More ways to be an advocate2. Arrive at your appointments prepared. Before your next well-child visit, take a look at the list of developmental milestones that your child is expected to have reached (find checklists at the National Center on Birth Defects and Developmental Disabilities
3. Insist on routine screenings. Last year, the AAP issued new guidelines to help pediatricians identify developmental delays and disorders that might benefit from early intervention. Though the new screenings are supposed to occur at the 9-, 18-, and 30-month well-child visits, some pediatricians have yet to work the new guidelines into their practice, says Pamela High, M.D., a professor of pediatrics at Brown University in Providence, Rhode Island. If yours doesn't bring them up at your appointment, ask for them, even if you have to schedule a follow-up to get them done.
4. Learn where to find the resources you need. Should your doctor discover a possible developmental delay, you've got a couple of options for your next step. He may refer you to a developmental pediatrician (one who specializes in treating children with delays), a psychologist, a neurologist, or other appropriate specialist. Or you can seek an evaluation through one of the state or federally funded early intervention programs. You don't need a doctor's referral to access them, and a child's initial evaluation is often free. You can find one through your local department of public health or via the National Early Childhood Technical Assistance Center
5. Get a second opinion. Any time your pediatrician recommends a procedure, medication, or other treatment that you have concerns about, ask her why she prefers to take that route. If the explanation doesn't allay your fears and you want another expert's views on the issue, don't be afraid to seek it out. "It goes back to 'listen to your instincts,'" says Dr. High. "If anyone ever suggests something that you're not comfortable with, don't ignore that feeling." In general, she says, insurance companies will cover the cost of a second opinion if you elect to get one, and in some cases they will recommend that you do. Plus, getting different takes can be helpful in a surprising way: Once a child is given a certain label, it can become difficult for parents, caregivers, and later, teachers to see beyond it. "There are certain diagnoses that should be given with extreme caution," she says. For example, many infants and toddlers display certain behaviors that suggest autism, yet as the children get older, the signs disappear. Dr. High calls such attributes "developmental variations" -- a far cry from a true condition.
Keeping all of this advice in mind, know that good pediatricians are always open to discussing various options with you and will readily refer you to a specialist if you wish to see one. "The relationship should be such that you're never afraid to express concerns about your child's care and recommended treatments," says Susan Sorensen, M.D., a pediatrician in Reno, Nevada. If you're ever in a situation where you feel that your child needs special services for any medical or developmental issue, don't take "no" for an answer. It's better to be (respectfully) pushy than to regret not having listened to your intuition. After all, nobody -- not even your pediatrician -- knows your baby better than you do.