What the Doctor can offer
We begin different areas of medical practice.
General Practitioners are family doctors, community based, providing primary care medicine. GP care supports children and family over time.
Paediatricians are doctors who have undertaken specialist training in the health care of children and young people (Royal Australasian College of Physicians).
Developmental paediatricians have specialised their postgraduate training and clinical focus on conditions that present through development and behaviour, rather than traditional medical presentations such as pain, fever, rash, and other physical manifestations of underlying problems.
Developmental paediatrics and health care
The assessment and care of children / adolescents who have problems with development and behaviour involves many professions, including teachers, therapists, and psychologists. In the care of children with problems of development and behaviour, what is the role for doctors?
We believe our role has many potential areas of contribution, including:
- Medical cause: Why is is this happening? What are the implications?
- Overview: Pulling all the pieces together, helping you determine priorities
- Developmental diagnoses: What are these, which are true, what do they mean?
- Medical treatments: Managing medication towards clear purpose.
- Advocacy. Helping you fight the fight.
- Support over time: More than managing problems, optimising the journey towards best long-term outcomes.
Why does your child have the problems they experience? Is it due to parenting? Is it temporary or permanent? How much can be treated?
Diagnoses like Autism Spectrum Disorder and ADHD provide information about what is going on, but not about why. They cannot answer the question of cause.
The question of cause is important. It guides how you understand and care for your child. It can relieve you from the burden of unnecessary guilt.
We don't always find a clear answer (thought the technology is rapidly changing). Where we don't have a clear answer, however, we can form an opinion, a hypothesis, that serves this purpose of guidance until further information arises.
We believe the doctor is well placed to see the full picture. This allows us to see how each of the parts may fit together. If a child struggles with language, for example, that may be a problem with language itself. It may also be part of a problem with learning more generally, with social thinking (autism), or with severe anxiety.
Seeing the whole also allows the discussion of priorities and sequences. What is most important at the moment? What needs to come first?
For certain conditions, school systems, or government departments require a doctor to 'sign off' on
the final diagnosis. This means that doctors must take responsibility for what is decided, even though other professions may have contributed assessment and opinion.
An important treatment option for children / adolescents who have developmental disorders is the use of medication. There is a range of opinion about this, however, it it comes up as an option, we can help you make the best decisions possible.
Our approach to medication is to define purpose. What is it that you are trying to achieve? How will you go about this? How will you know when it has been achieved?
Doctors are in a good position to advocate for children / adolescents. This may be advocating for understanding, for services, or against discrimination and bullying.
Teachers come and go. Therapists work for limited treatment periods. Who supports you over time? We believe good medical management involves support over time. This enable care to extend beyond just responding to problems. It enables the setting of goals (short, medium and long-term), and helping you work towards these.