Dear Savvy Auntie,

My nephew is a very good kid, for the most part. He's a bit hyper and a bit out of control at times, but that's what kids are and that's cool.

Our nephew was a late talker and when he finally did begin speaking, my wife - who is a speech pathologist - noticed that he was forming his words oddly. She mentioned it to her brother and sister-in-law, who agreed to seek help through their state-sponsored early intervention program.

When the early intervention period ended, they stopped treatment. At times, our nephew is barely intelligible. My wife has asked them to seek further treatment, but they seem unwilling to do so if they have to pay out-of-pocket (they have a decent family income and have good health insurance).

More recently, my wife noticed facial ticks and other habits consistent with Tourette's Syndrome and again mentioned it to her brother, who told us that the family doctor told him and his wife to "ignore it and it'll go away."

The problem, of course, is that if he does have Tourette's or some other neurological disorder, ignoring it won't make it go away and abstaining from treatment for too long is only going to hurt. They seem much happier to get the "nothing is wrong" whispered in their ear and just pretend that all is fine and there's no concern.

My wife is very upset and I get angry because I see this kid whose parents are more interested (it seems) in not hearing their kid isn't perfect than getting him the treatment he should be getting. They won't even get a second opinion.

How are an aunt and uncle supposed to handle this? Mind you, I'm not an expert, but my wife is, and we're not just some random hypochondriacs who read something on WebMD and assumed he had what we read.

Concerned Savvy Uncle

Dear Concerned Savvy Uncle,

It is wonderful to hear from a concerned, caring, and well-informed uncle - I salute you!

You don’t give your nephew’s age, but I assume he is in some school program, since early intervention has finished. Since your in-laws are in denial and avoidance mode and you are so correct that the earlier he is diagnosed and treated the better the outcome; I suggest an “end around.”

Connect with his school through various activities: volunteer at bake sales, visit his classroom and read to his classmates, or cook with them, minimally; pick him up at the end of the day. In other words, start to build a relationship with his teacher, principal or, most preferable, the school psychologist. These professionals should have their concerns about his speech and if they suggest an evaluation to his parents, they will probably be able to accept it better than coming from you and your wife.

If you bridle at the “sneaky” approach, I understand. However, I am a passionate child advocate who believes that all children should be evaluated annually for all abilities - not just physical, but emotional, gross and fine motor skills, social and certainly speech and language skills.

If your in-laws “see the light,” I would be glad to offer names of qualified testing professionals.

My best wishes,
Natalie Robinson Garfield ,

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