Dear Dr. Michelle:
I have been having problems with my toddler. He cries a lot and seems to be inconsolable. He is 2 and a half years old and is still not talking and he struggles to walk. He doesn’t engage very well when we play. When I take him to the doctor, she tells me to just give it time and doesn’t offer any other advice. Is this normal?
Margaret
Dear Margaret:
It is good that you are observing your child’s behavior and being curious about his development. What you are describing are concerns with developmental milestones. While there are certainly norms, there can also be a lot of differences in developmental milestones and it is possible that your son is an outlier.
There are average milestone expectations based on comparison data across children that can be used as a good resource and benchmark. The CDC provides information including charts, videos and written content to help you understand what to expect.
Based on what you have described, your concern and questions are warranted. Usually by two and half to three years of age, you could expect your child to be walking, doing more independent physical activities and stringing words together. If your son is inconsolable, he may also be experiencing pain. Crying is a very important form of communication for children and indicates hunger, thirst, or pain. If you know he is getting proper nutrition, then his crying could be communicating physical discomfort. Try to observe if there is a pattern to his crying. Is it happening during the same kind of activity or physical movement? If so, try to avoid that type of activity until you know what is going on.
Talk to Your Pediatrician
Usually, a child’s developmental milestones are something that your pediatrician would be tracking carefully, noting concerns, and requesting further evaluation if goals are not achieved. If you feel that your doctor is not listening to your concerns, you may want to find a different pediatrician for a second opinion.
If something more serious is going on with your son, you will want to know sooner rather than later so that you can start him on the right treatment. I recommend that your son be evaluated for medical and physical issues, as well as speech, movement, neurological functioning, and cognitive processing issues (how he thinks and processes information).
A pediatrician should be making appropriate referrals for specific assessments needed. If the doctor does not suggest further assessments related to your concerns, then you should request your doctor provide you with specific referrals to have the above areas evaluated.
When it comes to addressing a child’s developmental issues, the earlier you understand potential problems and intervene the better. Many issues can be resolved at a very early age and many children can get back on track developmentally if they receive immediate treatment.
Get An Evaluation
Find out if your state offers early childhood evaluations and interventions. Such services may be available through the education system. Call your local school district and see if this is part of your state’s childhood offerings. If you pediatrician continues to downplay the situation, look up child related developmental and neurological evaluation services in your area and initiate evaluation on your own.
Be prepared that going through an evaluation process might be long and laborious. There may be many different specialists that will need to get involved. I encourage you to be patient, don’t get discouraged and stick with it until you get the answers you need. If there is something concerning going on, you cannot get the right treatment until you know what needs to be addressed.
Some of the typical interventions for child development delays includes speech therapy, occupational therapy, and motor skill development. In addition, there may be autistic related services needed, or if there are physical and medical issues, surgery might be required.
I want to reinforce that you have reason for concern. You would be wise to push the issue and find out what is going on with your son.
Dear Dr. Michelle blog posts are informational in nature. The posts are not meant to take the place of consulting your physician, mental health professional, or other qualified health providers regarding your well-being or the well-being of others. Submitting a question does not establish a client/therapist relationship.
