Ask Dr. Gramma Karen: Stepmom Having Difficulty Getting Help for Her Stepson

Posted on 8-17-218-17-21 by Dr. Karen Rancourt

boy playing with matchbox cars — Photo by Aleksei Potov/shutterstock

Dear Dr. Gramma Karen,

I have concerns about my stepson’s cognitive awareness and abilities. Michael, who is three and a half years old, favors certain toys (hot wheels, spinning/flicking wheels), he rocks back and forth throughout the day, and we have a hard time getting him to eat, especially meat and grains. He runs on tip toes, laughs and makes inappropriate facial expressions at inappropriate times; he is hard to understand, and for a lot of what he says, there’s an obvious speech and language delay.

When you ask him questions, he will just sit or stand and look at you with a straight face and not answer. Further, he has made zero progress with potty training, counting or knowing letters, he is very hyperactive, and he can’t pay attention or concentrate when we read or try to work with him on things.

There are three months between Michael and my son Matthew, but they act close to two years apart. I think Michael might have mild autism, but the couple times I’ve tried to address the situation, my husband yells at me saying, “There’s nothing (expletive) wrong with him” or “He’ll catch up.” But I’m doubting he will catch up, and by then it would be too late to get him early help.

I’ve mentioned it to the grandparents, who blew it off too, but I think my mother-in-law is starting to pick up on it.

As most parents can attest, even before their baby is born, they have a fear that “there will be something wrong with him/her.” This fear never goes away. Coming to grips that one’s child may have some physical, emotional, cognitive, or neurological condition that will challenge their baby/child often begins with denial: “There’s nothing wrong with my child,” typically followed by rationalization: “Well, it’s nothing serious; they will outgrow it; it will self-correct.”

The observations about Michael’s possible developmental delays you have shared with his father and grandparents are being greeted with denial, rationalization, and even anger. With these dynamics in play, I don’t think much is to be gained if you continue to share your concerns directly with them. It seems clear that your voice and comments have been heard and rejected.

Consult With Your Pediatrician

For this reason, I am going to suggest that you consult with your pediatrician on how best to approach your husband to assess whether it is in Michael’s best interest to have him evaluated by experts. (It is not clear if your son and Michael go to the same pediatrician, but no matter. Whatever pediatrician you consult, he/she will be able to offer you guidance.)

How Best to Position Your Concern

I think it is important that you not use any diagnostic terms, e.g., autism, because you are not qualified to make a diagnosis, and casual use of medical terms can cause fear and lead to more denial and rationalization. Rather, a better position to take with your husband, and perhaps with the grandmother, is along these lines: “I am consulting with experts because I want to make sure that I am doing all I can to make sure I am giving both Michael and my son appropriate activities, experiences, and opportunities that enhance their development.”

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The approach clearly states your intentions in ways that do not focus on “something is wrong,” but rather on “I want to ensure that I am doing all the rights things for the boys.” Let the experts be the ones to communicate to you and your husband that your two boys may be at different points developmentally and may require different courses of action to support their growth and development. Further, this approach may make it easier for your husband to hear and accept that his son may have challenges that require working with specialized professionals.

I agree with you that if Michael is developmentally delayed in any way, appropriate interventions have a better chance of being effective the earlier they are implemented. However, if you are unsuccessful in getting an immediate assessment of Michael’s development, rest assured that any developmental delays will most likely be picked up when he attends school, in the next year or two. Such a delay would indeed be unfortunate.

If you are interested in learning more about typical developmental milestones for children who are your son’s and stepson’s age, I recommend these resources:

3- to 4-Year-Olds: Developmental Milestones
Spotting Developmental Delays in Your Child: Ages 3-5
Developmental Milestones: 3 to 4 Year Olds
Potential Warning Signs of Developmental Delays (This resource provides milestones for a range of ages, from 9 months to 5 years.)

You may be able to convince your husband and/or his mother to read one or more of these resources. It may help them understand the specific skills and behaviors that Michael may need help in achieving.

Yes, you are in a difficult position, but your intentions are good, and your heart is in the right place, in spite of the resistance you are experiencing. I hope my suggestions help you help Michael get the appropriate evaluations to determine if he could benefit from working with professionals who specialize in working with developmentally delayed children, or children who face other physical, emotional, cognitive, or neurological challenges.

Ask Dr. Gramma Karen is published every other Tuesday.

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Dr. Rancourt’s most recent book is It’s All About Relationships: New Ways to Make Them Healthy and Fulfilling, at Home and at Work