Ugh-not happy with first Developmental Pediatrician Appointment

CCinLove

I don't post often, so the background is that my son is 5 and was diagnosed with ASD at 2.5.  He has received speech therapy continuously since he was 18 months, and attended an integrated preschool program this school year.  He will be mainstreamed in K next year.  Other than speech and a social skills group, he has not had any treatments or therapies specific to the ASD.  I made the appointment with the developmental pediatrician because I feel like I'm not getting enough information about his development from his pediatrician.  The ASD doesn't really come up at his well child visits since it's pretty subtle, and when I've asked specific questions about resources or treatment, they aren't very helpful.  I wanted him to see a doctor that can give us feedback on what we need to be doing specifically regarding Autism, and also to screen for ADHD (he has ants in his pants ALL THE TIME, and much of his IEP seems appropriate for a child with ADHD).

Visit started off not so great when we were kept waiting for half an hour because he forgot that we were there and got sidetracked.  In order to get this appointment, I had to fill out a HUGE amount of paperwork, and submit copies of every evaluation he's ever had from his school, the school district, Early Intervention, and his SLPs.  The doctor had read none of it.  Not a word. In fact, he had to ask me what my son's diagnosis was.  We spent most of the appointment with me summarizing the information that was in all of that paperwork while he typed it into the computer.  He actually thanked me for helping him write up the report.  Thanks, dude.  With regard to my questions and concerns, his basic response was that our state sucks at wrap around services, and he wishes that he had some suggestions but he doesn't.  He'll have a social worker follow up with me, because maybe she knows something.  He told me that we could try ABA, but didn't really give any compelling arguments for or against it.  And he only spent a few minutes actually interacting with my son.

I honestly feel that it was a waste of my time.  Does anyone know if this is normally how these appointments work?  I'm trying to determine if this doctor just isn't a good fit, or if there just isn't a reason for my son to see a developmental pediatrician.  He wants us to come back in 6 months, but I don't see the point.  I've gotten better information from the internet.

hopecounts

ABA's intention is to focus on not the individual symptoms of ASD but the core issues as a whole (behavior/attention/speech/following directions).

Now it's appropriateness for more Asperger/HFA type presentation can be debatable because it can play into their rigid thinking if the provider isn't careful and the program isn't tweaked appropriately. 

For DD ABA has been amazing at this point. It has helped her a ton with attentiveness, being able to sit and stay on task (she still has some work to do but she is pretty close to age appropriate on this now which considering that a year ago when we started getting her to sit for more than a few minutes for anything but eating was next to impossible is pretty amazing to me), speech, behavior issues (though to be fair she has always been pretty mild behaviorally).

as for the Doc issue, we have had 1 dev. ped. appointment and that was her diagnosis her annual is coming up. At ours she observed from outside the room for 15-20 minutes while we were waiting (one way window) then came in and asked me questions and talked to me and DH while she further observed and interacted with DD. the Dev. Psych who did the actual testing was far more helpful in terms of info and suggestions and answering questions but she was the one who had spent a half day with DD so had a more informed take. 

CCinLove

You ladies are seriously more helpful than the doctor was.  Maybe he'll synthesize everything and add some new information to his report.  I guess I'll withhold judgement.

@hopecounts, very helpful.  I specifically asked the doctor what types of skills my son might work on in ABA, and he didn't give me any examples.  He just said that it works for some kids and not for others.  Duh.  Helpful to know that attentiveness and focus are areas that it can specifically address.  Those are 2 things that I think will be huge challenges for him in K, and make up at least half of his IEP goals.

@auntie, he was initially diagnosed through EI (a mobile team from the same office including a Psych, SLP, and OT).  A Psychologist is a great suggestion.  The doctor did note that our state is almost dead last for number of child Psychologists nationwide.  I think finding a Social Worker would be great as well.  I'm just overwhelmed trying to manage all of his therapies, and worrying that I might miss something because I don't know about every resource.  He nailed it...I'm looking for wrap around services that don't exist.  My son's SLPs have always been the people I've trusted and taken guidance from, but he was just discharged from private speech this month.  It will be the first time in 4 years that we won't have that relationship.  He will only be getting services through school, and I'm nervous about having all of our eggs in one basket.  Fortunately, he attends a wonderful school and I truly think they will do a great job working with him.  I guess I'll just have to keep using the internet to make sure I'm as educated as I can be.  I don't know what's up with my state...even finding a social skills group is SO difficult.  

d.f

My son's initial DP did not go like that. She spent about 1.5 hours with us. Half asking us questions which I later realized in the report were specific questionnaires. There was a lot of over lap between the questions and the 20+ page packet I filled out though. The other half she spent engaging with DS. She did a physical exam. Had him sort colors and shapes, stack blocks, climb stairs, throw and kick a ball...

We did not have a Dx at the time. She referred us to Speech and OT for evals. She also referred us to a psych who did the full developmental eval,

At follow ups she just catches up on the last year. Last time she screened for ADHD. Talks to us about concerns and makes suggestions. Unfortunately, her suggestions aren't always possible because of limited resources, specifically in the schools. They're kind of in a perfect world suggestions. She spends 30-60 min with us during follow ups. She also makes the social worker available to us who is fantastic. She is very knowledgeable about local private services inside and outside of Children's Hospital. Recently I emailed her and got a fresh referral in the file from the DP to restart individual OT (my insurance requires if come from a Dr).

Oh and my DS's regular DP is worthless when it comes to ASD. I adore her. She is very knowledgeable and competent regarding injury and illness just not more mild ASD presentations. She asks me if I think he will "out grow it" and gives off a very questioning the diagnosis vibe. (I have no doubt my son's Dx is accurate, it makes sense).

mommytoconnor

I feel your pain. My son is about to turn four and I just am looking for new dev peds. He has SPD, ADHD, and receptive/expressive speech delay. This devel peds we have seen twice had us waiting for over an hour each time, typed into computer most of the appt then wrestled with my son and then said "gosh is he normally this amped up". I said well if I do what you just did he would be. and then slaps diagnoses on him that I am not sure are accurate. I would go with your gut, get another opinion, that's what I am doing. I do think that your reg peds isn't really qualified enough to monitor a child with such diagnoses as your child has. Good luck.