“Talk to your doctor” is the kind of advice that sounds final – you’ll talk to your doctor, and they’ll let you know if what you’ve been worrying about is something you need to worry about. In real life, though, it doesn’t always feel that simple. Doctors are people too, and they see a lot of young patients. More than that, doctors are very aware that they only see their small patients in somewhat stressful situations – even the nicest, most easygoing doc can make a toddler feel a little off-balance.
This means that doctors often assume that a little shyness or lack of communication from young children has more to do with the lab coat or the stethoscope than with a genuine difficulty with communication, or irregularity in social skills. In some ways, this habit can be a positive thing, since many variations on normal development just indicate that a child is learning some skills in a slightly different order, or on a different timeline, than expected.
However, since primary care doctors are often generalists, who know how to treat children at many different ages, and who tend to focus on medical concerns, they aren’t always fully familiar with the more subtle signs of true delays. This means they’re not always able to recognize children at an early age who may benefit from getting a little extra help in learning the skills they need.
Asking your pediatrician questions
On well-visits, doctors have a list of milestones and warning signs to look out for, associated with a young child’s age. When it comes to making sure that young children are developing and learning everything they need to learn, this is a great place to start, but it’s also a very broad baseline. You can help your child’s pediatrician out by bringing up anything about your child’s behavior that you’ve found worrying or interesting. Some great types of questions to lead the conversation include the following:
- When should they start using this skill?
- If a skill is late in showing up, at what point should I worry?
- Can I help teach them this skill?
- What does this skill help them learn in the future?
- When will I know that they aren't growing out of this behavior on their own?
- Have you seen this behavior before?
- How familiar are you with the condition I’m concerned about?
After talking to your pediatrician
If you’re concerned that your child may be dealing with developmental delays or irregularities, talking to your doctor is a great place to start – it’s just also important to remember that you may need to be your child’s advocate as you express your concerns. Baby’s doctor may be a great doctor, but they don’t know them like you do – even if Baby is prone to sickness enough that it feels like the two of you are in and out of your doctor’s office once a week.
If your child’s primary care doctor says there’s nothing to worry about, but you’re still concerned about your little one’s development, you can still ask the primary care doctor or pediatrician for a referral to a specialist who may be able to tell you more. If you’d rather not, or if your family’s pediatrician isn’t willing to give you a referral, though, that’s not the only option.
In the U.S., Early Intervention specialists will provide a free evaluation for developmental delays of all kinds for children at age 3 or younger. You can set up an evaluation for your child by calling the Early Intervention services based in your area and talking about your concerns. From your description of what kinds of delays you’re worried about, Early Intervention will be able to match your family with experts who specialize in the appropriate developmental areas, and will work with you to set up an appointment for an evaluation either in your home or somewhere else your child feels comfortable. Evaluations are play- and activity-based, and generally fairly brief.
If Early Intervention specialists determine that your child is experiencing developmental delays, they’ll be able to help connect your family with interventions, services, or therapies that may help your child learn the skills they need to continue to learn, grow, and thrive. Early Intervention specialists may also make referrals to doctors who may be able to diagnose conditions like Autism Spectrum Disorder, if they feel that may be part of what’s at work. After age 3, they can also help families of young children connect with local public preschool programs designed to help young children – especially young children who may be experiencing delays – learn any skills they might need before they start school.