Once upon a time, most quirky children did not get assigned to formal diagnostic categories like attention deficit disorder (ADD ADHD). They were called eccentric or odd, and were humored as oddballs, coddled as infant geniuses, or ostracized as misfits.
We all remember such children from our own school days, and, chances are, they attended no special therapies, took no medications, sought no ADHD treatment, and carried no psychological terminology on their journeys through childhood.
Look around those same classrooms and schoolyards now, and you’ll see a variety of diagnoses: ADD, various learning disabilities, sensory integration dysfunction (SID), oppositional defiant disorder (ODD).
Childhood has become an alphabet soup. A child who doesn’t quite fit the mold is likely to receive intensive testing, leading to diagnosis and re-diagnosis and, in turn, to an individualized program of therapies, home-based interventions, and, possibly, medications. This is a good thing. We no longer take for granted that certain children who have a harder time ought to be left to struggle alone.
But for the parents of these children — namely, you — today’s world presents its own kind of struggle. In a perfect world, you would rely on an erudite and sensitive team of experts who would come to your child without preconceptions and take the time to get to know him. Their recommendations would be realistic and practical, and the evaluation and follow-up appointments would be fully covered by your insurance.
Sorry — we don’t have the map to that world. As you’ve perhaps discovered, with so many diagnoses to choose from, and a dizzying lineup of specialists to do the choosing, parents of quirky kids can lose time, money, and sleep and still find themselves knowing no more than they knew at the beginning — and perhaps trusting their instincts less.
Well, we may not have a map, but our goal here is to help you get most, if not all, of what you need as you put together your team of experts. Whether you’re still looking for a diagnosis that makes sense to you or are well down a treatment path, the following advice will help you make informed choices about your child’s professionals.
The Starting Point
Parents typically start with their child’s primary health-care provider—usually a pediatrician, family practitioner, or nurse practitioner. Some pediatricians have additional training in behavior and development, and many others have at least a special interest in the area. But every pediatrician spends much of his time looking at babies and young children and has some idea of the range of normal—and of the varieties that lie on the fringes of that range.
If you’ve expressed a concern about your child to your pediatrician—and he has listened carefully, interacted with your child, and examined him—but is not alarmed—consider letting yourself be reassured. It’s not a guarantee, of course, but it may well mean that what you’re looking at is more in the going-through-a-phase category. It can be hard to judge whether a two-year-old is off the charts in oppositional behavior and tantrums, especially if the two-year-old is your first child.
If you like and trust your doctor, you might consider letting it rest here, at least for a few months. There is probably no single vital test that needs to be done as soon as possible to get any one essential answer. (Obviously, we’re not talking about diagnosing a child who’s deaf or a child with classic autism or seizures. It is always important that children with major psychiatric or medical disorders be diagnosed—and treated—as rapidly as possible.)
But if you’re really worried about your child’s development, communicate that to your pediatrician. Stop him, look him in the eye, tell him you’re worried, and tell him exactly why. Then schedule a visit to talk specifically about your concern. Don’t try to discuss it during, say, a visit for a nasty ear infection.
Your concerns should prompt your pediatrician to do some kind of systematic developmental assessment, not just “eyeball” your child. If you don’t feel you’re being listened to, get a second opinion. Most pediatricians will be open to referring your child to a behavioral and developmental pediatrician if you are truly worried.
This article comes from the October/November issue of ADDitude.
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