Getting Your Child Evaluated… When to Take that Step?

A parent recently asked about her two year old son. Like many boys, his language is delayed. Family and friends have commented that it might be a sign of autism. That got her worried. Should she take him to get evaluated by a specialist? Is that overreacting?

I find the best course of action is not to get worried unnecessarily or jump to worst case scenarios. That never helps a parent figure out what’s the next best step. Development is complicated and messy, especially in boys, with many false starts and alarms. Keep a clear head. Seek information from the right people. Don’t rush. Stay calm.

If you’re concerned, the best course of action is to start with your pediatrician. He or she already knows your child and his history. Set up an appointment specifically to talk about these issues. Don’t try to fit it into a rushed 15 minute wellness visit. If your pediatrician is also concerned about language development – or any other developmental areas – then the next step would be finding someone (or some program) that can do a good, balanced evaluation. It should inquire about a range of developmental areas: language, fine motor, gross motor, various mental operations, basic social skills. It should be someone (or a team) that takes into consideration the whole child and his environment, including what’s going on at home. They should spend time 1:1 with him doing tasks, waiting for him to feel comfortable, and engaging him to show what he can and cannot do.

Keep in mind that the process of evaluating children is not an exact science. It is a clinical process. I get concerned about simple “screening” that some professionals use. Those are simple checklists or quick meetings that, while convenient and cost-effective, often only give the appearance of a solid clinical evaluation. They aren’t. A proper evaluation should be a clinical face-to-face process. It shouldn’t be wrapped up in one brief meeting.

As for the advice family members and friends give, don’t let other people’s worries distract you from your task at hand. Stay focused on seeking knowledgeable people who can be objective and who see many kids in their professional work. Such people are developmental pediatricians, pediatric neurologists, psychologists, and learning specialists such as speech and occupational therapists.

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