First DP appointment

[jszy10]

Hey ladies!!  I'm new to this board (I live over on Success after IF), so wanted to introduce myself and also ask for some advice.  My son is 19 months old, and we just got set up with his first developmental pediatrician appointment at Chop.  I was curious if any of you could tell me what to expect at the first appointment/evaluation, or offer any suggestions or tips on what to bring or what to know!?  My son just recently qualified for services from early intervention. He started with a special instructor last week and will start with OT as well next week.  After being told there would be a 6-9m waiting list, I was excited to hear from the DP so soon, but now I'm super nervous and wondering if the timing is good for his age?

Thanks in advance for any help you can offer!

[akafred]

I think a lot of it will probably depend on the concerns. DD is 7.5 now, and has dx of SPD, ADHD, and anxiety. She is not on spectrum but is sort of "neurodevelopmentally immature."

We first went to the Dev Ped when she was about 19 or 20 months old. She had already been seen by a private OT who said she showed clear sensory diffeeenxes but because she wasn't developmentally delayed, she didn't qualify for a dx of SPD at the time. (That came when she was 4.) The appt with the dev ped followed, and they had us see a nurse practitioner. She asked eleventy million questions about DD's development (plus the 4 or so pages of questions we answered in advance), and then did a brief physical exam (listened to heart, looked in eyes, that sort of thing). They also did height and weight. Then she said that she basically agreed with the OT and nothing was really wrong.

Of course that doesn't actually prove to be the case. When DD was 4 we again started the process. The OT did "dx" SPD at that time. The dev pedi (again, NP) did the same thing as before and said to come back in 6 months. We ended up leaving this dev ped group and using a private psychologist who dx DD with ADHD and anxiety a week before her 6th birthday.

But anyway, the meat of it will be the same. Tons of questions, short physical exam, which I figure is a kind of triage. Depending on how your child triages, they may order additional tests. But that will probably not happen at the first appt.

[jszy10]

akafred, Thanks for sharing your experience. At 15m I expressed mild concerns about a few things (lack of speech, no real imitating, no clapping or waving, difficulty in social settings, no response to his name or general directions, some repetitive actions) that each had no improvement or growth by 18. My ped believes he may end up with ASD and referred us to EI and a DP. He just started with a special instructor last week and will start OT next week. I do believe he is making small improvements just with age, but nothing big to report since 15m.

[mrsbuttinski]

CHOP Philly or Pgh?

DS got his second opinion ASD/ADHD at CHOPhilly. He was seen at the Autism Center some 16 years ago, so the protocol may have changed. Plus DS came in with a dx from a clinical psychologist and was 7 when dxd at CHOP.

Assuming he is walking, they may try to do an ADOS. But generally, there will be interviews of you and observations of your DS. For us it was a long day- probably 6 hours but, again, this was a long time ago when DS's dx was considered a 1 in 6000 thing- the dev pedi wanted to bring in his fellows, residents and medical students to meet a child with his particular presentation. DS didn't have any speech or fine motor delays, he was very engaged with adults and had passed the MCHAT.

Sometimes they will look to get your child out of his comfort zone deliberately in order to observe him when he isn't being accommodated.

[jszy10]

mrsbuttinski, Chop Philly. Yeah they want us there at 8am for an 830 appt and we will most likely be there for at least 3 - 3 1/2 hrs they said. Thanks for sharing. It's not hard to get DS out of his comfort zone when he's away from home, and I think that is what I'm most worried about. He obvious acts different when in a comfortable space than he does when he is somewhere new around people he doesn't know...but I'm sure that is something they need to see.

[mrsbuttinski]

When your car is making a funny noise and you take it to the shop, it's really useful for the mechanic to actually hear the funny noise.

[numbbears]

Welcome. I tried to convince the psychologist that DS could say "go" and respond to his name despite trying for ten minutes and that he was just distracted because they had too many toys in the room. But like Mrs.B said, they didn't need to see him at his best, they want to help with the things he struggles with.

[mrsbuttinski]

I'm not sure how they do this these days, but back when DS was being evaluated we did a long developmental history package ahead of the appointment. I used his baby memory book and medical records to refresh my memory- because DS was almost 7 when he first saw his dev pedi.

Another useful strategy is to record any behavior you are concerned about or that you have difficulty describing. Sometimes it's easier to show a clip of some odd behavior than itt is to put it into words- like clenching or all consuming meltdown behavior.