Trust Your Instincts
Still, many parents report that their doctor dismissed their concerns about their child for months -- or even years. By the time her son, Patrick, was 2, Chicago mom Mary McGuire (who asked that their names be changed to protect their privacy) noticed that he simply didn't play the way other kids did. "At our weekly playgroup, the other toddlers would quietly build block towers, but Patrick just wanted to knock them down or run wildly through the house," says McGuire. In preschool, he adored his classmates but had trouble relating to them because he'd get overly excited and physical. His pediatrician repeatedly dismissed McGuire's worries, pointing out how verbal and intelligent the boy was, but Patrick continued to have problems in school for years. "Every time we went to the pediatrician, she'd say he was fine, which was what we wanted to hear," says McGuire. "We'd be happy for a week or two -- until his next playdate. Then I knew that something was off, and I wished we could figure out what it was.
Finally, his third-grade teacher suspected that he had Asperger's syndrome, an autism spectrum disorder. McGuire decided to change pediatricians, and the new doctor agreed with the teacher's hunch. He referred them to an autism clinic, where Patrick was lucky to be seen within three months, and he was diagnosed with Asperger's. Fortunately, he has made rapid progress: Now in fourth grade, he is doing well with a full-time aide in his classroom and he has close friends. "However, if we had switched to our current pediatrician sooner, Patrick could have been diagnosed years earlier," says McGuire.
Most parents don't realize that federal law stipulates they are entitled to have their child evaluated by their state's Early Intervention Program -- even without a doctor's referral or an official diagnosis. If a child is found to have a significant enough developmental delay that he meets his state's legal criteria to qualify for therapy, the state is supposed to start providing it within 45 days. Although it's ideal to work in partnership with your pediatrician, you should get your child started in therapy as soon as possible, says Dr. McBrien. So if that means having him evaluated when your doctor says it isn't necessary, so be it.
Developmental problems can be challenging for general practitioners to diagnose, but doctors often have a laissez- faire attitude when parents worry about whether their child is behaving normally, admits Dr. Gardner. "Older pediatricians were taught that it was okay to wait until age 2 to intervene if a child wasn't walking, and until age 3 if he wasn't talking." Sometimes, rushed pediatricians simply don't take the time to evaluate subtle problems or they're too quick to reassure parents who seem overanxious. However, it's important to be honest and direct about your worries. Dr. Gardner suggests saying something like, "For my own peace of mind, I'd rather look into this now because I'm uncomfortable waiting."