When is it Appropriate?

[Unregistered]

to let a parent know your concerned about a child's behavior? I get so frustrated by those who feel its ok to constantly tell parents they 'think' the said child has autism or ADHD! I feel that is so over diagnosed, especially as a parent who's child was singled out by daycare. Turned out he had nothing wrong with him. The said provider just thought it was her 'job' to tell me my child did this or that wrong. Changed daycares and he has thrived for over 3 years now.
I would think as a parent, the parent would notice if something was off with your child or if he or she was not meeting their goals. I'm curious to see when a provider thinks its ok to step in? I appreciate a kind heart with concerns but I'm not paying a provider to diagnose my child for anything. If i wanted this I would consider a center where they typically do these assessments, not a home daycare.

[DBug]

I personally don't think it's my place at all. I prefer not to label kids, and a child has certain behaviours, I prefer to work on those, as opposed to finding a reason for them. If a child needs to find ways to cope with sensory overload, too much energy, social interaction, etc., I like to help them find methods that work for them. I think alot of times we (as a society) fall back on diagnoses as excuses (ie. he's ADHD, that's why he's talking back, etc), and we don't spend enough time looking for solutions, other than to pass the buck to a doctor, or to depend on medication. Yes, many times medical intervention is a necessity, but I don't see that as my place in a child's life. My job is to love, nurture and provide for a child while in my care, while helping him or her learn how to play, learn and live alongside other people in behaviourally appropriate ways.

If dealing with a specific child's behaviour was beyond the scope of my expertise, I would discontinue care with that excuse. I would not make an attempt to diagnose or suggest any disorders. However, that's just MY opinion -- I'm not saying any other providers should share it .

[momofsix]

I wouldl never "diagnose" a child, I am not qualified to do that! What i have done is suggest that parents might want to discuss something with their child's doctor,and have the Dr. be the judge. I had one little guy that was not talking and his parents thought it was b/c they were bilingual. It was very hard for me to suggest to them that he might have hearing issues and to point out that his speech was not where it should be, but as soon as i talked to them they said they had been wondering too, but didn't really know if he was behind or not. Since providers have experience being around kids all day every day, we might see what is "normal' and where there might be a problem sooner than a parent might, but we are not qualified to diagnose something like autis., I do have experience with autistic children, but if I thought your child was autistic, i would suggest you make an appointment with your doctor, but i would also point out things that I saw in daycare that you might not see at home for you to bring up with your doctor.
I do think it wasw your provider's job to tell you if your child was misbehiving at daycare, wouldn't you want to know what kind of day your child was having? i also believe it is my joob as a provider to look out for the best interest of the children in my care, and if that means it might sometimes offend a parent, or shatter their thoughts of their "perfect' child, then that's what I have to do. but I would hope that our relationship would be good enough do discuss the child's development in a positive and constructive way for all involved

[momofsix]

oops-can't delete this second post!

[Unregistered]

to let a parent know your concerned about a child's behavior? I get so frustrated by those who feel its ok to constantly tell parents they 'think' the said child has autism or ADHD! I feel that is so over diagnosed, especially as a parent who's child was singled out by daycare. Turned out he had nothing wrong with him. The said provider just thought it was her 'job' to tell me my child did this or that wrong. Changed daycares and he has thrived for over 3 years now.
I would think as a parent, the parent would notice if something was off with your child or if he or she was not meeting their goals. I'm curious to see when a provider thinks its ok to step in? I appreciate a kind heart with concerns but I'm not paying a provider to diagnose my child for anything. If i wanted this I would consider a center where they typically do these assessments, not a home daycare.

Well, first of all, there is a difference between "diagnosing" your child and expressing concern about certain behaviors that may be cause for concern. Secondly, not all parents are experienced enough with disorders like autism and adhd to recognize the characteristics that go along with them. Speaking as a long-time child care provider and mother of a son with Asperger's, I can tell you I tread very carefully when I have concerns about a child in my care. I don't make the decision to speak with the parents lightly. I only approach parents after observing the child for quite some time and never if I see one or two characteristics of a disorder -- the behavior really has to stand out for me in order to suggest that a parent discuss the behavior I'm seeing in day care with the child's pediatrician. As much as I hate those conversations (I've had to do it twice in 14 years), I know how important early intervention is and I would never want a child to miss out on getting the services he needs because I didn't bring my concerns to the parent. As far as your child is concerned, I'm glad things worked out well for you. It sounds as though your child care provider wasn't a good match for you or or child.

Before I end, I just wanted to say that in my experience, autism is not "so over diagnosed". It took years and a fair amount of testing for my son to receive his diagnosis and I know of many families who have gone through a similar experience. Although my son is very high-functioning, I knew there was something "different" about his behavior when he was very young. Despite my concerns, his pediatrician (who specialized in special needs kids) reassured me that everything was fine. My son's child care provider at the time never mentioned any issues to me but if she had, I would have been grateful to get that much needed back-up.

[AmandasFCC]

I don't think it's ever our place to "diagnose" or even give suggestions as to what we think a diagnosis may be. HOWEVER, I think IN SOME CASES it's very important to discuss problem behaviour, and behaviour that may be indicative of a major problem. Early detection is key in a lot of cases, and while I do agree that a lot of things are over diagnosed, sometimes the children DO need extra support from what we can offer alone.

So when is it appropriate to discuss these things? I would think when all reasonable options have been exhausted by the provider (if we're talking about a problem behaviour), and you sincerely, truly, absolutely believe that there's a problem.

[TGT09]

I agree to a point. I do believe that it is our need to step in and mention things you've noticed since technically you are spending a very large amount of time with the child. The parent may not have had the child in a situation to notice it. HOWEVER, it is not my place to diagnose, let alone harp on it. I would mention it once and 99% of the time I wait for the parent to ask or mention it.

Point in case: 7 yo dcg last year had severe problems concentrating on her homework among completing other tasks, wouldn't listen, etc. I had only been open a few months at that point and she seemed VERY like me when I was that age so I left it alone realizing I turned out ok. :-) However, about 2 months into school dcm mentions she's having her tested for ADD, which she did have and is on medicine for now and has changed so much!

Same dcm mentioned to me that she was making dcg start wearing deoderant because she started to smell her. I said I thought that was a good idea since I too had smelled her. She was upset that I hadn't said something to her sooner and I told her that A.)I didn't want to embarass dcg and B.) I'm not her parent and didn't want to step on her toes.

Just my 2 cents. :-)

[missnikki]

"When is it appropriate to let a parent know your concerned about a child's behavior?"

It is appropriate when:
1) There is a danger/ safety issue I am repeatedly addressing
2) There is a decency/ appropriateness issue that involes others
3) I feel that I need the parents to address outside of care for consistency

If you are referring to developmental issues, that's a different ball of wax- I tend to do as a pp said, and work on the strengths and weaknesses of each child. As far as the parents go, I would try to find a way to work it in out of concern, but not until I'm positive I can back up what I'm saying with concrete examples and by NO means suggest anything other than getting checked out by their pediatrician.

[MarinaVanessa]

It is appropriate when:
1) There is a danger/ safety issue I am repeatedly addressing
2) There is a decency/ appropriateness issue that involes others
3) I feel that I need the parents to address outside of care for consistency

I agree 100% with this. I also can't "diagnose" issues but I think what we're talking about here is not diagnosing a child ourselves but being concerned when a child acts in a way that may indicate that there may be an underlaying issue behind it, when the child is a risk and may hurt himself or others or when a child acts in a way that makes it hard for the caretaker to provide adequate care for the other children in care.

I don't see anything wrong with bringing the childs behavior challenges to the attention of the parents as long as it comes from a good place. I won't say, for example, "Hey so listen, I think your kid has ADD. You need to get him checked out" I'd say something more along the lines of "Hey so I've noticed that child often does this and this and this. I have tried different things with this child and havn't seen an imporovement which concerns me. Have you ever thought that the child may have behavioral challenges? It could be nothing more than the child has a lot of energy but then again it could be something else altogether. Just giving you something to consider".

I can see where people think it's not our place to mention things like this but for the sake of our sanity I think that if we think there may be something wrong then we should at least bring it to their attention. Yes parents know their children but those parents are the ones that get their children evaluated, work with their children etc. These are the good parents that pick up on their children's actions.

My daughter had trouble in pre-K and I even once had to pick her up because she was screaming, throwing furniture and spitting on people. The teacher spoke to me and brought to attention that there could be behavioral challenges. I didn't take offense, I didn't get angry or embarrassed at hearing this from her, I simply wanted what was best for my daughter and so took her to a specialist. They did test and found nothing. Still I didn't get upset because she was wrong. Something was happening and I wanted to know what. I then took her to a behavioral psycologists where I was told that she just didn't know how to express her emotions in a proper way. I took a recommended workshop which gave me tools to help her and after updating her teacher at school they even took it a step further and connected me with a social psycologist that went to my daughter pre-k class and sat with her once a week to observe and guide her when issues came up. It worked wonders within just a few weeks and now she's great. If this teacher wouldn't have said something I would have continued to think that I just simply had a high energy, naturally curious, active child.

On the other end of the spectrum ... I have a cousin that had a pre-term baby (was born at barely 6 months). He was so small that he would fit in the palm of your hand and his entire foot was only as big as the end of my pinky. The first week they didn't think he would survive but he did but the doctors told her that more than likely he would have either permanent health or developmental issues or both. They prepared her and gave her all of the info. As he grew in his 1st year we questioned whether he was developing at a normal rate, she said he was fine. By his 2nd year our entire family had suspicions that he was not developing properly and nowhere near where he should have been, she would become angry and defensive and insisted that he was fine. By his 3rd year it was obvious that he had autism and she continued to defend her position. Even after doctors had initially told her that he had a high chance of having some sort of behavioral and developmental challenges and apparently even after her own child's pediatrician had told her on several occasions (we did not know this) that he thought that her son should be evaluated she was in denial. HER son could not have anything wrong with him, HER son was normal, HER son was right where he needed to be. Finally in his 4the year he became so out of control that she became depressed and our entire family came together and had an "intervention". It was an uproar. In the end she agreed to have him evaluated only after her sister became so frustrated that she threatened to call social services and report her for neglect (she wasn't even sure that she could do that). She went in to have him evaluated (her sister went with her to make sure she did it) and apparently the evaluater immediately recognized that he was in fact autistic. This past year he has had speach, behavior and social therapists and we have seen an improvement and now she kicks herself in tha *ss because she didn't do it sooner.

So, yes parents know their children but unfortunately not all of them want or know how to recognize what is average and what is not. All we can do is offer the information, and it's up to them whether or not they want to do something about it. If they don't and we as providers continue to have trouble with kids whether they have a disorder or just behavior challenges, then sometimes we are left with no other option than to terminate the child to keep our sanity's and those of the rest of the children and just pass the torch to the next provider.

Just a thought to this very complicated subject.

[SilverSabre25]

Bringing challenges and difficulties to the attention of the parent is, IMO, part of our job. We see children for many hours a day, we see many children of similar ages, and we see each individual child for many/most of their awake hours each day or week, and we often are the only ones who get to see a child interact with other children. We know, from experience if not from training (whether just state-mandated training to keep your license or a full-blown Bachelor's or higher in Early Childhood Development and Education), what is to be expected at each age and stage. A one year old who isn't crawling? That's a problem. A two year old with NO words? That's not normal. A four year old who has the occasional tantrum and doesn't want to listen or talks back? Probably normal.

Furthermore, mentioning a possible issue to a parent might be their wake-up call, might be the final push they need to trust that their instinct is correct, might confirm their suspicions. You might be wrong...but you might be right. Any parent in their right mind has NO right to get upset with a provider for suggesting that their child might have issues that need looked at further by a professional.

On the provider's side--we do need to be tactful. We do need to present the information in a non-confrontational way. If we suspect something specific, we need to say so, but say why we suspect that--"I'm concerned because your 18 month old doesn't even try to communicate, doesn't make eye contact, and doesn't even respond to his name" might not mean much to a parent who doesn't know anything about autism and the parent goes on thinking that he's a late talker or just a baby, but if you mention that these things "could be signs of autism, and I think you need to run it by your child's doctor or call Early Intervention for an evaluation." That gives the parent some specific information, specific things to ask the doctor about, and resources to turn to. Obviously, if YOU don't know enough about autism, or ADHD, or speech/hearing delays, or sensory troubles, or whatever, you might not feel comfortable saying a specific thing. You might just want to say "this isn't normal behavior for his age" and refer them to the doctor or Early Intervention program.

[Unregistered]

to let a parent know your concerned about a child's behavior? I get so frustrated by those who feel its ok to constantly tell parents they 'think' the said child has autism or ADHD! I feel that is so over diagnosed, especially as a parent who's child was singled out by daycare. Turned out he had nothing wrong with him. The said provider just thought it was her 'job' to tell me my child did this or that wrong. Changed daycares and he has thrived for over 3 years now.
I would think as a parent, the parent would notice if something was off with your child or if he or she was not meeting their goals. I'm curious to see when a provider thinks its ok to step in? I appreciate a kind heart with concerns but I'm not paying a provider to diagnose my child for anything. If i wanted this I would consider a center where they typically do these assessments, not a home daycare.

I understand where you are coming from BUT I am a parent of a special needs child and everyone kept telling me his agressive out of control behavior was NORMAL for a 2 year old when I KNEW something wasnt right but everyone kept saying he was fine and stick to your guns and be stern with him blah blah well guess what at 5 I finally found out he has ADHD with the therpay and Pshychiatrist he is getting the help he NEEDS just wish he would of gotten it when he was a toddler as his toddler years would of been easier for him. Ive had 2 kids come into my daycare I knew right away something was off told the one parents they took him ASAP to get tested and he WAS autistic then with the other parents kept telling them and telling them something was off doc kept saying he was fine well guess what they got him tested when he was 18 months and he is SPD and has a devlopmental delay so you see sometimes we HAVE to speak up as some parents can be in denial about there kids we dont want to think something is wrong with our baby and if I wouldnt of spoke up I would of felt bad for not because the child wouldnt of got the help he needed earlier.

[MarinaVanessa]

We see children for many hours a day, we see many children of similar ages, ....... and we often are the only ones who get to see a child interact with other children.

You make a good point here that I did not mention. Often times daycare is the only time that this child is around other kids his/her own age and we get to see their interactions from first hand observation.

Obviously, if YOU don't know enough about autism, or ADHD, or speech/hearing delays, or sensory troubles, or whatever, you might not feel comfortable saying a specific thing. You might just want to say "this isn't normal behavior for his age" and refer them to the doctor or Early Intervention program.

Agreed. I personally wouldn't even try to diagnose or guess at a diagnoses wothout knowing what I was talking about. Telling a parent that you suspect that there could be an issue because of what you observe and what you do know might be that child's chance at getting help and in the end being a happier individual.

[Unregistered]

I am thankful

I have to weigh in here. My daughter had a problem with her eyes and it could have been something serious (thankfully it wasnt) but my child care provider pointed it out (kindly of course) that she noticed it and I was in a terribly busy, crazy time in my life and I honestly hadnt even noticed. I was so greatful to my provider! I would have not known for a long time or maybe even at all. Now we take her to a specialist and she keeps it from growing worse. What could have happened to my daughter if my daycare provider would have "kept quiet" about her observations? I thank God for that provider everytime I look in my daughters beautiful eyes