Anti-Bias Work with Preschoolers

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By Alexandra Dutton, Old Firehouse School Lafayette Program Director

“Mommy, why is he so fat?”

“Papa, how come the food they’re eating smells funny?”

“Mama, she’s walking weird. What’s wrong with her?”

For those of you who have verbal children, you may have encountered embarrassing moments in which your child has asked a question, quite innocently. While they might be just asking a question, you might be feeling badly for the other person, who may have overheard, and simultaneously you might be scrambling to come up with an appropriate answer.

During our March Staff Development Day, author and teacher Deya Hill came to speak with us about understanding anti-bias and helping children develop compassion for others. Some important take-aways from her very thought-provoking talk:

People do not only have bias towards different races. Bias also happens against the disabled, LGBT people and different cultures, and genders.

Often, misunderstanding leads to fear of differences. Here’s a real life example from Deya: A child in her preschool asked “Will his hands get clean after he washes them?” He was noticing that his friend, who is black, has different color skin and was mistakenly attributing the color to dirt. For many of us, that kind of question would mortify us. However, Deya knew that the child was very innocently asking this question and genuinely curious about the answer. Rather than hush the child or scold him for such an insensitive question, she offered to have them all wash their hands together. Holding out her hands, as well as the two children’s hands, she pointed out how we are all different colors. Together, they washed hands and no, the color did not come off of anyone! That satisfied the child; she was able to respectfully answer his question and also respectfully include the other child.

When we shush our children for asking something about another person, we are unintentionally teaching them that there is something wrong with that person, which leads to our children developing bias. As parents and teachers, we have to be open to talking to children when these moments come up. Children won’t give us any forewarning -- but if we can learn to handle these moments honestly and thoughtfully, we can help all our children grow.

The worst thing we can do is ignore a child’s bias. A child who makes fun of someone with crutches or laughs because someone speaks with an accent can learn that people are different. Sometimes children use humor as a way to deal with something they don’t understand, and these moments are opportunities to say, “You noticed that she has crutches. They help her walk. I wonder what it would be like if we couldn’t walk by ourselves,” or “He sounds different, doesn’t he? He comes from another country where they speak another language, like how our neighbors/teachers/friends are from China/France/Mexico. He speaks Chinese.”

It’s okay to go back and have the conversation again if you feel like you didn’t handle it well. We sometimes will quickly address (or not address) an issue due to where we are -- the grocery store check out line, for example -- but we can always say, “Remember earlier when this happened? I want to talk more about it. _______ (enter your improved comment here).” Sometimes other people will not always handle it as well as you would hope. The person who snaps, “Make sure your child learns manners,” after your child says “She looks really old,” is teaching your child a new lesson. Not everyone will take their comments or questions well. We can say this to them: “Some people who are old are kind and some are not, just like people who are young can be kind or not. But, you are never wrong when you are kind.”

Holiday Helpers: Developing Compassion & Empathy

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Holidays are a special time for children. There is typically an abundance of family and friends, cooking and baking is plentiful, and special, meaningful traditions are made that they will remember for the rest of their lives.

Rather than spending the majority of the season discussing what they hope to be getting for presents or what’s on their individual wish lists, we hope that we can instill a sense of compassion and generosity in our children during this holiday time. It’s important for them to understand that giving can be just as rewarding as receiving.

This Holiday season we’re excited to partner with the Mill Valley Fire Department and Toys for Tots for our local Toy Drive. We will be collecting new, unwrapped toys, books, art supplies, gift cards, and board games for children of all ages. There will be two donation boxes at the school for convenient drop offs. Additionally, each time a donation is made, we allow all our children to partake by witnessing the excitement of giving.

 

Local Public Schools, Transitional Kindergarten and The Aims of Education

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For eight months I have been trying to write a post on the local public schools and the status of transitional kindergartens serving the OFS community.   Woe is the parent reporter, teacher, or Superintendent who is trying to see through the current muddy waters of the state fiscal crisis and its effect on our public schools.  But today I vow to tell you what I know. 

When I first moved to California 37 years ago, California’s education system was one of the best in the United States. Due to many socio-political and economic factors, we can no longer claim that position.  However, the truth is that in our more prosperous communities children do still outperform those in most other states. This of course comes as no surprise, since most of you moved to our community for the school system. 

When this formal educational experience should begin has been a hot topic for educators, parents, and politicians for more than 100 years.  In 2011 the California legislature made a momentous decision to change the kindergarten entrance date from December 2nd in 2011 to November 2nd in 2012, October 2 in 2013, and September 2 in 2014.   In other words, formal public education should not begin until a child is five years old.  Since so many children with the late birthdays would not be eligible for Kindergarten, the legislature offered a new program called “transitional kindergarten” which would be available for these late birthday children.  Yet, with such severe budget shortfalls, Governor Brown thinks this is not the time or place to roll out another year of education.  Historically, many OFS families often decided to hold their late birthday children back for an extra year in our preschool or developmental kindergarten classrooms.  Nonetheless we do have quite a few families in limbo even now about what they are going to do next year. 

In other parts of the Bay Area there are many children whose families cannot afford the luxury of keeping their children out of school for another year. These families are further hindered by the fact that there is also a dismantling of publicly funded preschool programs.   Truly, it is these children who will suffer most from the current education crisis.  As Billie Holiday observed in song, “Them that’s got shall get, them that’s not will lose.” 

You moved here probably because you believed that these school systems will give your child a better chance for a successful and happy life.  Will they?  Or are there other, more weighty influences? 

About 80% of OFS children move into the local public schools.  Because we are luckily in affluent communities, most families believe that the quality of local schools is quite high.  As Lafayette Superintendent Fred Brill says, the parents in our community expect a private school experience within their local public schools. 

I recently attended a “Learning and the Brain” Conference for educators. In every session the concern about how far behind American children are to their Chinese contemporaries was emphasized.  As one presenter stated, “It’s no longer appropriate to remind our children to clean their plates because children in China are starving.” Now he says we should say, “Do your homework because children in China are studying so hard that they are going to take the bread right off your plate if you don’t work harder.” 

International expert on global education Yong Zhao tried in vain to calm this furor by reminding the audience that American children are happier than their Chinese counterparts and that he thought there was a relationship between happiness/self-concept and later success as entrepreneurs and creative people.  He did not think that China could produce a Steve Jobs — or a Lady Gaga, for that matter.  According to Zhao, what matters is diversity of talent, creativity, entrepreneurship, and passion.  He thinks the United States will continue to be the world’s leader if we pay attention to those qualities rather than to test scores. 

On another front, Malcolm Gladwell in Outliers suggests that it is age compared to peers that might hold the key to achievement in math, sports, and leadership.  He points out that children who are older than their peers (6 to 9 months) have so much more opportunity for leadership and confidence building in the 12 years they are in elementary and high school.  Maturity matters, he argues.  The older child is often the dominant child. It’s not IQ but birthdates relative to peers that will give our children the edge.  Let’s think about this for a minute.  Children who are in the 1st grade and are seven years old when they take reading tests do better than children who are 5 ¾ years old who are also in the first grade and take the same reading test.   Hmmmmm. 

John Walsh, author of Smart Parenting, Smarter Kids tells us that it’s self-restraint and self-regulation that presages success in education and life.  To illustrate, he offers the story of the marshmallow research project:  Put your four-year-old in the room with one marshmallow on the plate. Tell them if they don’t eat it for 15 minutes then they can have two.  Those who can wait will get ahead faster and farther than those of us who go for the immediate rewards.  He argues that American parents have gotten bad at teaching self-restraint. 

What about the children in our community? 

First, I have to say how truly impressed I am with the educators and parents who are working on these problems.  Stephanie Tiechmen, Lafayette School Board President, kindly spent an hour with me explaining the ins and outs of Lafayette Schools / state finances.  Lafayette Schools Superintendent, Fred Brill  spoke to the same issues in an interview with Stacey Higgins last summer (August, 2011). 

Raoul Wertz from the Mill Valley School Board spoke to our Education Reporter Lindsay Helge.  (See full text of interview below.) Although it’s been 8 months since these interviews took place, the same strengths and problems are still in play.  

Basically, both the Lafayette and Mill Valley school districts are unhappy with the cuts but can live with them.  Lafayette just passed a parcel tax last year and had already planned for worst-case scenarios in terms of state funding next year. They are ready if in July serious budget cuts happen. 

As it stands now, the state legislature says the school districts have to provide transitional kindergartens.  Governor Brown says there will be no extra money for it, although districts may decide to let 4-year-olds in on a case-by-case basis.  One wonders if there will be any lawsuits by frustrated parents tired of dealing with this wiggle waggle. 

 At present the Transitional Kindergarten issue is stacking up this way: 

  • Orinda is not planning on offering a transitional kindergarten.
  • Lafayette is not planning on offering a transitional kindergarten.
  • Moraga is waiting until the July state budget comes out to decide.
  • Mt. Diablo, which serves our Pleasant Hill and Martinez families, is at this point a go.
  • Walnut Creek is not stating on their web site nor are they answering my calls.  Neither Buena Vista nor Parkmead is offering one.
  • Mill Valley is not offering one.  They estimated the cost of providing the program would be about $80,000 for the eighteen children who are legible. 

There are about 40,000 California children who have November birthdays who are missing the cutoff date this next year.  One wonders what will happen in the 2013/14 year when the number will rise to 80,000.  A lot will depend upon the economy and consequent state’s tax revenue.  As of right now, the battle goes on in the legislature with State Senator Simitian (San Jose) saying that school districts who are not offering it are breaking the law and the Governor saying, “We can’t pay for it.”   What’s a school board to do???? 

Democracy is sure messy. 

Next topic for this blog is on local private schools.  Stay tuned.

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Interview with Mr. Raoul Wertz, Mill Valley School Board August, 2011

At Old Firehouse School, we recognize the transition from preschool to kindergarten as one of the most pivotal moments in a child’s educational experience. As a preschool, we feel it’s important to help families bridge the connection from preschool to kindergarten.  We help our older preschoolers graduate to kindergarten with confidence, and also we want their parents to be informed. In order to gain perspective about how the Mill Valley School District is fairing, I interviewed Mr. Raoul Wertz, who is currently serving on the school board for the Mill Valley School District (MVSD). I was also fortunate to speak with Ms. Trisha Garlock, founder and Executive Director of Kiddo! about their efforts to raise funds for the arts and technology in Mill Valley’s public schools.

School Finances

Currently, districts across the state of California are facing budget cuts and simultaneously experiencing growth in their enrollment.   Enrollment growth in the Mill Valley School District has increased steadily over the past six years.  However, contrary to what many people believe, the district does not receive more money because they have more children to serve. “The MVSD is a ‘basic aid’ or ‘community-funded’ district,” said Mr. Wertz, who added, “Our revenue does not automatically grow when the student population increases. Rather, our revenue is primarily derived from local property taxes.”

For the past three years, Mill Valley’s tax revenues have been declining or plateauing.  Because of this lack of property tax growth, combined with continued state funding reductions and increased enrollment, the district has been unable to add teachers and support staff commensurate with enrollment growth. As with other California school districts, Mill Valley is fortunate to receive a small amount of federal funding.  However, Mr. Wertz points out the bind with federal money: some federal money “is considered ‘one-time’ money which makes it an impractical source for planning long-term expenses. Also, if we don’t use it by the expiration date, then we lose it.” The district has to be careful how they choose to use the federal money because they cannot ensure they will have additional funding sources once the federal aid runs out. The MVSD is fortunate to have a loyal community that continues to value education and support ballot measures to help fund its schools, but the school district’s planners do not want to commit to a program only to see the funding run out and not have a way to continue the program. 

Kindergarten in Mill Valley

The kindergarten programs in the MVSD are well-supported, with an average class size of 24 children to 1 teacher.  Each classroom is also staffed by a Kindergarten Aide, and often parent volunteers as well. The MVSD has created a strategy to integrate new kindergarteners into the elementary school setting.  As Mr. Wertz explains, “The program for the first two weeks of kindergarten is a short day. It’s a getting-to-know-you period for students, parents and teachers, as they learn the routine.” Parents may find that the shorter school day allows children to transition into kindergarten with ease and adjust to the school routine. During the start of the new school year, teachers focus on getting to know the students on an individual basis. The relationship and trust established between student and teacher in the first few weeks of school will benefit the rest of the school year. Mr. Wertz notes, “All of the teachers are keyed into each of the kids individually.” This caring, individual attention and focus on a smooth transition in the beginning of the year, is the same this year as in previous years.

Some changes are under way, however.  Many parents have heard about the changes in eligibility for kindergarten, and the addition of public “Transitional Kindergarten” (TK) programs for children who are too young or not developmentally ready to enter regular kindergarten.  Currently, many private preschools offer TK programs for children ages 4 and 5. 

With the passing of Senate Bill 1381, the state is moving the cut-off date for kindergarten back one month each year. Children had to be 5 years old before December 1, 2011 in order to enroll in kindergarten for the 2011-12 school year. By 2014, the cut-off date for kindergarten will be September 1st. The new law simultaneously requires redirecting money that would otherwise educate young kindergarteners into a “TK” program. The responsibility for running a TK will fall on the districts, at no cost to the parents. Asked how the MVSD plans to handle this change, Mr. Wertz said, “A transitional kindergarten for the Mill Valley School District is undetermined at this point. We are waiting for guidance from the Marin County Office of Education.” Parents of children who would be entering kindergarten on the young side may wish to look into a TK program offered by a private preschool until the district implements its own option. 

Kiddo! Foundation

Happily, the Mill Valley School District has an incredible fundraising organization that helps supplement the district’s budget — specifically focusing on the arts and technology. Kiddo! was founded in 1982 and has since raised over $20 million to make programs available to every child in grades K-8 in every Mill Valley public school. “Kiddo! funds, solely through parent and business contributions, art, music, dance, technology and classroom and library aides. These are the programs that the district and parents feel are an important part of education. A well-rounded education includes the arts and technology,” said Ms. Trisha Garlock, Founder and Executive Director of Kiddo!.  Assuring that every child receives a well-rounded education has driven the mission of Kiddo! from the start. “We are very lucky to live in a community that supports education to the extent that Mill Valley does, through community, parent, and business contributions,” noted Garlock.  

Parents’ Role

Mr. Wertz offered this advice about how parents and community members can help our children thrive in school: “Support young learners as much as possible and be involved in the classroom if you can.” He noted the importance of making sure children are well-rested, nourished and relaxed as they start their school day. “Parent involvement has huge benefits, especially when the kids see their parents taking an interest in their learning, their classroom and school.” Joining a committee or volunteering in the classroom is a great way to get to know your child’s school and be involved. You can never underestimate how much children benefit when their parents are actively involved in their education. 

Closing Thoughts & Resources

In conclusion, the MVSD is a community that values a well-rounded education. The district, with support from the community, is bracing itself through tough economic times by making fiscally responsible spending decisions. The Kiddo! organization continues to raise money to support the arts and technology in the schools. To new parents, Mr. Wertz would like to say, “Welcome to a dynamic community!  There is a lot going on in each of the schools across the district.  Get involved where you can contribute time and skills.” He adds, “There are lots of places to get involved and it is a great community and a great support network for students and parents.” Changes are ahead for public schools across the state of California. However, the MVSD has strong support and aid from a community that truly values education. 

For additional information and resources please visit:

http://www.mvschools.org/

http://www.mvschools.org/news/finance/BasicAidBasics.pdf

http://www.kiddo.org/

Mr. Raoul Wertz has been a Trustee of the Mill Valley School District since November 2009. He is currently serving his four-year term.

Ms. Trisha Garlock is Founder and Executive Director of Kiddo!

Dr. Rob Schechter On Vaccines

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Posted on December 1, 2010 by Dorothy

Dr. Rob Schechter is a pediatrician with the California Department of Public Health Immunization Branch.

When Dorothy asked that I blog about vaccines, I thought I would talk about recent headlines that touch on two important aspects about the decision to vaccinate, protecting your child and protecting those around you in the community, including your family and friends.

LONDON CALLING

In January 2010, the General Medical Council (GMC), which regulates English physicians, reported that Dr. Andrew Wakefield, who first suggested a (now disproven) link between the measles, mumps and rubella (MMR) vaccine and autism, had acted “dishonestly and irresponsibly” and with “callous disregard” to children in conducting his research. His actions are itemized over 55 pages of the report from the 2½ year GMC investigation: They include having had developmentally-disabled children receive spinal taps and colonoscopies without any medical need.

In response to the GMC findings, a premier medical journal formally retracted Dr. Wakefield’s original 1998 article that reported the research in question. Ten of Wakefield’s 11 co-authors had issued a partial retraction in 2004.

When speaking with the press at the time of the article’s publication in 1998, Dr. Wakefield advised against giving children the combination MMR vaccine. His ideas received extensive publicity in the British media and public, and in the ensuing fear, the proportion of British children immunized against measles fell to a low of 80% by 2004 (See bars in Table below). As a result, there are now enough people in England who are not immune to measles to permit widespread transmission. The number of people sick from measles, a potentially life-threatening disease, has dramatically increased in the UK (See trend line in Table below). In response to the spread of measles, vaccination rates have increased since 2004 but still have not regained the pre-1998 levels of over 90% that minimized the spread of disease.


2-FOR-1

This episode illustrates that vaccines can provide 2 layers of protection to you or your child. The first layer is to the person getting vaccinated. The second layer is to entire community, but only if enough people are vaccinated to limit the spread of disease to other people.

In England, the level of immunization nationwide against measles has dropped below the level of community protection with dangerous results. The same situation has occurred on a smaller scale close to home. In 2008, outbreaks of pertussis (whooping cough) in our neighbors and of measles in San Diego, resulting in children getting hospitalized, took place occurred in schools and social networks where many parents have declined to immunize their children.

When you decide to vaccinate your child, you are providing immunity to your child and to your child’s community at OFS and beyond. Likewise, high levels of vaccinations of all of those around you help to keep your child healthy. As an old hymn asks (if in a different meaning), “will the circle be unbroken?”

Dr. Robert Schechter, MD


Welcome to our first posting!

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Posted on December 14, 2010 by Dorothy

I chose a discussion of childhood vaccinations for our debut not only because vaccination is a vital contemporary issue worldwide, but because it is a significant one for me personally.

My business, and my life’s work, are based on caring for our community’s babies and small children. Being the owner of three preschools brings with it a tendency toward macro-level concern for public health, and has raised strong feelings in me about vaccination.

As part of my preparation for addressing this topic, I interviewed local pediatricians and read the new book by Michael Specter titled Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives. The author’s premise is that the validity of the scientific method, and decision-making based on its results, is falling out of popular favor, leading larger and larger groups of Americans to make fear-based decisions fueled by anecdotal or emotional input, rather than evidence-based decisions based on statistical probabilities and reliable scientific data.

Specter, a staff writer for The New Yorker, explores in depth three American examples; one of these is the vaccine controversy. He observes with dismay that parents are increasingly swayed more by one compelling individual story linking vaccine to neurological injury, than by a comparison of the likelihood of contracting a vaccine-preventable disease to the likelihood of vaccine injury.

Specter’s point really spoke to me. I have listened carefully to the worries of our parents about the possible vaccine-Autism link, and other concerns that they share about vaccine injury. While I understand these fears, I confess to being mystified at the decision to give less weight to polio, rubella deformity, meningitis, or the horrible death that can be caused by whooping cough, than to the very small and probably disproven possibility that vaccines might cause Autism. Even if a cause-and-effect relationship could be confirmed between the two, the numbers still overwhelmingly favor vaccination.

As a parent myself, I chose and would again to vaccinate on schedule. However, I genuinely support a parent’s right not to. I know that many parents truly agonize over vaccine decisions, and are left with some degree of discomfort regardless of what they choose. We must make the best decisions we can based on what is right for our child and our family. In the end, only each child’s parents can make this call.

However, the discussion becomes even more complex when we factor in the health of our community as a whole. Pediatricians agree that the time of greatest vulnerability to disease for an American child is approximately 9-15 months – after many finish breastfeeding, but before completion of the recommended vaccination schedule. Of course, beginning care at a preschool often also roughly corresponds to the end of breastfeeding, that powerful immune system ally.

Babies in this age-range who enter Old Firehouse School, along with the mothers pregnant with siblings of our children, are the members of our community most vulnerable to the fatal illnesses we have worked so hard to eradicate through vaccination. Preschoolers whose parents have chosen to avoid or delay vaccination are the population most likely to be carriers of these very illnesses.

As the person at whose desk the buck stops, I worry about the dangerous combination I am unwillingly allowing in our preschools. Mixing these populations in close quarters is bad public health policy, yet Old Firehouse School is legally required to do exactly that; if I turn away children whose families have chosen not to vaccinate them, or to delay vaccination, we will lose our childcare license. I can’t help but feel a mixture of worry and a sense of grave responsibility when I think about the unprotected kids we care for, and the little babies so close by.

An extremely troubling illustration is the current epidemic of whooping cough in California; we even had a case of this disease at one of our schools. Writing for The San Diego Union-Tribune, Janet Lavelle states that as of September 22, 2010, “Statewide, there have been 4,017 confirmed cases so far this year, including nine deaths. All of the deaths were infants under 3 months of age…” PKids.org has addressed the epidemic in this video:

Here on our website you’ll find videos of me discussing these issues with several of the most experienced and well-respected pediatricians in our communities. I hope that hearing their thoughts and the information they have to offer on this difficult subject will make these tough choices easier for some of our parents.

Dorothy Stewart, Ed.D.
Executive Director and Founder Old Firehouse School

Finding the Right Pediatrician

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One of the first steps toward caring for the new child we are bringing into the world is choosing our baby’s doctor. These days, this decision can feel a little bit daunting. Whereas best practices were once highly standardized across obstetrics and pediatrics and doctors simply delivered decisions to compliant parents, there is now a great deal of discussion — and disagreement — about birthing practices, sleeping habits, vaccinations, medications, and other controversial topics. It is perhaps both a blessing and a curse that parents now expect themselves to be knowledgeable partners in their children’s care, and to choose practitioners who share their childrearing values.

When I was pregnant, I made appointments for informational visits with two prospective pediatricians. Afterward, I was at a bit of a loss to choose one, because truthfully I found both of them quite intimidating. I ended up choosing the doctor to whom most of my friends were going, although I hadn’t felt much rapport with him.

When my daughter was born, her new pediatrician’s practice sent a doctor over to visit her, but it was not the doctor I had chosen — he was not on call that day.  

We took our daughter home from the hospital and our little darling slept peacefully on and off for three days.  On the fourth day she woke up screaming.  To my new-mom’s ears, no infant had ever screamed with this much urgency. In a panic, I looked up the number for her pediatrician (who had still never met her) and called his practice.

The phone was answered by an icy receptionist to whom I explained that my baby wouldn’t stop screaming. A few moments later, the pediatrician came on the line. Apparently his first order of business was my emotional state.

He chided, “Calm down, calm down! Now what’s the baby’s name?”

I froze. “Wait a minute,” I said, “and I’ll think of it.”

The doctor laughed, “Call me back when you remember who your baby is.” And he meant it, because he then said goodbye and hung up.

In retrospect the anecdote is funny, but our doctor’s condescension was not what I needed at the time. And it proved to be typical of our interactions. Too often, I felt foolish for asking questions or sharing my concerns.  Luckily, our daughter’s health issues were few and far between so that I didn’t need to interact with her doctor very often.

As it turned out, our pediatrician’s bedside manner was none too successful with my daughter, either. Around the time she turned four, she said she didn’t like him and wanted a new doctor.  Specifically, she said she wanted a “girl doctor.” I suspect that preference was simply how she was able to articulate her lack of “connection” to her current pediatrician. Her feelings, combined with mine, finally motivated me to action, and I found a wonderful female doctor whom both my daughter and I could relate to.  

We are fortunate in the Bay Area to have so many wonderful and aware pediatricians to choose from. You, too, will find one who feels like a good fit for you and for your child.

Based on my own experience as a mom and on my professional life working with so many OFS families over the years, I’ve put together a brief guide to choosing your child’s pediatrician. I hope you find it helpful.

We have also included here an interview with Dr. Drew Nash, an East Bay pediatrician who has recently launched a concierge practice for local families. In this interview, he offers some great pointers for finding a pediatrician, and he also discusses how to develop and maintain a good relationship with your children’s doctor.

Ten Steps for Finding a Good Pediatrician

Step One:  Begin early.
A good rule of thumb is to begin your search for a pediatrician in the seventh or eighth month of pregnancy. (If you will be moving and currently have a pediatrician you like, ask him or her for a personal referral, or for any leads about where to start looking in your new community. Also let your current pediatric office know ahead of time that you will be needing to transfer your child’s medical records.)

Step Two:  Check with your insurance company.
Most health insurance companies publish comprehensive lists of “providers” who participate in your particular plan. (You will also want to know which hospitals in your area are plan participants or are covered in case of an emergency, and exactly what services are covered at what cost.)

Step Three:  Ask for referrals.
Ask family and friends about their pediatricians. Listen particularly closely to those who have had to deal with chronic health issues. They will have a good sense of how their pediatricians work with families during trying times. Childcare centers are also good places to ask about local pediatricians; after caring for hundreds of local children, we often know with whom our families are most happy. Your own doctors, particularly your obstetrician, may also be good sources of recommendations.

Cross-reference as many recommendations as possible with the list of covered providers from your insurance company. Identify at least four potential practitioners whom you would like to consider. This is your short list.

Step Four:  Make a telephone inquiry.
Call the offices of the doctors on your short list and ask:

  • How many pediatricians are in this practice?
  • Is (potential doctor) taking new patients?
  • Does (potential doctor) do informational interviews, and if so, what does your practice charge for them?

Step Five: Consider logistics: travel and parking.
On your way to the appointment, note the travel time. Project how commute traffic might affect getting to the office when you’re in a hurry. Is parking easy to find and close to the entrance? Imagine taking a sick child with you on this trip — is it doable?

Step Six: Waiting room reconnaissance.
Notice whether the waiting room is crowded. Try to get a sense of how long the wait is. Is the waiting room clean and cheerful? Does it have interesting things for children to play with?  Is there a separate room for ill children who may be contagious? Strike up conversations with other parents and ask them about the pediatrician you’re interested in.

Step Seven:  The interview.
Make a list of questions to take with you. It's important that you find a doctor whose medical approach is consistent with your own values.

Medical Philosophy
Here are some possible topics you may want to discuss:

  • breast feeding
  • the family bed
  • age of entrance into child care
  • circumcision
  • stem cell collection
  • vaccinations
  • allergies
  • how and when antibiotics should be used
  • philosophy on discipline
  • potty training
  • the doctor’s knowledge of any specific conditions or allergies in your family

Logistical Issues
You may want to ask the pediatrician or office staff about:

  • billing
  • scheduling
  • house calls
  • same-day or drop-in appointments for sick children
  • how sick-child care is handled after hours
  • how insurance co-payments are made
  • when phone calls are returned
  • who will see your child if your pediatrician is not on duty

Step Eight: How is the chemistry?
After your informational interview, take a minute to check in with yourself. How do you feel about this doctor? Listen to your intuition; observe your comfort level. Did you feel that the doctor had time for you or did you feel rushed?  Do you feel that you could communicate well with each other? Did you feel respected, and that your concerns would be taken seriously?

Step Nine: Do a background check.
It’s a good idea to do a basic background check on your prospective pediatricians. First, you will want to make sure that you choose a pediatrician who is board-certified. In addition, if any doctor has had disciplinary action taken against him or her, there will be a report on file with the Federation of State Medical Boards. You can visit the federation’s website at www.docinfo.org or call them at (817) 868-4000 to inquire about the pediatricians you are considering.

Step Ten:  Change if you need to.
Keep in mind that nothing is irreversible. If it turns out later that the pediatrician you picked isn't quite working out, simply find a new one and move on. That's all!


Care to recommend or share some positive information about your pediatrician? No complaints or negative comments, please!