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As we were getting to the point of realizing we needed to discuss concern about our daughter with our pediatrician for the first time, my sister suggested we start a log of what was going on. I started by using my computer to note anything that seemed relevant. These notes quickly led to a document that included a lot of information: a tool that has proved to be useful in many ways we had not anticipated. Below you will find "Advantages of maintaining a log" and "What you may want to include in your child's log."
When you have a first visit at a care provider's office, you may be handed an overwhelming amount of paperwork to fill out. Personally, those make me want to walk back out the door, but they are necessary. The log saves you a lot of time and hassle in filling out all those pages. You already have most, if not all, of the information in one place. This is much better than tackling your purse or wallet to find business cards or trying to think back to what dates your child was seen by whom and where.
When you are in appointments, often you may feel rushed or you may simply forget all you wanted to say. You may also not be in the frame of mind to think clearly if you are tired and overwhelmed (which by the time most of us approach a doctor for the first time, that is exactly how we are feeling!). Your child may not be able to sit quietly while you and the doctor talk. To help with this, when you check-in for your appointment, ask the staff to make a copy for the care provider (mony health care providers are great at skimming the log or speedreading it...it may also give them a better idea of what questions to ask). One alternative here: when you schedule your appointment, ask if it would be beneficial to email or fax over the log prior to your visit. It may get looked at before you get to the appointment or not, but it's worth a try.
Appointments are often short in length - the log is a synopsis of a lot of information you simply don't always have time to cover during the appointment
If you are paying out of pocket for an appointment, every minute counts - sometimes, even with insurance, we find ourselves paying out of pocket to get a quicker appointment or to see someone highly recommended; in this case, time is money. The log is time-saving tool. This means you spend less time on trying to recreate your child's entire history, and more time on discussing immediate concerns.
If you ever find your family in a situation where 911 is called (by you or your child), the log isn't "legal" but in talking with sheriffs' offices, they agree this would give some credibility to the fact that your child has an illness.
If you need to go to a hospital or crisis stabilization unit (CSU), the log is important to give the doctor a more complete picture of your child's history.
PLEASE NOTE: The following suggestions of what you may want to include in your child's log are divided into 6 sections. You may want to read this in two sittings. This covers a lot of information and details which can be daunting if you are overwhelmed and lack energy like most of us parents are! I guarantee the log will save you time, effort and hassle, but give yourself time to develop it; it's ongoing, not a one time deal.
Section 1 - Child's identifying information
Child's full name and the name they go by
Date of birth
Social security number
Insurance card information (ID#, group#, telephone numbers for customer service, mental health services and the physician line)
Section 2 - Contact information for child's treatment team; medication history; weight log
Full contact information (name, office name, address, phone number, fax number, email address, website, dates of service and reason for care) for your child's pediatrician, psychiatrist, 2nd opinion psychiatrist, 3rd psychiatrist, therapist, psychologist and any other related care provider
Medication history including every medication, dosage, dates dosages started/changed/stopped, prescribing doctor and what the medication was prescribed for
Weight log - this can be very important if your child is taking medication as some medications may cause weight loss and some may cause weight gain
Section 3 - Family history and child's history birth to present
Family history - before we first saw the pediatrician with our concerns, we were not aware of just how important the role of family history could play in getting a diagnosis; be sure to include any family history of alcoholism, drug use, violence, illness (including mental) back to at least maternal and paternal grandparents
Child's history from birth to present - any complications with pregnancy, delivery/birth; any medical problems, trauma or behavioral concerns; development history (did your child sit up, crawl, walk, talk in the generally accepted "average" time range).
Section 4 - Child's behaviors and interaction history
You may want to include a general idea of the child's day to day behaviors regarding diet, restroom use. I certainly recommend noting sleeping patterns.
Child's interaction with peers - does your child play and interact well with other children?
Child's interaction with parents - often, children may feel more comfortable expressing themselves with their parents, so behaviors may be more intense when home
Child's interaction with other adults - does your child respect other adults? does she argue with them or fear them?
Section 5 - Quality of life and educational background
Tell how your child's concerning behaviors are affecting quality of life for her and the rest of the family (i.e., do you find yourself pulling away from friends or family members because they think you just need to have more firm discipline or maybe because your child is too disruptive for them)
Educational background - what kind of schooling environment the child has (public, private, homeschool, etc.); is the child at grade level?; what is the child's history with teachers/staff, other students, reports and grades?
Include everything that comes to mind and let the professionals decide if it is important.
Up to this point, your log has a lot of great history and information for the doctor. This is the point where you can actual start a dated record.
Section 6 - Dated record - what to record on an ongoing basis
As soon as you decide to start your log, record the date of any concerning behaviors, mood swings, anxiety, fears, obsessions, hallucinations, etc. It can be sentences or notes, just get it in there.
If you find yourself needing to log several times a day, you may want to add the time. Sometimes patterns can emerge that you may not even be aware of until you see it on paper.
Note any triggering events you notice - being told "no" or to do something, being interrupted during an activity, loud noises, too much stimulation, seeing something that scary on tv; I have to say, you can't always decipher the trigger. We sometimes tend to jokingly say in our family that the trigger could be the wind blew the wrong way or maybe even it was the fact that the moon was full - we could only guess at what upset her or set her off. Other times it is apparent. If you know, include it - if you don't know, include that, too.
Note specific examples of what concerns you
As mentioned earlier, this may seem overwhelming. It IS a lot of information. At the same time, this is something you can continue to use and update. We still maintain our log. We find ourselves logging when things are not going so well or especially during times of a medication change (noting any suspected side effects, changes in behaviors, etc.). Whenever we go to a new specialist, we just print the updated copy and hand it over. I can tell you that the log we maintain has been an invaluable tool. So often I find myself thinking in a blur and if I am asked a question, I may not know the answer - until I open up the log! This is one tool that is free, enlightening, helpful, time saving and even therapeutic, if you get that result from writing. It is also something you can do right away while waiting to get in to see doctors, so you can feel you are moving forward and doing something proactive to help your child!
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