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Shout out the William Penn High AP team. From left to right: Lawrence Bopp, Natasha Mathis, and Kijuan Felder. Physicians may also find it challenging to identify children at risk for developmental delays and disorders and difficult to express their concerns about a child’s development with parents or caregivers. No doubt about it, these are critical life-changing discussions that require time, sensitivity, honesty, planning, and follow-through on your part. Nor do they address behavioral problems. This, combined with routine observations and comparisons of other children is very powerful. This cuts across all populations: income, education, social level, culture, etc.
A physician can make great use of these observations at a well child visit where the average time for a professional to observe a child is only 15 minutes on average. When you have concerns about a child, remember, this is a family you anticipate having a professional relationship with for the next 18 years. It’s important to develop the ability to say, ‘Okay, this is a problem you’re experiencing, I’m going to take it seriously. In the short term, it improves the quality of life and functioning for the child and for the family. Pediatric clinicians are in a unique and central position to identify developmental concerns early and refer children at risk on for further evaluation and treatment.
Parents depend on pediatric clinicians for advice, guidance, and support. They need healthcare professionals who can speak the language of development with them and work with them to keep their child on a healthy developmental path. I would advocate a preliminary developmental screening for all children. And if a parent comes in and has concern about a child, there should be an immediate discussion about it. If the pediatrician doesn’t have time, it would be well for him to either have a person to whom he refers the family or for one of his staff to be able to sit down with the family for 15 minutes and make them feel heard. This makes it essential for medical practitioners and clinicians to understand the key social, emotional, and communication milestones and to have a firm grasp of red flags.
That’s one in every five patients or so, especially if you include the more serious mental health problems. One out of every five patients that you run into will be experiencing a developmental problemit’s a huge concern. Simply by making developmental surveillance a regular part of every office visit, you can sharpen your observations, elicit better information from parents, and heighten your index of suspicion. Physicians need to have an index of suspicion. And they need to listen to parents.
Even when I was a resident back in the dark agesthere was this whole idea about being an overanxious mother. I don’t think I’ve ever seen a mother that I thought was overanxious. You’re usually anxious for a reason and if there is a reason, you need to know what that reason is. So if they’ve got a busy schedule, it would be appropriate when Mrs. Ask the parent how little Johnny or Susie lets them know what they want and listen carefully for the explanation. If at 12 or 14 months little Johnny or Susie simply cries or wants the parent to guess what he or she wants, but can’t use purposeful signaling, such as taking them by the hand or pointing to indicate wants or desires, that’s a warning sign. Try to observe a few minutes of free play.