When Should I Worry?

I get a lot of parents asking me if they should be worried about their kids.  Do I think they should come in for an assessment or should they let it ride and see what happens?

It always makes me a little uncomfortable because I have a definite opinion on the matter, but I'm not a trained psychologist or any kind of trained expert.

At its core, the question is always a mask for something else.  Usually "Do you think I'm crazy or overanxious for worrying?" or "Please tell me there's nothing wrong."  More of the former than the latter.  Those who don't want to find there's something wrong are less likely to call me in the first place.

As a society, we mock overanxious parents: the dad who thinks a food stain is a bruise, the mom who brings her kid to the hospital for mosquito bites, thinking it's chicken pox.  By the time a first time parent hits their child's first birthday, they've already been the subject of numerous patronizing smiles and dismissive professional opinions.  So when they are noticing signs of autism or any other developmental issue, they start to second guess themselves.

I tell parents that, in my opinion, they should get testing done sooner rather than later.  The tests are not harmful (although they are expensive).  And if there is a diagnosis waiting, the sooner a parent knows about it, the sooner the child can begin to get help.

It really frustrates and infuriates me when family doctors tell parents to wait a year or two and see what happens.  That is a lot of valuable time lost and bluntly, most of the time, when a parent is worried, there is something going on.  With a flippant pat on the head, those doctors condemn families to months and years of uncertainty and stress and make it that much harder to help the child in the long term.

This is how I look at it.  The doctor is saying to him or herself: there's probably nothing wrong here.  Maybe because they don't have much experience with autism.  Maybe because they get used to telling parents that their concerns are no big deal.  But I would prefer it if they would start thinking about that advice in terms of consequences.

Either the child does or does not have autism.  The parents either get testing or don't get testing.  It's really easy to map out.

Child doesn't have autism, child doesn't get testing: this is the everybody wins scenario.

Child does have autism, child doesn't get testing: Parents miss out on the vital window of early intervention, making it harder to teach their child the necessary skills.  If they start later, treatment will be more expensive, take longer and is usually less effective in the long term.  (Again, this is my opinion based on reading of various articles that I've done.)

Child does have autism, child does get testing: The autism is identified and treatment can begin.

Child doesn't have autism, child does get testing: Assuming that another condition isn't diagnosed, in which case the family can begin treatment, then the parents and child can go on exactly as before.

Not getting testing has the potential of everything fine or disastrous consequences.  If the parents get the testing, the worst possible consequence is for everything to continue as is.  To me, that's a simple and obvious decision and I'd really like to know why so many family doctors continue to advise parents not to get testing.

If you're worried, get your kids tested.  End of debate.