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The Comprehensive Caregiving of Dr. Audrey Griesbach

Regular listeners know that Jason and I usually talk with caregivers and siblings of children and young adults with disabilities, but every now and then we also like to pick the brains of or highlight those people who support us in the care of our children. Dr. Audrey Griesbach is a developmental pediatrician in the Los Angeles area whose practice is devoted entirely to the comprehensive evaluation and treatment of children with a wide variety of neuro-developmental disorders, including autism, cerebral palsy, genetic disorders, developmental and cognitive delays, learning disabilities, and ADHD and other behavioral disorders.

We learned today that Dr. Griesbach has been involved with providing services for the follow-up of high risk infants in area hospitals and has served as a clinic physician for California Children's Services in their medical treatment units in the school setting. Dr. Griesbach has served on the board of Westview School for children with learning and emotional challenges and was a founding board member of the WISH Charter Elementary School which provides inclusive educational opportunities for children with disabilities.

Dr. Griesbach and her two associates, Dr. Batra and Dr. Mandelberg, evaluate children who have "some glitches in their development, whether major or minor." They actually get "down and dirty and work with them and test them and get to know them, not just take a history, not just look at somebody else's testing." The developmental pediatricians can thus get a feel for what's really going on with that child and whether they are anxious and resistant to doing the work or whether they have motor problems that are interfering with their ability to sit in their chair. They look at the individuals from a very comprehensive perspective, including their medical situation.

"The other thing that we do is that we are very engaged in connecting with the people already working with that child. So the teachers, the occupational therapists, the speech therapists, the educational therapists and so on -- we can really develop a good concept of what that child's strengths and challenges are," Dr. Griesbach added.

Sigh (from me). An angel playing a harp (heard by Jason)

After hearing about all the things the developmental pediatrician handles, I confessed to feeling envious that we never had access to a developmental pediatrician, but Dr. Griesbach revealed that there is a shortage of the specialists for a variety of reasons, including the way pediatricians are taught in medical schools and how they are reimbursed. Developmental pediatricians spend hours on their patients, but insurance companies often don't cover their services. When they do, reimbursement rates are very low. We spoke about empowering families to explore services offered by their school systems and regional centers, but I admit to feeling discouraged that disadvantaged families would not have the resources to get this kind of comprehensive help their children deserve and need.

In today's podcast, we also asked the doctor whether there was an increase in the numbers of children with diagnosed developmental disabilities and what her thoughts were on the causes. She asserted that it was a very complex issue and causes could be from a number of things, including higher demands placed on children in early education when they are not developmentally ready, technology and screen time usurping the activities of old -- cutting with scissors, playing with tools, coloring, crafting -- in addition to environmental factors like plastics which are endocrine disrupters. Dr. Griesbach had strong words about limiting children's screen time or restricting it completely. We had a lively discussion about "screen time" and technology and noted how powerful and life-changing technology has been in the disability community.

"We have both sides of the coin here -- the tremendous value and yet the tremendous impediment that it poses -- not only the impact on the brain but the loss of engagement in other activities that are so important developmentally," stated Dr. Griesbach.


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