It's no secret that children with developmental delays will have their share of doctor appointments. Children with developmental delays are generally referred to a neurologist. Speech delays tend to trigger a visit to an audiologist or ENT and to a dentist specializing myofunctional therapy. Children with delays also may have additional medical concerns like seizures, strabismus (cross-eye), or other issues. In addition, developmental delays may come hand-in-hand with sensory processing issues.
Unfortunately, most specialized medical professionals don't seem to have training in sensory processing issues or handling pediatric patients in general. It's fairly easy to manage doctor anxiety when your child is only seeing a pediatrician every few months, but when that turns into a few visits per month, or more, with a variety of providers, it gets exponentially more challenging.
Our two year old daughter has seen the following health care providers (not including therapists):
Pediatricians
Audiologist
Ear Nose and Throat (ENT) Doctor
Dentist
Developmental Pediatrician
Neurologists (general)
Neurologist (leukodystophy specialist)
Neurologist (medical geneticist)
Biochemical geneticist
Genetic counselors
Dietician
Optometrist
Ophthalmologists
Emergency Medicine Doctors
Orthotists
Physiatrist
Doctor of Osteopathy
Needless to say, we've developed a few tricks along the way to help make these appointments less traumatizing for our daughter (and us).
Find pediatric-focused offices. This seems straightforward, but you'd be surprised how often we were referred to providers who didn't regularly see pediatric patients or gave us a lab order with no direction on where we should get the lab work completed. Ask your doctor when they give you a referral who is the best with children. Call the provider's office and ask whether they have a child's play area in the lobby (that is usually a tell tail sign that they have a high volume of pediatric patients) or whether they see a lot of pediatric patients. Check out the Yelp reviews and ask other parents when possible.
For lab work, try to find a Children's Hospital whenever possible. -- they typically have an outpatient laboratory that you can visit. We've had the best luck with these types of facilities for blood work. Drawing blood from an infant or toddler often requires special training (the veins are much smaller and difficult to pierce) and a special (smaller) needle and the providers at these labs have this special training and experience. Avoid Quest, Lab Corp., and the others unless you know from other parents that they are good with pediatric patients.
What to Pack. Our daughter is two and half years old and isn't walking independently yet. We always bring her stroller or a carrier (I thought I didn't need it once and the pediatrician's office was running and hour and half behind... my arms have never been sorer.) I love the Ergo Baby Hip Seat (for babies 4 months old +). It can hold babies up to 45lbs, so it's especially great for parents with children who aren't walking yet.
Diaper bag essentials:
Toys that connect to straps are your friends. You can connect the strap to a stroller, the carrier, or your child's clothing or wrist. You don't want toys falling on the floor of the doctor's office being re-used.
For particularly challenging appointments (eye exams, blood work), MRIs, etc., bring a brand-new toy for your little one to open after. It will help distract them after and bring immediate joy.
Toy wipes. Inevitably, you will lose some toys to that dirty, dirty floor. Bring some wipes so the fun can continue.
Snacks and drinks (for both of you). I've been stuck at doctor's appointments for almost three hours before. Yep, 3 hours! Both of you will need snacks and drinks, and plenty of snacks will do wonders for your child's mood and yours. It is super helpful to have your child's favorite bottle (with their favorite drink) and offer it right after the exam, blood draw, or vaccine. For infants, studies have shown that sucking on a bottle (and being swaddled) after vaccine appointments decrease their pain scores. We practices the 5 S's with our daughter and found having a bottle (with an age appropriate nipple/straw) has helped calm her down more quickly after more painful, invasive examinations and procedures well into her toddler years.
An iPad. If you can, bring an iPad to play Cocomelon or your child's other favorite show. Our daugther loves Cocomelon and can get through most appointments if she can distract herself with her favorite show. Ask for the Wifi password when you check in or use your phones hot spot.
A large muslin blanket. I don't know what it is about the white tissue paper on the examination tables, but our daughter HATES it. It triggers sheer panic, and she immediately starts crying. I've found that setting her up on a blanket (muslin is thin so generally easy to pack) and sitting with her on the table (with Cocomelon playing) and her toys spread out has helped tremendously. For eye exam appointments (where the rooms have chairs instead of tables), I set up the blanket on the floor.
Request permission for another person to join the appointment. With COVID, doctors' offices generally limit one caretaker per child. Unfortunately, this has a disparate effect on parents of children with special needs (who often require two people to manage). Some offices offer exemptions/waivers, if you call ahead and request one. It's unbelievably difficult to manage a child who is over 25 pounds and not able to stand or walk in general (let alone when you need to use the bathroom). And, it's particularly helpful to have another person there to speak with the doctor while you sooth your crying child (or vice versa). It's incredibly difficult to speak with a doctor about important medical issues when you have a wailing, heavy child in your arms. Explain the issues and request a exemption/waiver for another person to help you.
Consider telehealth and in-home visits when possible. Telehealth can be a great option when in-person physical examinations are not needed. They're less stressful on your child and super convenient. We try to take telehealth appointments whenever possible.
When our child is sick, we've recently started using in-home medical service providers. For example, Dispatch Health is one of many companies that offer home medical visits. They bill your insurance for the visit, just like an in-office visit, without the driving, waiting, and other stresses. You can sign up for an appointment online, or call, and they will send a qualified health care provider to your home. We've loved this service to help avoid exposure to COVID at doctor's office and to help manage our daughter's doctor anxiety. Appointments are so much easier from the comfort of your own home. (My husband and I even use this service for our own medical needs!). You should never use this kind of service for medical emergencies, instead, call 911.
Spread out and pile on as needed. Sometimes, we can tell our daughter is overwhelmed from doctor appointments and needs a break. In those instances, we request telehealth visits or push unnecessary appointments out a few weeks to give her a break.
For procedures that require sedation (MRIs, surgeries) we try to coordinate with our daughter's doctors to add any diagnostic tests that she will need while she is sedated. So far, her doctors have been very open to this (it may depend on the particular surgeon or the hospital). Our daughter has an upcoming cataract removal surgery, and they will be performing a dry eye test, neuropathy test, and diagnostic and regular blood work, all while she is sedated. We're so grateful to add these onto her procedure, so she doesn't have to experience these uncomfortable and painful tests while she's awake.
Play, read, and sing “doctor.” Buy a couple of books that describe doctor appointments for toddlers, like Leo Gets a Checkup. Play doctor with a play kit. Cocomelon‘s Doctor Checkup Song is great. The more you can normalize going to the doctor, or even make it fun, the better!
When you need more. Try homeopathic calming teething tablets or Benadryl before particularly challenging appointments (with your child’s doctor’s okay). Sometimes, older, stronger children will need something stronger like a prescription for Clonazepam or Valium. Talk with your child’s doctor.
We hope these tips make your child's doctor visits a little easier, on both of you! Please share other tips you have in the comments below.
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