Would You Tell a Friend That Their Child Seems Delayed?
August 18, 2011
New York, NY
Hi Mamas! I am a health professional with a four year old daughter. A friend has a 20 month old daughter who seems developmentally delayed. My friend doesn't seem to notice. I know that this would be hard for her to hear, but if there is something really wrong, early intervention would be beneficial for her child. On the other hand, other friends say that they would not say anything for fear of offending the mother.
Would you or have you expressed such concerns to a friend about her child? If so, what was the outcome and how did you approach the topic? Thanks.
Thank you all who responded to my question. After receiving over 40 responses, there were slightly more of you who said that I should not say anything vs ones who said that I should. I found that the responders who made suggestions as to how to approach the issue were the most helpful. I did bring it up to the mother by asking about the baby's "milestones" and asking about whether they were happy with their pediatrician. She took it very well and I can see that I have opened a window for more conversations so that she knows that I am just concerned about her and her baby.
I believe that we should all be concerned about the well-being of children, even those who are not our own. It takes a village to raise a child, right?
It would be devastating for me if I didn't say anything and then years later, I would come to find out that I could have helped this child by suggesting early intervention. I think it would be irresponsible of my part as a human being and as a friend to let it go for fear of upsetting the mother. What kind of person would I be if I let that happen?! We all should ask ourselves that question once in a while -What can I do to help a child today?
Thank you all for your opinions.
It really depends on the relationship I had with my friend whether I would say something or not. I however have to respectfully disagree that just because she is taking her child to well visits that the pediatrician would be able to pick up developmental delays especially if the mother seems unconcerned or unaware of possible delays.
Yes, and I have. I have a friend whose middle son is 4. He is nonverbal and the only way he commuicates is by punching, throwing things and grunting. When he was allmost 3 I asked her what her dr said about him not speaking yet...She said she just didnt think he was ready to speak and he would eventually. I must not have been the only person that asked her about it. Right before his 4th bday she finally asked her dr about it and noe he is in speech therapy. It wasnt easy to ask her about it ( noone wants to be the person to point out that there could be something wrong with someone elses child) but I had a feeling that she was hoping there was nothing wrong and that if she pretented she didnt notice it he would be just fine.
If she is concerned she will probably bring it up.
If she is in denial she will not bring it up and wouldn't listen if you bring it up.
If she is inexperienced, her first child, she's not around kids much, etc. then Casually, with neutral words, ask questions about milestones, Has she started using a cup? Oh I remember my daughter was drinking from a cup. Or what does the doctor say about her learning to walk? Is he concerned?
I respectfully disagree with the moms who suggest leaving it to the pediatrician.
I trotted my son in and out of the highly qualified, board certified ped's office for 9-10 years before we ever got any clue or traction on the real issues that plagued him, and it certainly wasn't because my ped brought it up. They just kept plying us with antibiotics and telling us he would probably grow out of his problems. It took pulling my son out of school, homeschooling, working with three different specialists (not covered by insurance) before we saw ANY progress. And it took another couple of years of fine-tuning to get him where he is today, at 14 - reading at a high school level, a black belt in karate, 6 feet tall, and the picture of health. I CRY with relief sometimes.
But I also cry with frustration and regret, too, wishing that I knew - when he was 2, 3,4,5 - what I learned when he was 9-10 years old. The window of time when they are little is SO important imho.
Therefore, depending on my relationship with this friend, I would try to bring it up in as delicate a way as possible. If she seemed receptive, I would try to offer ideas and resources. If not, I would back off and wait patiently for the time that she is ready (and it may come). If not, at least I knew that I tried. And I would always just try to be a good, non-judgmental friend.
And if I was a health care professional (which I'm not), I would be even more careful. I would not give her advice, but I would just point to my own experiences and give her a "heads-up" on the resources out there.
This is a tricky situation and I applaud you for caring about your friend and her child. Good luck.
I know a Mom who's a pediatric psychologist. She specifically deals with issues such as ADD/ADHD, autism, & many others. Her patients are usually between toddler to teen years. She's been doing this for years now.
Despite all of this in her background, she was devastated when she learned that she missed the issues in her 2nd child. He was diagnosed with mid-level autism & several other issues to boot. It was so apparent & identifiable that her mother's intervention brought it to her attention. & she was completely devastated that she had missed this in her own child.
Since then, whenever I notice something, I find a way to casually mention or bring up the concerns - after I make sure that I'm not jumping to conclusions. & I want to be clear....sometimes its months before I say anything! I make danged sure that I'm really worried/concerned before opening my big mouth!
The next part of the equation is: I do not assume that I'm qualifed to diagnose. I simply draw attention to the action (or lack of) which is concerning me. Hope this helps.....
Yes, because I'd want a friend to tell me. If you're concerned about how she'll take it, how about sharing a milestone chart so she can "score"her own child? 'Jenny, I came across the milestone chart I used with little Susy when she was your daughters age and figured I'd pass it along. If you have any questions give me a call and I can help or refer you to a colleague.' That sort of thing.
Is it her first child? My son was developmentally delayed and I was a bit naive about the milestones he should be hitting. At his 9 month well baby check he fell off the growth chart as was referred for services. I'm not sure how I would have handled it if my friend has said something to me. It's hard to hear that your baby isn't developing properly when we mommies tend to compare all the time. I had a friend who's 5 year old needed speech therapy as you couldn't understand anything he said. I didn't say anything to her about it and it was a double edged sword. I thought she wouldn't appreciate it, but yet I think he missed out on some services b/c nobody said anything. He didn't get any assistance until Kindergarten when the school noticed, so he missed out on early intervention. My son is doing SO well and I attribute early intervention to his success.
So, perhaps if there is a way that it comes up you could share your concerns, but it would be hard to be like, "Oh by the way...." it could come off the wrong way. If she brings it up it would be easier to say what you are thinking. many have said, if she is getting the kiddo into well baby checks in a timely manner one would hope her pediatrician would notice any delays.
Good luck! It sounds like you are a great friend who only wants to help and are thinking of being sensitive as well. :-)
I like Angela S's answer as well!!! Lots to think about!
To a friend? No. I am a child psychologist and can spot a delayed child from 50 paces, but unless I'm in my office with my "shingle out", I don't bring it up. I have several very close friends who have specifically asked me for my professional opinion or have asked me to say something if I notice something. Because they have asked, I will share my thoughts.
I have "said something" TWO TIMES in my entire career outside of my professional role, both to close family members. My niece's language was so significantly delayed that I could not let it go any longer. When I mentioned it to my in-laws her mother said that she had been concerned to and was going to ask me about it that afternoon anyway. The other was when I noticed really serious neurological red flags in my nephew. I mentioned it to my in-laws and they did not act on it. He started experiencing seizures within two months.
If she brings it up... mention that she may want to ask her doctor about it at their next visit. If she doesn't, then you can't really create an opening without alienating your friend.
I have a friend that has a daughter who I feel is delayed, but I have NEVER actually mentioned it. I've asked about some milestones in a "small talk" mommy chat sorta way and my friend always follows her responses with: "I'm a little worried, but the ped says to wait until such and such age to really worry about any delays." Her daughter has yet to reach the age the ped has given as a benchmark and has yet to progress.....As a Special Needs teacher, it is hard to keep my mouth shut, but I know that I would definitely overstep my bounds if I pushed her on this since her ped and her have already discussed everything. Should a diagnosis occur later or intervention is needed, I'll be there to support and assist in whatever way possible and won't do the "Well I thought that...." I would NEVER want that treatment from a friend, so I wouldn't do it to her.
I would try to find a roundabout way of mentioning it to her. Just casually ask her how many words her daughter says or ask about other milestones. Then maybe ask her if she's checked with her pediatrician. If she gets defensive, just drop it or you might lose a friend.
No! It is not your place. If a friend came to tell me what she "thought" was wrong with my child, I would be mortified. If you were looking at a 3 or 4 year old, then sure you would notice something, but 20 months??? What can you possibly tell a mother that thinks the world of her child. My son didn't say ONE word until he was almost 3, today, 6 months later, he's brilliant, talkative, and a pleasure to be around.
I beg of you, don't take the chance that you would hurt your friend. If there were an actual issue, the parents will find it in time.
My son has some delays and guess what, the ped really did not catch them very early. I like our ped but really he only would see him for 20 minute visits every few months and so didnt get the whole picture. He kept saying oh he is just a late walker he will do it when he wants, me being a first time parent I did not know what to think. It wasnt until my son was 18 months and not walking and not even crawling on all 4's was he like hmmm...then he wanted to do all this testing and finally we ended up with EI services. My son did not end up walking until 26 months and my sons PT said if caught earlier he probably could have been walking by 18 months with services! Boy was I bummed and now that he is almost 4 people are like oh yeah he wasnt doing this and this and he was doing this and this which wasnt normal and that hurts me more now than I think it would have at the time
Yes I would tell her. I have. I had this neighbor friend an we hadn't been friends for very long 6 months maybe and she lived with her mom and he had 2 kids at age 20 and all she wanted to do mostly was party so she wad rarely home and her son was 5 and I had noticed that hisleft eye would kind of roll ? And she had never mentioned it or addressed it so I was like jy have you noticed his eye does that? An she was like does what what do you mean? Then I showed her and she was honestly surprised like as if she rlly didn't kno. She said she would have it looked t but moved a couple of months ago and I have never known if she did get it looked at. She tries her best to be a good mom and is a good person but she got pregnant young and wig two kids she was overwhelmed all the time. It was very awkward but I think it opened her eyes
Normal development is a very wide range. You may be a health professional, but you only have one child. How many children have you interacted with? In what situations? Are you clear on what is within the range of normal? Is your friend's child out of the range of normal, or just on the edges of it? Is your friend's child out of the range of normal for the environment she is in, or out of the range of normal for your home?
For example, in China it is a serious concern if a 4 year old can't pick up a peanut with chopsticks. This is not a valid marker of developmental skills in the United States.
Unless you have a *lot* of experience with many many children, it is best to just share your observations and leave any evaluation to the parent. For example, you could say "I've never heard your daughter make a sound. Does she talk at home?" Your friend might say "No. But I was a late talker too." Or she might say "No. Do you think it's time to be concerned?" Or she might say "Yes, she's a complete chatterbox at home. I don't know why she's so quiet with you."
Also be aware that in most people's minds "developmentally delayed" is a polite word for "retarded" which is a polite word for "stupid." None of these are true, of course. But I get very irritated when random relatives ask me if my son is developmentally delayed. No, he's not. He has a speech disorder. He has sensory problems. He has dyspraxia. He probably has other learning challenges. He used to have severe sleep deprivation due to undiagnosed asthma. But he is not developmentally delayed. He may be a bit developmentally scrambled, but his cognitive abilities are excellent and appropriate for his age. It's just very hard for him to demonstrate his intelligence, especially to people who know very little about children.
Share your observations with your friend, but do not diagnose. If she asks your opinion as a health professional, offer it. Otherwise, share your observations as a friend and let that be enough.
My friend's daughter had such poor muscle tone and was so delayed on gross motor things, that I was convinced she had a birth injury or genetic problem. Additionally, as she got older she also had a terrible temper problem. I have often thought something is just not right here. Mom and Dad babied her because of her phisical delay, which probably impacted the emotional part.
I asked a lot of questions - i.e., are you worried she isn't crawling at a year of age? She always assured me the pediatrician told her that her child was just a later crawler/walker, etc. I had grave misgivings about this doctor.
But ultimately, I did not tell her, "Look something is wrong with your child." I guess I felt like she was doing the minimum of what she needed to do - going to her well baby visits. I can't replace the doctor, and I can't make her hear the doctor. I suspect the doctor was worried, but she was only hearing the optimistic side of things.
Her child eventually went to physical therapy, and walked at a bout 17 months, but is still clutzy and emotionally not too stable even as a 4-5 year old. If she hadn't ended up in physical therapy, I probably would have said somehting. I personally think it came about 6 months late. But the doctor and my friend's family has to make these decisions. I believe if I questioned her decisions, I wouldn't know the child, and I still don't think it would have made her pursue extra help. She would have dismissed my concerns.
So, do you think your friend would listen to you and act on what you say? Because otherwise, you aren't helping her, and you are risking a friendship.
I wouldn't, unless you are ready for her to end the friendship. She may already be aware of things even though she seems not to notice and see your concern as intrusive or embarrassing.
Last year at this time my sister and next door neighbor were telling me there was something seriously wrong with my then 16 month old because he wasn't walking on his own, hadn't crawled the "correct" way (he 'scooted" a perfectly acceptable way to crawl according to experts and his ped) and his "feet were too small"!! My sister is a "know it ALL" (not saying you are, I realize you are a health professional) and my neighbor is a former childcare director so they consider themselves experts on children (and both of them have out-of-control sons!!)
Unbeknownst to them I had already spoken to our pediatrician about these things (well, not his foot size, good grief!) and she had said if he wasn't walking unaided by 18 months we would look into it. He walked at 16 months like a pro. But I felt so condemned by their perceived lack of intelligence on my part and no longer share any concerns (I hadn't anyway) with them. They try to pry things out of me but knowing how they are they don't need to know anything and I just keep my mouth shut. And I won't say anything to another friend if I notice something, either.
I am a Pediatric Occupational Therapist and a mom of a 3 year old boy who has minor speech delays and has received EI for Speech, and will be getting speech therapy again in pre-school for his articulation. I am lucky that I knew quite a bit about child development, and knew/worked with speech therapists, so I was able to get my child services early. (His needs were not huge to begin with, so I am guessing many parents would not have picked up on it until much later.) However, by getting my son services early, he made gains quickly, before it really effected his self esteem and academics. He only received EI for 6 mos., then he did not qualify because he made so many gains. However, recently, I noticed that he is still hard to understand and had him re-evaluated, and he qualified again. From my point of view, I am grateful he can get the services early and realize that it can only help him. I would hope that somebody would have told me had they noticed his delays if I were not in a position to know what to expect with typical development. I have also been in the position where I have almost brought up such issues in my nephew, but, my sister-in-law was just as concerned about him and actually got him evaluated before I even had to recomend it (he is very similar to my son, they both had many ear infections as infants, hearing loss due to fluid and Ear Tubes.) She was also grateful that she had me to talk to and get info from since my son is 2 years older and had been through it. Also, even if this mom is a very attentive, caring mom who brings her child to her well visits, subtle delays may not be picked up by the parent or Pediatrician. A parent does not necessarily know the stages of typical development and a Pediatrician only sees your child for 15 min. a couple of times per year, certainly not enough to really get a glimpse of how the child functions on an everyday basis. Overall, it may be hard for her to hear at first, but it can only help if she gets her evaluated, and if they do catch something, she will probably be very grateful that you said something.
Don't say anything. if she has a pediatrician, she just saw him/her 2 months ago, and she'll see him/her again in 4 months. You are a health professional, but not a pediatrician or early intervention specialist. Children all develop at different rates. If you are really concerned, you could somehow bring up "topics I discussed with my doctor" or "worries I had when my daughter was that age," but don't tell her you think something is wrong.
I had a friend whose son seemed "off." Now that he's older (and in daycare), he's speaking much more (and in 2 languages) and seems much more connected to other kids. I too considered saying something, but I'm glad I didn't because I was just judging by my own daughter and a few friends, and obviously he was on the spectrum of normal.
I have a couple of friends that have children who I beleive are Autistic.. I have hinted around it but some parents just have a hard time dealing with reality.. truth is hurtful, especially for someone's child. I really dont know any good way unless maybe you can contact their pediatrician??
You know, it's a tough one. Does your friend not noticing because she is in denial? I had a friend like that, She had a daughter that everyone though was delayed. Parents ignored it. Some coments like "What? You think a child should be able to know her numbers at 4? That is ridiculous!" kind of gave clue that the parents just do not want to see the problem. So we all kept quiet. No one wanted to be the bag guy. School sent the child for the evaluation, mother was furious, called the teachers lazy and stupid and transferred child annually and sometimes twice in a year. Police questioned them after the child just wandered off from the school in the 3rd grade, again, they blamed the school, not a clue that this behavior is just inappropriate for an 8 y/o. The police officer grilled the parents about how come the child is not responding to him adequately and doesn't know her address or phone number being 8 y/o, well, the parents just dismissed it on the child being scared and overwhelmed and that was it. I told the mom once, very carefully, that she may need to consider to see a developmental psychologist to get the situations with the schools under control. She started grilling my "WHY? and did you ever had to do that?" What do you tell a parent who has no clue?
You have to gauge this very carefully. If a parent is concerned, looking for answers - by all means, give her the info. If the parent is defensive - try to gently open her eyes (it did not worked with the family I am describing).
I am not sure what you mean by health professional that could span so many areas but if you are a pediatric specialist of some sort (through EI services-OT, PT etc) then you could try showing some delays. I am an OT and noticed some delays with my 8 week old nephew. My SIL/brother are defensive about everyday parenting matters and there is no way that I was going to step in about their 8 week old! Instead I would hold him and "play" the same way I would with my kiddos in therapy. He seemed to have increased tone (which is difficult to distinguish and my SIL/brother attribute his right sided fixated head position to strength). They would observe me playing with him, attempting to have him hold his head in midline, to the left, open his fingers, tolerate tummy time, focus on an object....they eventually pointed the delays out- should he be able to do that now, should we ask the MD?? I shrugged off my "therapy" part not wanting to worry or offend them/isolate my nephew from me. I just told them it wouldn't hurt to mention it, and that they could just keeping "playing" with him as I was and that this would help, and it certainly wouldn't hurt. The pediatrician had not mentioned it prior to his next check-up, they asked, the ped checked further and referred out to several specialist, including a pediatric opthamologist. In the mean time we all continue to get along while we play with my nephew. Good luck this is a tough position to be in, but remember sometimes the more knowledge we have is not always the best thing. Even as a mother I have to back off and separate my health care knowledge from my mother based knowledge!
Gosh- that's a hard one. I think if it were my friend, I'd tell her. I have a more than honest approach to most things in life but this will take some tact and deep compassion.
I don't know how you would say it but I think if you come from a place of deep love and concern, the message will carry. She may be very mad at you, but hopefully she's adult enough to realize its not your fault and you did it with the utmost desire to help.
I know that kids develope at diffrent rates and speeds and at 20 months it is, while not impossible, rather hard to tel and/or diagnosel. You did not state what you think your friend's child is behind in and without that it is hard to give some good advice here.
I agree with the people who said we would really need more information about what you think is delayed, because 20 months is pretty young, and she may just be at the tail end of some things. (My daughter didn't walk until 15 months, but I wasn't worried at all, and she is very bright and totally coordinated now.) Some kids also don't talk until quite late, and are ultimately fine. (There's the famous example of Einstein not talking until he was three.)
If it's more serious and specific, you may want to ask "Have you mentioned that to your pediatrician just to make sure it's nothing?"
No, I wouldn't say anything. Like others have said, as long as the mother is taking the child to her regular well child visits, I'm sure the pediatrician would be aware of most developmental delays. If my friend spoke to me first about a concern she had, I would just tell her to talk to her pediatrician to make sure her daughter's on track. When someone other than my actual pediatrician makes a comment about one of my kids, it just never sits well with me.
I agree, as long as she is taking her daughter for checkups, then I wouldn't say anything. Maybe just ask her who her pediatrician is, if she likes her, questions like that in a casual conversation, to see if she's been going.
It depends on what you are seeing and how close you are to the mom. If you have noticed language loss, (not delay but a toddler that used to say Mama, Dada and now doesn't for example), extremely poor or virtually non existent eye contact, repetitive head shaking or banging, walking on tip toes, lack of engagement with people (like not really smiling, laughing or engaging in some way with finger plays), and you are close to mom, then I would say something. I don't know how I'd say it, I'd have to be close to the mom to even imagine what I would say but knowing how important early intervention is for autism and how long it takes to get it in place and how limited the overall duration can be, I would want that child evaluated and started on a program, if necessary. If you are just seeing for example, speech delay or one or two underdeveloped motor skills, but otherwise seeing warm interactive behavior, I wouldn't.
I think it depends on how close you and your friend are. I know I could tell my best friend if I saw something wrong with her child, but I wouldn't tell a co-worker that I don't have a close relationship with. If you two are really closed then just suggest to her to have her child seen by the doctor, tell her you've noticed that her child is not doing things that other children at that age would do. But be kind and positive about it.
DON'T, unless you want to lose a friend. Your friend is more than aware of how her daughter compares to others. If she's not worried about it, then neither should you. Assuming she is taking her child to regular well-visits, her pediatrician will identify any developmental issues that need addressing.
If however your friend comes to you for advice, by all means give her your opinion (though don't say you've been concerned for a while now... irrevelent, and it will make her feel bad), and support her efforts to get her daughter the help she may need.
Not directly. I would in a round about way inquire how the doctors visit went at 18 months. Did the doctor mention--- whatever it is your concerned about.
My son had speech delays and wasn't pointing at 18 months so I was very concerned. My ped did the M-CHAT and sent us for EI evaluation. My friends son is 4 months younger than my son and has some of the same issues. Her ped told her nothing was wrong. Didn't do the M-CHAT. I've just mentioned to her how much sign language has helped and even loaned her some signing times dvd's (which she didn't watch). I finally decided that she just wanted to ignore the problems and hope they go away. I hope that they do, but I don't feel like it's up to me to push her.
I agree with the other mom's who say if she's bringing her daughter to see a pediatrician then it is not necessary to bring it up as the doctor probably already has or will. If something serious happens, she'll need her friends for support and advice only if asked for. If you feel very strongly about it, perhaps bring a magazine that has an article that discusses the delays you believe her child has and mention that there were some interesting articles in it that you thought she'd like reading. Just an idea. :-)
i have 2 developmentally challenged sons who are now 36 and 37rs old
with seizures, tourretes disorder emotional probelms and as very young children extremely hyperactive and had the greatest neologist, regional center who helps with early interevention.
yes ,i knew as a mother that was something quite wrong. and none of my friends supported me emotionally or even bothered to watch them so that I
could even restl
i would have welcomed intelgent imput, but i would gently as a professional
that you are softly exlain your concerns. if she cannot see for herself she the main concern should be for the child foremost and she can seek therapy for herself and family. with warmest regards;
You have to consider whether or not this particular friend would be receptive to your observation. I have certain friends that I would express these types of concerns to, and others that would be too defensive and would only get angry at me. If you think she would be receptive and do decide to tell her, tread cautiously and approach it in the gentlest possible way. Good luck.
Unless you are asked keep your opinion to yourself.
I am sure you friend is discussing her child's development with her pediatrician and if she has any questions for you, she will ask you.
As a healthcare professional you should know that health matters are private and many people prefer not to discuss their child's health or developmental issues with their friends. Just because she doesn't talk to you about it, does not mean that she doesn't notice.
I don't think we have enough information. If the parent seems a bit slow themselves and I have any reason to believe that the child can not catch up through the natural course of time, I might say something. But 20 months is too young in my opinion to be looking for and expecting much. I've seen kids that seemed very slow to catch on to things suddenly sail through all kinds of milestones. If the parent was a little slow though or they had other children that were older and it seemed like it runs in the family, then I'd be concerned.
No, I wouldn't say anything. This is one of the reasons parents take their children to the pediatrician. Nobody mentioned to me that they thought my son had a speech delay. Rather, the pediatrician told me.
I guess in a nice way you could. My 2nd daughter was a late walker, started at 17months but when she started she ran steady right away, no problems. Nobody said anything to me because they knew I was already "on it". Talking with the ped, etc. My neighbor has a son who's speech is definitely delayed and I have talked with her about it. She's getting services for him. I am probably going to talk to her about her daughter who's speech seems a little behind to me. But in a nice way, she is a good friend and I love her kids. I would not want to be hurtful to her. Our kids are sensitive subjects, believe me I know!