Questions to Ask Paediatricians About Your Child’s Development

questions to ask paediatricians about your child's development

Overview: Children are often late in reaching their developmental milestones. Slight delays are normal, but significant ones on many fronts can be an issue. Here, a developmental assessment can help a paediatrician decide if there’s cause for concern. But what are these assessments? How can you prepare for them? And what questions should you ask? Read on to find out.

Watching your child grow up can be a rollercoaster ride of anxiety and joy.

At 18 months, your child isn’t speaking yet so you take her to a paediatrician. The doctor runs her through a series of tests and you find out your child has definite delays in picking up language. So, you start sessions with a speech and language therapist and notice that your child is back on track with her developmental milestones. Joy! But at a subsequent checkup, you learn that she’s talking more than she should and has trouble making eye contact. She’s soon diagnosed with dyslexia and ADHD, which saddens you. But you and her teachers learn how to focus on her strengths and she goes on to live a fulfilling life. Many parents are familiar with this rollercoaster ride of emotions, but you can smooth out the highs and lows if you track your child’s development. That way, you can spot issues early and deal with them proactively.

It’s normal for a child to reach developmental milestones a little late. But a significant delay is worth looking into.

It’s common for a child to lag behind slightly in reaching common milestones. So, you don’t need to worry just because your baby isn’t rolling over by 5 months. But if she’s not rolling over, can’t hold up her head, and isn’t ‘babbling’ yet, then it’s a sign of a developmental delay. It could also be because of a developmental difference like autism.

This is where a developmental assessment is invaluable.

It’s a chance for your paediatrician to get an objective idea of your child’s strengths and weaknesses, and thereby create a care plan tailored to your child’s needs.

Here’s what a paediatrician will be assessing.

  1. Muscle control. Is your child able to control her larger muscle groups? Depending on her age, this might mean crawling, walking, bending over, running, jumping, etc. And does she have control over smaller muscle groups, too — like those in her hands and fingers. These are the muscles she uses for daily activities like eating, dressing, and grooming.
  2. Can your child use age-appropriate communication? That might mean cooing (making vowel sounds), babbling (repetitive consonant-vowel combinations — e.g., mamamamama”), using ‘jargon’ (what sounds like a string of words but really isn’t), or speaking regularly. Your paediatrician will be checking two things: (1) Can she make speech sounds (by moving her tongue, teeth, and lips), and (2) Can she use language to communicate.
  3. Sensory processing.How your child processes what she sees, hears, tastes, smells, and feels will determine how she responds to the world. Sensory processing issues may make your child less curious about her environment. They might cause her discomfort — for example, if sounds and smells disturb or startle her. And they can put your child at risk, too — if for example your toddler doesn’t feel pain, or reacts to it very slowly.
  4. This refers to your child’s mental functioning — how she thinks, learns, analyses, remembers, etc. For younger children, the paediatrician will look at how your child plays (the ‘quality’ of play). And for older children, she’ll test your child’s ability to understand cause and effect, or remember places and things.
  5. Social-emotional development. What’s your child’s temperament and personality like? Can she express and control emotions (e.g., does she have a social smile)? Does she get along with others (or bond with her caregiver)? Can she self-soothe? These abilities will affect the kinds of relationships she learns to form, and as a result, the quality of her life.

Taking your child for a developmental assessment may be a bit daunting, so these are some tips to help you along.

How to prepare for the session

  • Arrange for other primary caregivers to come for the assessment. This way, you’ll be able to provide a more thorough overview of your child’s life.
  • Keep your child comfortable. If she’s anxious or scared, she might not cooperate. The same goes for if she’s unwell.
  • Gather as much information as you can from healthcare professionals, support groups, books, and reliable websites. This will help you decide which gaps in information the paediatrician can fill.
  • Collect and organise her medical records and notes from previous visits to the doctor. This can help set the context for the assessment.

Questions you can ask

Just as the paediatrician will be doing, try and focus on the different areas of your child’s development. For example, you can ask questions about:

  • Muscle control: Check to see if the paediatrician has noticed any delays in movement milestones. If there are delays, ask about which ones you should be concerned about and what you can do about them. If she suggests occupational or physical therapy, find out more about what that involves and ask for referrals if possible. You could read our article on occupational therapy, to start with.
  • Speech and language: Discuss the communication challenges your child might be facing. Would a speech and language therapist help? What kind of skills could she learn? Will alternative communication options be useful — e.g., sign language? Are there resources you can look into?
  • Sensory processing: If there are significant challenges, find out more about them. For example, how can you help your child if she’s overwhelmed by sounds and smells and has a meltdown? And what can you do to minimise the number of meltdowns she has? Also, how can you figure out the limit of sensory input she can handle? And how do you set up your home and her classroom to not exceed this limit?
  • Social development: You’ll be able to provide valuable information here. For example, what have you observed about your child when she’s playing with her friends? Does she get along easily with others? Is she accepted by the group? Your paediatrician will be conducting her own tests, so if she picks up delays that you haven’t, explore why that is. Perhaps there are specific cues that you can learn to spot? Ask if your child will need a child psychologist to help, and if so, ask for suggestions about who you can contact.

How to deal with overwhelm

If your child has significant challenges, the information you get can be emotionally overwhelming. So, here are some tips you can use to cope:

  • Write everything down and ask for a written report of the assessment and its conclusions. This way, you can revisit the discussion later and process each bit of information thoroughly.
  • Ask questions. The assessment will have identified a list of your child’s new needs. Make sure you understand every item on that list clearly and how you can address them. Ask for things to be repeated if you don’t fully understand them and feel free to tell your paediatrician if you disagree with any of her findings. It’s worth talking through your concerns so that everyone is on the same page.
  • Set up a time to talk again. If the session seems rushed for some reason, ask for another appointment so you can work through all your questions.
  • Bring someone for support. If you anticipate that the experience might be too overwhelming, consider bringing a family member or friend for support. They’ll also be an extra set of ears and eyes to pick up things that you’ve missed

Ask about what comes next

  • What are the next steps? Find out about them so you can decide what information you’ll need to gather and whom you’ll need to contact.
  • What do I need to know about the care plan? If your paediatrician has a plan of action, find out about that. Will you need further appointments? With whom, when, and how often? Also, how long will the process last?

Autism-specific questions

Developmental assessments are especially useful in detecting autism spectrum disorders (ASD), so these are some autism-specific questions you can ask. Remember, spotting ASD early and developing a care plan can help improve your child’s IQ, communication, and social interactions. This is the sort of information you’ll need:

  1. How severe are your child’s symptoms?
  2. How will her development be affected from here on in? How independent can you expect her to be?
  3. Will she need to go to a special school?
  4. What changes will you need to make at home to look after her better? Where can you get more information about these changes?
  5. Will she need medicines? If so, what are the benefits and side effects?
  6. Are there support groups you can join?
  7. If you plan to have more children, are they likely to have ASD too?
  8. Will the treatment plan be tailored to your child? Remember, ASD affects children differently, so you’ll need a customised plan and regular follow-up assessments.

Are you concerned that your child is missing important milestones? If so, consider setting up a developmental assessment.

The Ed Psych Practice offers consultation, advice, and problem solving for parents, nurseries, schools, and colleges, in London. We have paediatricians and therapists, who can help.

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