Overtaxed parents may be at a loss for advice and support in raising their children, especially when the grandparents work and extended family members are far away.

Parents may turn to the pediatrician, family physician or nurse practitioner who has shown an interest in their child’s physical health. They hope for a similar concern about the child’s mental health.

As a result of the huge strides in pediatrics, better treatments than ever are available for an increasing number of diseases. However, because of the pressure on pediatricians-in-training to master this always-growing body of knowledge, too little attention has been paid to child development or to the art of listening and responding to parents’ concerns.

Now the field is changing. Training requires a (still too brief) time devoted to learning about child development.

I’m convinced that if we made more room for teaching basic communication skills in medical schools, doctors would be even more effective in identifying disease early and in helping their patients understand what they must do to fight it.

Of the medical specialties, it may be the family physicians who are most attuned to the importance of these relationships, since they take care of all members of a family.

Some pediatric groups now have the advantage of a nurse practitioner or a child psychologist in their practices who can help with behavioral “problems.” If so, you should be able to arrange to see this specialist periodically — either to arrange for an assessment of your child or to get answers to your stored-up questions.

Having a primary physician keeps you from having to rely on the staff of an emergency room for problems that aren’t emergencies. The emergency-room doctors and nurses won’t know you or your child and will only address your child’s most urgent need — often only with a short-term solution — before rushing off to the real emergencies.

Regular checkups with a primary physician mean that he or she will know you and your child when something goes wrong and, in a crisis, can benefit from prior knowledge of you and your child.


1. Consider what type of doctor is best suited to the needs of your family — a pediatrician or a family physician? Family physicians are trained to provide primary care to adults as well as to children, and some families prefer to share the same doctor.

2. Check the physician’s credentials. Is he or she well-trained, with access to a good hospital and round-the-clock coverage?

Most physicians practice in a group, so one member is available at all times. I don’t believe that quality medical care can be provided to families of young children when they must switch from one doctor to another for every routine visit. I urge you to choose a practice that is set up to give you your own doctor — the same one to see for each well-child visit, and for urgent visits whenever possible.

When your child is sick, your familiarity and relationship with the doctor will be more important than ever.

3. Ask others in your community about the doctor’s personality. Do friends whom you respect seem to like this doctor?

4. Know the options. Pediatricians who have been trained in child development sometimes teach in a medical center and conduct clinics to which parents bring their children for developmental assessment. Thus they can recommend early intervention when there are problems, physical or psychological.

If you have concerns about your child’s development that are not being addressed by your physician, consider using one of these child-development clinics or set up a referral through your doctor to gather information to supplement your doctor’s medical advice.

Questions or comments should be addressed to Dr. T. Berry Brazelton and Dr. Joshua Sparrow, care of The New York Times Syndicate, 620 Eighth Ave., 5th Floor, New York, N.Y. 10018. Questions may also be sent by email to:

[email protected]