parents may fear the worst and not move forward. Other parents may feel uncomfortable questioning their physicians. Proceed with confidence, as parents know their child best. Only by pursuing your questions and concerns, forming a sharing relationship with your child’s physician and then by following up with him/her, can you ensure the best possible outcome for your child. Be patient with yourself and persistent for your child. Get the help your child needs.

“Pediatricians are the only professionals with knowledge of development who are in routine contact with the families of young children. Parents turn to their pediatrician for information about development, for assessment of whether their children are doing all right or not. If pediatricians don’t know or aren’t sure or don’t have the appropriate tools, the children with delays or disorders are missed.” (Frances Page Glascoe, Ph.D., Professor of Pediatrics)

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