Thursday, May 24, 2012

Pediatrician Visit - The Emotional Part

Today was difficult. First of all, I have a cold, which is never fun. It's even less fun when you have an infant to take care of and an exuberant older child that you're trying to shuttle around to end-of-school-year activities. But Malcolm let me sleep from about 10:30 until 5 am last night, so I was doing okay (he wasn't asleep that long, but he'd been fed and Ryan took him downstairs while I went to bed; I have no idea when he actually fell asleep).

The boys had a pediatrician visit today. We were a bit rushed getting out the door (I didn't get any breakfast), but we made it there and things seemed to be going well. Gareth was his usual chatty self - he thanked the nurse for letting him play games (test his vision and hearing) and was perfectly cooperative and patient. Malcolm was a bit on the pukey side, but that's nothing new. Then the pediatrician started talking about how Gareth seems to be working at a higher level than most kids intellectually, he's very thoughtful and she's worried about Gareth socially. Uh, what? She thinks he has some quirks that could be off-putting to others. I mention that he's very outgoing, loves making friends, etc. She says that's fine but it's only half of it. He needs to recognize that others aren't reciprocating. And she goes on about how missing those social cues is one of the symptoms on "the spectrum". I don't know about you, but the only thing I can think of for that to mean is the autism spectrum. She doesn't want to label him just yet - maybe he'll be fine - but she wants to start the conversation. There are social skills training classes for kids.

Unfortunately,  I wasn't feeling well enough and was so blind-sided by what she said that I didn't think of all I should have at the time. What "quirks" is she talking about? No idea. Sure, he has some, but what five year old doesn't? Yes, there will probably be kids who think he's weird or don't like him. I'm pretty sure that happens to most of us. How can she tell anything about his social skills from a ten-minute check-up? I was basically left feeling like any kid who isn't instantly in the popular crowd is now being told there's something wrong with them. But I don't want to be in denial if there's something going on, so I decided I'd talk with his preschool teacher.

We left the doctor's office, ran to the toy store to pick up something for the preschool pinata and a birthday gift, then rushed home to grab me some orange juice and Gareth a sandwich. Off to the pharmacy to get Malcolm some tylenol since I'm doubtful he'll happily make it through Gareth's "graduation" without it. We get to preschool late, just in time for the graduation stuff to start. I've yet to really eat anything, I'm not feeling great still, and Malcolm is starting to get fussy, so my emotions are barely in check. I made it through the graduation stuff and talked with a close friend about the morning's visit and she seconded my idea to talk to the preschool teacher.

I asked the teacher if we could talk after class (thinking I'd go home for the last hour of preschool). On my way out the door I broke down when a couple of moms asked how I was doing. I ended up talking with several other parents about what had happened, all of whom were full of indignation at the pediatrician, told me she's crazy, that Gareth does a great job socially, and even gave me some food. By the time we finished chatting I figured I may as well stay until class was over. So we went out to recess with the kids where I talked with Gareth's teacher. She sees him four times a week socializing with other kids. She also agreed that the pediatrician didn't know what she was talking about, that Gareth is developing just fine socially. Of course he won't pick up on all social cues yet - most kids his age don't; it's something they're learning still. She's bothered by how cookie-cutter the pediatrician's comments feel rather than letting each kid have their own personality. While we were talking we could see Gareth happily playing with his peers. Then he was engaging with some kids from the elementary school, kids two or three years older than him. We found out later that they had come up to Gareth and some of his friends and told the preschoolers that the playground was the older kids territory and the little kids shouldn't be there. Gareth was the one who had no problem telling them that he and his friends were allowed to be there and that there was their teacher and this was their place to play also. His teacher reassured me that Gareth is perfectly fine socially.

All of this has left me feeling less than confident about our pediatrician. Up until now she's been amazing. She's usually very non-alarmist and reassuring. This came completely out of left field and I'm not sure why it came up at all. I think I'll be trying to talk with her to figure out where this came from. I'm hoping she can re-build my confidence in her, because I'd really hate to have to change pediatricians right now, but if I need to I have no problem doing that.


Matt White said...

Erin, I had a fair share of quirks as a kid too. I bet I could have been diagnosed with a social disorder, given the right (or should I say "wrong") person evaluating me. I'd bet Gareth is totally fine, no "weirder" than Ryan is (haha). If it really worries you though, it's my understanding that most schools can bring in a child psychologist to do an evaluation. Unless your pediatrician is specifically trained in spotting autism, there's a good chance she's off. I have a friend/colleague with an autistic daughter who agrees with that.

Susan said...

Seems like all doctors are so quick to find problems these days. What used to be "oh they'll grow out of it" is now "better see a specialist." I get that doctors have to cover their backs due to the extremely litigious mentality a lot of folks have. But, if the people that know Gareth the best don't see anything wrong with him, there probably isn't!

Erin said...

Thanks, guys. Yeah, we're pretty certain that there's absolutely nothing to be worried about. If he were a 2nd or 3rd grader and was struggling to understand social cues, maybe, but at 5, I don't think so. It sounds like he's right on par with his peers. And his preschool teacher focuses on the social/emotional development as opposed to academic, so I trust her judgement.

Someone else told me that it's Autism Awareness month right now as well, so it could just be that that's on their minds more right now and so they're seeing problems where there aren't any. I'll call and see if I can work things out. But luckily I've got a whole preschool full of pediatrician recommendations I can get if we decide to switch!

Amy Rose said...

Oh my goodness, I would have been a wreck too! Sometimes I worry about what people will think of Hallie, because sometimes when you talk to her she just stares at you and doesn't answer, but then I remind myself that she's only four - there are a million reasons she could be doing that, probably most likely is she doesn't know what you're talking about! I hope you can find out where this came from with the pediatrician. I had to switch ours a while ago because he kept saying really ridiculous things - he told me to keep an eye on Hanna because she might develop cancer, yeah. That was the last straw.

Alanna said...

I read this and was annoyed with doctors all over again. Sorry it's taken me so long to comment (we just got home from a trip), but every time you've posted I've thought, I need to comment on that post about the annoying doctor! I'd chalk it up to a bad day unless she continues to make dumb suggestions like this. I know next to nothing about autism, but my impression is that it's pretty difficult to diagnose (especially a case that isn't severe), so thinking you could spot it after a ten minute conversation seems pretty asinine. I would definitely trust his preschool teacher's advice over the pediatrician's.

I'm glad you're feeling better about things now, because you should be.

Aye Spy said...

Good heavens! I agree with everyone else and the preschool teacher - the doctor was out of line. And like another commenter said, Gareth's definitely no weirder than Ryan is or was. :D Don't forget that as his mom, you know and love Gareth best. Trust your instincts!

kristine N said...

Ugh. That's annoying. I'd probably cry, too, if someone tried to label one of my kids that way, too. Glad you have good friends and teachers around who can provide a reality check.

Some people just see disorders everywhere. My mom could spot autism from a mile away in people I considered good friends and really reasonably normal (at least, normal for the crowd I hang out with). Actually, I've found that to be true of many people who have a passing knowledge of psychology...

Momof8 said...

I agree with all the above. I'm thinking that if I had taken five-year-old Ryan to her, she may have said something similar. And Ryan was and always has been the quiet, think-before-you-say-anything-or-just-don't-say-anything kind of kid. I doubt he would have been so brave as to tell the older kids at the playground he had the right to play there.

You are raising a wonderfully intelligent young man who gets his brains from both his Mom and Dad. And he is very much a boy--eager, active, enthusiastic--but he can also be quiet and thoughtful when he needs to be.

If this is the definition of a "spectrum" child, we need more of them!