Pediatrician
Dr. Shapiro completed his undergraduate education at UC San Diego, earning a B.S. in Biochemistry and Cell Biology, and a B.A. in Political Science. He furthered his education at UCLA where he earned a Masters Degree in Public…
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Your Child's Development: The Importance of Screening
Posted in Aphasia by Dr. Jeremy F. Shapiro on May 15, 2008

A pediatrician will often be kidded for primarily taking care of colds, ear infections, and the routine vomiting/diarrhea illnesses. Throw in the occasional "zebra diagnosis" and a few well child care visits and most people think they've captured the daily routine of a pediatrician. But in today's pediatric landscape, the Pervasive Developmental Disorders (PDD), which include Autism, Rett Syndrome, Childhood Disintegrative Disorder, Asperger Syndrome, PDD-Not Otherwise Specified (NOS), now maintain an overwhelming presence.



For those with children, I assume you know of what I speak. In fact, at every child's well child care exam, your child's pediatrician should be devoting a good portion of the exam to appropriate developmental milestones. In my office, along with some of my own developmental questions, a questionnaire (Modified Checklist for Autism in Toddlers-MCHAT) is answered by the parents at both the 15 and 18 month appointments to assist in identifying any potential developmental issues. Now whether your pediatrician uses the MCHAT or another developmental screen is not as important as something needs to be used. And, by the way, the American Academy of Pediatrics (AAP) now recommends a screening tool be used at all 9, 18, and 24 or 30 month well child care visits or at any visits where a developmental concern is noted.


So why the big deal of early screening? Well, we all have seen the talk shows and perused the books at our disposal these days. And although I may not agree with all of the viewpoints that are made (feel free to check out an earlier blog "Autism, Vaccines, and More" (http://dailystrength.org/blog/52-autism-vaccines-and-more) for more of my take on autism and vaccines), I do appreciate a common theme that everyone seems to share: Early Intervention (EI) is the key to maximizing not only your child's development but also his/her eventual benefit to and within society. And believe me when I say the research validates this claim.


In years past, parents, teachers, and doctors alike may have brushed aside the importance of making an accurate PDD diagnosis, and consequently, prevented the timeliness of appropriate care and therapy. This should no longer be the case. If your child's physician is not spending adequate time discussing and screening your child's development, either you need to be the one who brings this to the physician's attention or you need to find one who will. Your child deserves this.


Dr. Jeremy

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8
Good blog Dr. J. It is so hard to get a pediatrition to spend the time, and have them be open minded to the fact that the whole world is not learned in the Medical school Text books and that many times developmental delays are masked or not recognized in the office. To have a well baby visit if you are not very well insured or on government funded insurance is a 5 minute heart beat check and now they don't even care to see the kid stripped. Many times I was not even seen by the Doc just the nurse and they still bill the insurance nearly $200. Tests are ordered and not interpreted and the persons who are so educated are too busy to use the wisdom education is supposed to provide. Why should a mother who is possibly not even educated or herself suffering from the developmental difference and not able to see the forest from the tree, have to tell a Doctor who is making hundreds of dollars to walk into the examiniation room and go through the motions of pretending to know what they are looking at? Where are the ethics and what about the creed to first do no harm! We need to train the public to police the school administration and health care industry because the fact is there is no real service for the tax or private funded insurance payment. Nobody is accountable and most people are rendered cold hearted and over educated to have the compassion to care in a humane fashion. Thanks for the vent, and again good point!
By Olismom  Jul 10, 2008
7
My sons now-former pediatritian did not do these screenings - my son was late with ALL of his developmental milestones and that Dr. kept smiling and telling me he'd be "just fine Mom" - and I started having concerns at 8 months! I would tentatively bring up my concerns and be brushed aside every time - told that he was just a little late. When he had a major regression at 15 months - lost the 3 words that he had, lost ALL eye contact, started with hand flapping, head shaking, toe walking and many other behaviors I went straight to his pedi - and was AGAIN turned away! He said in the most condecending tone I have ever heard: and I quote - "it is my professional opinion that he is going to be just fine - he'll catch up soon"!!!!!

My response was to the effect that were they not supposed to look into ANY loss of language regardless of the age?! Again I was told he'd be fine - "after all he's so mild mannered - he's probably just shy" I was furious - and thank God I am not one of those parents who are afraid to stand up for thier child - I'd held in my concerns since he'd been 8 months - but no longer. I got him into Early Intervention myself - they told me he was too mild mannered to be autistic - and said he just had sensory issues - again I refused to accept this - every thing I read on-line said Autism - loud and clear! I called Children's Hospital of Boston myself and got him on a waiting list - 8-10 months they said! Then I called every one I could think of and my local Autism Resource center got me in touch with a research study and he was diagnosed Classic Autism in December - he was non-verbal then. He started treatment - ABA in January {in addition to OT - ST was added in March and Hippotherapy in June} and he is making amazing progress. He communicates with sign language, PECS and has words now. HE still does not communicate with words but he does have words and I now know that he will someday communicate with words. He told me "NO" the other day and I almost rewarded him - but then caught myself - it was a typical 2 year old response to being told to do something - and I had to hold in my laugh.

I am so happy that I chose not to listen when people kept telling me to wait - my sons progress is proof that he needed help - it is going to be a long road but man-oh-man is he ever on it! Oh and Children's Hosptial saw him over a month ago and their diagnosis was the same as the research study - Classic Autism. He's still my mild mannered Little Dude but that does not make him any less Autistic - and I'm so happy to have him in treatment. You are so right - the earlier you get a child into treatment the better it is for them.

Dr's need to start listening to parents - we are not clueless - after all we are the one who lives with them!
By NicksMom40  Jul 01, 2008
6
I could not agree with you more. My grandson was referred to a Pediatric Neurologist when he was 6 months old for developmental delays and clonus. He was 8 months old when he had his first appointment. After the Neurologist finished his exam and told us what he felt was causing the clonus he said he was more worried about the Autism with him as we had no coo's or babbles, eye contact, would not cuddle or let anyone hold him. This early diagnosis was very valuable as I started at 12 months to teach him sign language since he still did not make any sounds. The diagnosis was recomfirmend at 14 months. He is now 18 months old and has use of almost 30 signs and is able to use them to communicate his wants and needs.
If I had a doctor that was not adequately watching these developmental milestones then I am sure right now I would have a very frustrated 18 months old that would not be able to let me know what he wanted or needed.
I firmly believe that early diagnosis and intervention is the key to helping a child reach his/her fullest potential.
By MawBear  Jun 27, 2008
5
My research Dr,
http://www.sitochiropractic.com/imm...



Updated News...
Chiropractic and Children: It's All About Function
Why do millions of parents bring their children to Doctors of Chiropractic every year? Is it only for highly dramatic health conditions? Is it only for when my child is hurting? Not at all!

Read more...


Murray DR, Irwin M, Reardon CA, et al. "Sympathetic and immune interactions during dynamic exercise. Mediation via a beta 2 - adrenergic-dependent mechanism." Circulation 1992 86(1): 203
One of the most important studies showing the positive effect chiropractic care can have on the immune system and general health was performed by Ronald Pero, Ph.D., chief of cancer prevention research at New York's Preventive Medicine Institute and professor of medicine at New York University. Dr. Pero measured the immune systems of people under chiropractic care as compared to those in the general population and those with cancer and other serious diseases. In his initial three-year study of 107 individuals who had been under chiropractic care for five years or more, the chiropractic patients were found to have a 200% greater immune competence than people who had not received chiropractic care, and 400% greater immune competence than people with cancer and other serious diseases. The immune system superiority of those under chiropractic care did not diminish with age. Dr. Pero stated:

“When applied in a clinical framework, I have never seen a group other than this chiropractic group to experience a 200% increase over the normal patients. This is why it is so dramatically important. We have never seen such a positive improvement in a group…”
By NATURALLYCURED  May 20, 2008
4
Early intervention is SO important. My son has been in the system since he was 2 and not saying more than individual words. But he had enough that they were only coming out once a month to work with him.

At 3 he was tested for receptive language and found to be 17 months behind! And he's never "caught up". He's doing pretty well now at the end of 2nd grade, but kindergarten was a disaster. Kids don't learn to control impulses without language abilities, and dealing with other parents who think your child is just 'bad' is very difficult. And the school just didn't get it either.

More intense Early Intervention, could have prevented so many bad experiences for him!
By patti22  May 19, 2008
3
I would enjoy seeing your research stating the "chiropractic care for children is proven to create a healthier immune system for children". I am certainly an advocate for alternative medicine but enjoy the research to substantiate it. Thank you.
By DrJeremy  May 16, 2008
2
i say NO vaccines, or atleast spread them out over the years, its insane what they shoot into babies now adays. i know 25 people that have NEVER been vaccinated and NEVER taken a single drug and not a single one of them even have severe allergies!
chiropractic care for children is proven to create a healthier immune system for children. also brest feeding is proven in the long run to be benificial for children. all doctors seem to want to do is push pills... for add, adhd, ear infections, childhood diabetes, obesity, while many of these "diseases" can be cured NATURALLY!
while it is good that dr's are screening and looking for early warning signs to these new "diseases", i feel that we need to find out what CAUSES them and eliminate that, not simply TREATING them...
By NATURALLYCURED  May 16, 2008
1
You raise a very good point...something to encourage with atleast with your pediatrician.
By DrJeremy  May 16, 2008
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