Is My Child Normal? Children and Developmental-Behavioural Issues

Alan Mease, MD

Developmental Pediatrician, Director of Specialty Pediatrics Clinic

BeijingUnited Family Hospital and Clinics (BJU)

 

As parents you may have questions and concerns about your child's physical or cognitive development, learning, or behavior. We are here to help with these questions and concerns.

 

Many children face physical or cognitive challenges that require special attention at home, at school or in the community. We would like to partner with you so that, together, we can address the unique needs of your child. By evaluating your child’s unique strengths and challenges, we create a family-centered care plan to help your child achieve his or her greatest potential. We can also help you and your child cope with the practical and emotional concerns that often accompany developmental and behavioral disorders.

 

At BJU’s Department of Pediatrics, we recently started the Developmental and Behavioral Pediatric Services (DBPS) to devote more of our resources to the developmental needs of our patients’ families.

 

What are developmental-behavioral issues?

Child development is the result of the biological, psychological, sociological changes that occur in human beings between birth and the end of adolescence. Child development is the resultof acomplex interaction between genetically-controlled processes, environmental factors and learning.

 

During these complex interactions, problems can arise which have developmental and behavioral consequences. This could lead to a delay in achieving developmental milestones in motor, speech, social, emotional and mental areas. In turn, these delays can lead to behavioral problems, which could include sleep issues (nightmares, trouble sleeping, etc.), misbehaving (aggression, tantrums), unexplained pain, bed-wetting, excess crying, bowel control problems and general phobias.¹

 

Why establish a clinic for developmental-behavioral issues?

The motivation for establishing DBPS is to give children the time and attention required to properly assess their issues and develop a treatment plan. This process involves a lot more time than a regular Pediatrics clinic is prepared to give to a single appointment. The children that DBPS serves would receive the special testing they need. They would also benefit from the service’s interdisciplinary approach that combines pediatric medicine; psychology; and speech, occupational and physical therapy.

 

Developmental pediatrics requires recognition of the essential unity of the body and mind. With a developing child, there is no way to separate the body from the mind. Therefore, developing children require a bio-psychosocial approach. Too often, pediatrics deals only with purely physical issues. And the Psychological Health Center deals with purely psychological issues. But there is a whole group of kids out there that need a more holistic treatment approach.

 

For example, imagine that a set of parents brings their 2-and-a-half-year-old in for a consultation. The parents are concerned because the child has not started speaking yet. Most doctors would agree that this is a cause for concern. However, this concern is premature if the child’s family situation is not considered. If the child is born in China to expatriate parents who speak two different languages, and the child is attending a Chinese school, then context has a huge influence on the child’s delayed speech. DBPS has the resources to explore further whether the child’s problem is situational, developmental or psychological. Additionally, DBPS has the bandwidth to ask whether the child’s symptoms are the beginnings of a serious problem or nothing at all.

 

Regular Pediatrics clinics do general checks, but DBPS can focus on specific issues with an interdisciplinary approach. Everything – from serious issues to everyday challenges – is appropriate subject matter for a DBPS consultation.

 

In the end, the goal will always be to maximize each child’s potential. That’s the perspective that will bond our doctors, DBPS staff, the parents and the child together as an effective treatment team.

 

Early screening, early detection, early intervention

Studies have shown that detecting developmental/behavioral disabilities and addressing them early in childhood can lead to significant benefits for children.^2-9 These types of concerns and complaints are best addressed by using a bio-behavioral approach. Partnering with BJU’s Psychological Health Center, DBPS will evaluate and monitor progress in children who are at risk for developmental and behavioral disorders on the basis of a variety of factors, both biological and psychosocial.

 

Early screening does not necessarily work the way many people imagine. Not all active children are at risk for ADHD. A diagnosis of autism requires a battery of tests that are not usually performed in the Pediatrics clinic. Developmental/behavioral screening requires the use of brief validated measures that could encompass general development or be tailored for specific conditions.¹

 

I encourage parents to bring children for a consultation if they or their children have any of the following:

 

All graduates of Neonatal Intensive Care Units (NICUs) are encouraged to come in for a consultation, especially children who were considered a “very pre-term birth” (gestational age less than 32 weeks) or “extremely pre-term birth” (gestational age less than 25 weeks).

 

Additionally, children who experience the following are also encouraged to consult me:

 

In closing

I hope none of this information comes across as intimidating. The last thing we want to do is to give parents a reason to feel paranoid about their kids. There is simply a great need for pediatric developmental/behavioral services, and we want to get the word out about DBPS. Personally, I have had more than 30 years of clinical Pediatrics experience and more than 10 of them have been in China. Over the course of my career, I’ve encountered all of the conditions mentioned above, and I’m happy to now have the environment and time to focus on these issues.

 

Advances in neuroscience have shown that early intervention yields great benefits in the lives of children with developmental delays, and this clinic is the first step toward building a program to support that. I am honored to be a part of my patients’ treatment processes, but my ultimate goal is simply to help maximize each child’s potential. If parents or kids themselves have any concerns, I invite them to come see me.

 

To contact DBPS, please call the BJU Pediatrics Department at (010) 5927 7222.

 

 

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