As a behavioral pediatrician, I have forged many relationships with my families. I have had the honor of helping guide families through some of their worst crisis points. One patient named Ella* (name changed for confidentiality) was 9 years old and brought in by her grandmother because she was acting out at school, and as a result, her grades were falling.
Ella’s father was on drugs and having a tough time getting things together to consistently take care of her. I learned that her parents had an explosive relationship and were constantly fighting. Ella’s mother would take off for weeks with no notice. There was always uncertainty as to whether she was going to come back. So, Ella’s grandmother stepped in to provide the love and support Ella desperately needed and to help out her son.
Sadly, these situations are not unusual given the current opioid epidemic we are facing in this country. These types of issues, called adverse childhood experiences or ACEs, are never easy to talk about, especially with someone you have just met. And yet, by the time families get to me, they need someone to just listen. At the end of the first meeting, Ella’s grandmother gave me a hug and said, “I know we have a ways to go, but I feel better knowing we have someone who took the time to get to know us.”
After taking time to connect with Ella’s school and talk with her teacher and counselor, we came up with a treatment plan. Eventually, she started on medication and we got her into therapy. Her grandmother had to have a heart-to-heart with her son about the need for stability. He was welcome to see Ella, but he had to be consistent. If he couldn’t be, then he would have to take the time to take care of his own things first.
This was not an easy discussion for Ella’s grandmother to have with her own son. However, we know that a child’s growing sense of self is directly tied to the quality of their earliest relationships with their parents. Children can thrive, no matter what life throws at them, if they have safe, supportive, and nurturing relationships with parents and other trusted adults. In Ella’s case, her grandmother became the steady and strong support for her while her parents continued to get on the road to recovery and to figure out the best way to co-parent.
I never got to meet Ella’s biological parents, even though I was involved in her life for a little over a year. Ella slowly began doing well, with a big piece of her treatment success coming from partnering with her grandmother who put in place routine and structure and minimized the heartbreak over her parents’ comings and goings.
It is important to call this out. Ella had a tough road, and there was not a “quick fix.” But one of the main reasons I believe she did well was because we were able to gather the right people to be “on her team.” This included not only me, but her teacher, her school counselor, and principal, and later her therapist. By partnering with her grandmother, we got everyone on the same page and, most importantly, empowered Ella’s grandmother to understand what Ella truly needed to thrive. Armed with this knowledge, she was able to take the steps needed to have those tough conversations with Ella’s parents. Yes, her grandmother had to repeat herself multiple times over that year, but she found the strength to give voice to Ella’s needs, knowing she had her team behind her.
Ella had a tough road, and there was not a “quick fix.” But one of the main reasons I believe she did well was because we were able to gather the right people to be “on her team.”
So even though visiting the pediatrician is primarily for the health and well-being of your child, pediatricians will likely ask parents how they are doing and if they feel supported and able to navigate those messier moments of parenting. Expect to be invited to share stories about your family life and the daily stresses and questions you may have. No question or concern is silly, minor, stupid, or unimportant.
Sometimes life throws us curve balls. This is why involving your pediatrician as early as possible during a crisis is always a good idea. We can and should be someone you turn to when the going gets tough. We encourage you to make your pediatrician one of the three people everyone should have in their corner when it comes to raising healthy and happy children. We’re calling this “finding your three,” and I believe everyone needs at least three people or organizations to turn to when they need help during a time of adversity.
Pediatricians can be thought of as a coach who will help you build your support team, whether your child is relatively healthy or has ongoing developmental or behavioral concerns. We want to ensure all children have a chance to thrive, by helping parents know we will always be ready to listen without judgment and always with compassion. Parenthood can be challenging at times, but knowing you have your child’s pediatrician as “one of your three” on your team is the first step.