How Can We Improve Communication & Get Better Support from Our Developmental Pediatrician? (Listener Question)

Debbie: 

Hey everybody, it’s Debbie here from Tilt Parenting. I am joined today by Margaret Webb. Margaret is not just a dear friend of mine. She was my very first parenting coach. She’s also the lead parent coach in my Differently Wired Club where she beautifully supports parents in that community. She is also the author of the wonderful new book, A Hero’s Journey in Parenting, Parenting the Child You Didn’t Expect When You Were Expecting, which we recently talked about on this show. So definitely go check that out if you haven’t listened to that episode. But all of that to say, welcome Margaret, thanks so much for being here.

Margaret Webb:

I am very excited to be here, as always.

Debbie:

Okay, well let’s dive right into the question for today. The question is, do you have any tips on getting the most out of your time with a developmental pediatrician? My child is seven years old and we’ve been seeing a developmental pediatrician twice a year since he was four. We get at least an hour with her when we see her and she’s been available by phone when needed. Our son is fairly resistant to speaking during appointments so we end up doing a lot of talking in front of him. This doesn’t always feel good. Sometimes we leave feeling like we haven’t addressed the scope of our challenges even though our developmental pediatrician is very receptive. We plan to move forward with a neurological evaluation early in the summer to understand if he is autistic. He’s been diagnosed with anxiety and avoidant restrictive food intake disorder. Occupational and play therapies have been unsuccessful for us. Margaret, I’d love to hear from you first on tips you have on getting the most out of your time with a developmental pediatrician. What came up for you when you first heard this question?

Margaret Webb:

Yeah, so the first thing that came up was the curiosity around is it just you or are you going with a partner or somebody who, because it said we, and so if it is you and your partner or you and somebody else, it might be an opportunity to spend the first 20 minutes, 30 minutes where your child is in the room where they’re being evaluated or the developmental pediatrician can do their exam or the consult or whatever that looks like. But then another person is able to take the child out so that you can have a conversation based on there’s talking in front of him, which isn’t feeling great. So keeping that in mind and seeing if there’s any flexibility, any possibility to have somebody to take him out so that you can discuss things that you want to where you’re not feeling like you need to, you know, kind of cushion things or be careful about things that you’re sharing. So there’s that part. And regardless of what it is, I recommend so highly to write down and spend a little bit of time before each, whether it’s a developmental pediatrician or whatever kind of expert appointment you’re going to, I would take time to write down what your intentions are, what your wants are, what your needs are, what your curiosities are, what your noticings are, and get those down in writing because so often when we get into those appointments or those meetings, We are, you know, especially if our child is there, we can get distracted, we can lose focus, we can feel like it’s not that important. But if we take that time ahead of time, then we can narrow down to like, these are really important things that I do want to discuss. It sounds like this particular person is open to outside communication. So you might email them and email them those questions or the noticings, things that you want to and say, these are some things that we want to talk about during our session so that there’s clarity around that. And if you’re able to do that, well, and even if you’re not able to email him, I would definitely put them in writing, print them out and hand them to them and allow them to have a couple of minutes to scan through.

So that even if your child is there, you can talk about them by, you know, like, oh, this is in response to, you know, your first point. And then you can have a conversation where you’re not having to sit there and explain everything in front of your child, where you’re both looking at the same information, but doing so where you’re bypassing all of the conversational explanation of where it’s coming from. And so taking that and just going from there. So I feel like that’s the most helpful to not only beforehand get clear, but then during. And then again, you said that you’ve got somebody who’s willing to talk afterwards. You know, or to talk outside of that, to, you know, not take advantage of their time. But if there was something that you forgot to mention that you think is important in guiding the decision -making about how to move forward with your child, I would definitely reach out and share that with them. Chances are if you spend time ahead of time, that’s not as likely to happen. And so you’re taking care of that in advance, but if there is something where you get in the car and you’re like, ah, shoot, you know, I forgot to mention this. Let them know, because they want to help you.

Debbie:

Yeah. Great, great advice. And yeah, I had a lot of, you know, Margaret and I didn’t consult ahead of time. So I have similar things: keep notes, bring in notes, list of goals in advance, specific questions. I’m thinking about this as almost like a business meeting, you know, where you don’t leave a business meeting without your next steps, right? But I’ll just say that as I read this question, I could feel that sense of like walking out the door and saying goodbye and inside your mind going, but wait, I didn’t, but wait, this and that, but we still walk out the door anyway. I have been in that situation so many times. So I just want to encourage you so much to not leave the meeting without the answers that you need. And which is why being prepared in advance can be so helpful. I wanted to throw out a couple of things. 

One that came up for me in reading this question is there’s a tool from Understood.org. It’s called Take N.O.T.E. I’ll have a link in the show notes page. I actually did an episode with Amanda Moore and years ago when Understood first introduced this tool, but it is a, it’s an approach or a tool that they’ve created to help people notice, observe, talk, and engage basically to track. They actually have a downloadable PDF where you can kind of track specific behaviors and what you’re observing so that when you go into a meeting, you’ve got it all laid out. It’s a tracker tool. Again, I’ll share it in the resources for this, but that can really help you, you know, you keep like a tracking log or a diary over the course of a month or something to really have some concrete examples of specific things that are concerning for you or that you want to make sure you touch upon. So I wanted to share that resource. And then I also just wanted to throw out there that not all developmental pediatricians are created equally and not all really have a detailed understanding of the latest in where we are with understanding and recognizing neurodivergence in our kids. So sometimes there might be a tendency for more of a wait and see approach. 

And then as a parent, you’re like, but, I’m seeing this and I’m worried about this and you know, well, let’s check in in six months and that might not feel good for you if you have this really strong gut intuition that no, there’s something going on here and you don’t want to, you know, spend that time just waiting and seeing. So a lot of us, maybe me, maybe this is just me, so I’m generalizing, but you know, we can feel very connected and attached to these, you know, professionals that we have relationships with, we don’t want to hurt feelings or egos. But if you have a strong intuitive hit that your needs aren’t being met or this expert person you’re meeting with isn’t really getting it or fully seeing what’s going on, I would also explore making a switch and researching, asking around and trying to find someone who is really neurodivergent affirming in that they are not just looking to diagnose disorders, right? But they really have a deeper understanding about kind of, again, the latest in neuroscience and the latest information we have about the complicated ways in which things like ADHD and autism show up in our kids. 

And I want to give a shout out to doctors Donna Henderson and Sarah Wayland. They wrote a wonderful book called Is This Autism? I had them on the show, their book is phenomenal, but they really have taken the criteria for autism and gone much deeper and explained different ways that those criteria can and should be interpreted that are often missed by even people who are doing neuro -psychs to assess for autism. So things are moving quickly in this field. So I just wanted to throw that out there as well. So trust your gut. Don’t worry about hurting people’s feelings and be as prepared as possible and don’t leave without getting the answers that you want. Margaret, do you have anything to add before we wrap up?

Margaret Webb:

I’m so glad that you said that about not hurting the feelings because I’ve got a whole section in my book about the experts not always being the expert in our kids. Like we are the experts and we can go and we can consult with those who are, quote unquote, the experts in their field and we can take their information in and we can allow that to help us to make decisions. But like, being mindful of who we’re handing our power over to is really important for us as parents to trust our guts and to trust what you were saying of like, okay, like this is what I’m seeing and I don’t want to wait six months to do X, Y or Z. It feels more important and allowing yourself to advocate for that and say, this is what I’m seeing and this is what I’m wanting, and to feel very clear and confident and empowered in those decisions as opposed to just handing over power, yeah.

Debbie:

Yeah, that’s great. Yeah, thank you. Thank you so much for that. And thank you so much for submitting that question. I hope this feedback was helpful for you. Good luck as you navigate this. And thanks again, Margaret, for joining me today.

Margaret Webb:

Thank you. Great question.

Debbie: 

All right, bye everybody.

Margaret Webb:

Bye.