Tick box culture and our children… a rant!


Little Mr standing

I’ve been trying to rearrange Little Mr’s 12 month health check with our health visitor team for a few months now. He was originally invited for an appointment on a Wednesday when I work all day so rang them to rearrange and they cancelled the appointment and said they would rearrange for a Friday. Another letter comes through the post for another Wednesday appointment. Repeat the phone call and again, another letter comes through the post for a Wednesday. Head. Wall.

Giving up on ever getting a Friday appointment, earlier this week with hubby being off enjoying the school holidays, I asked him to take Little Mr to our local baby clinic to get him weighed and to take along the appointment letter and questionnaire they asked us to complete on Little Mr’s development.

The questionnaire was aimed at the development of a 14 month old baby and asked questions in relation to his motor skills, his speech and other general development. I had to answer the questions with either Yes, No or Sometimes. At the end of the questionnaire, there’s a tally box where the health visitor would add up the number of yes, no or sometimes answers and Little Mr would have his 14 month old score and then she would discuss his development with us. Completely wrong in my opinion.

Little Mr isn’t walking yet. He’s standing up, cruising and crawling everywhere but will not walk independently. I don’t have a problem with it at all as I’m a big believer that he’ll do it when he’s ready but the health visitor was concerned. She told hubby that he had a slight delay in his gross motor skills and wrote in his red book that she would make a referral to the health visiting team to check on him in 6 weeks time. This is the same health visiting team that said they would check on him back in November to check his progress with crawling. They never rang. So I don’t have a huge amount of confidence in their opinion on my son’s development, that they took from a questionnaire. This is the same health visiting team who told me to make an effort in taking Little Mr to baby clinic 10 days after my c-section, despite being unable to walk the 2 mile to baby clinic in the snow with an infected section scar.

Wouldn’t it have been better to sit with him for twenty minutes and let him play. Watch how he moves around and stands up and plays with the toys rather than me ticking the boxes of a questionnaire. What if I was one of those parents that ticked yes to everything when in fact he didn’t do any of it. They wouldn’t know any different. I know different health authorities check little ones progress in different ways as friends with children of the same age have had different experiences. My experience doesn’t fill me with any confidence that I would want their opinion on any concerns I may have in the future.

As I said before I’m not concerned with Little Mr’s inability to walk independently. He’s showing signs that he wants to and cruises around the house, often standing independently for brief moments before collapsing onto his bottom. Isn’t a questionnaire a cop out for watching and spending time with children? I dread to think what would happen to the children that really have issues but go unnoticed due to parents that don’t want to make a fuss or in the worse case, don’t give a hoot anyway!

What’s your experience of your health visitors? Do you find them useful or just irritating?

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  • Reply Amanda Walsh 18/04/2014 at 11:52 am

    I have no time for health visitors what so ever! You cant ‘grade’ a child in a tick box. Each and every child is different and will do things in their own time. Why should we have to push them to do things just so they can fit a tick box! My eldest walked at 10 months but Dayton didnt walk until he was 16 months, like you I wasn’t worried. Our health visitor wanted to refer him to, I told her not to bother! As long as your happy with his development thats all that matters, mothers know best not text books!

  • Reply Emma T 18/04/2014 at 1:24 pm

    Our first health visitor post birth was brilliant. Really supportive but knew who needed/wanted help and when, but would fit you in if needed (despite her clinic being at a surgery 20 mins drive away – no idea how that works and why our surgery is linked to that one). Our 12m review, she came to us, watched N play etc, as you would expect.

    But got to 2 year check and we had the same as you. New questionnaires came in, they were new just as he turned 2 and had his check, so HV had only just known about them. Our HV had left, and the new one wasn’t starting until the day after our appt. Like you, I worked, so just wanted the appointment rather than struggling to find another later date, plus I didn’t know this until we turned up. It was held at our surgery where there is no HV office so it was in a normal GP office, no toys in the surgery, no nothing suitable for him to play with and relax with. It was done by a manager from Oxford, and she basically checked the list that I’d done, asked me if I was worried about anything. No, as he’s always done everything text book (apart from not being interested in potty training, but she wasn’t worried about that at 2). Spent 10 minutes trying to get him to stand up in place to check height and then weight – he refused. She didn’t interact with him at all, so had no idea about him.

    She then totted up the scores wrong, so had to ring me later to get them corrected in case anyone followed up because she’d scored him as a problem on every development area.

    Friends of ours had a mix of similar – just tick boxing, others had group play sessions where HV just observed and interacted, others had 121 in home. Ridiculously inconsistent, but the questionnaires are rubbish as based on what a parent says.

    For N, the HV missed a mild tongue tie – really should have been picked up at birth, but had no symptoms other than not breastfeeding and dribbling lots until he was speaking, then clarity was initially more of an issue than it should have been. Really should have been picked up at the 2 year check, but there’s no way she could have known as I had no idea either. Luckily our nursery’s on the ball, and all’s ok…but even with that, we had to go via GP as we couldn’t get a HV appt for 6 weeks. I don’t even know the name of the new one.

  • Reply Jen Suburban Mum 18/04/2014 at 1:57 pm

    I found their questionnaires highly irritating when M was that age. He didn’t walk till 15 months – having crawled at 9 months. I knew he was perfectly OK – he was quite happy cruising round holding on to the ridiculous amount of furniture we had in our tiny front room at the time. He didn’t talk till he was just over 2 years either, which again they said was “concerning” but although I worried about it initially, I spoke to other mums and family and friends and everyone assured me he was absolutely fine.

    It’s the same with the Edinburgh Scale they got me to do when he was first born. Yes, I knew I was depressed but I was intelligent enough to know what answers would mean alarm bells and what wouldn’t. The first time I filled it in I deliberately made out I was fine. Then a few months down the line I actually asked to complete it again, knowing by that stage I needed some help, so of course I ticked all the “right” answers and got myself some help.

    I think if you have questions or just need support then the Health Visitors are a great service to have available. But unless as you say they sit down and interact with the child I don’t see how tick sheets can ever give them a good picture of a child’s development!

  • Reply Claire toplis 18/04/2014 at 2:39 pm

    Health visitors annoy me they couldnt see y son wasnt talking .
    It took 3 1/2 years till he talked only with me pushing

  • Reply Donna 18/04/2014 at 4:07 pm

    Eugh. I could have written this.

    Our health visitors have been useless – Telling me that LP couldn’t have strawberries before she was 1 because they were citrus fruit is a prime example. I only took her to be weighed when I thought I had to – When we were changing car seats really, other than that I avoided health visitors as much as I could. We didn’t get sent a letter or appointment when LP turned a year and so I didn’t bother to take her.

    When LP was 14 months old she broke her leg. It was awful. Social services involved and everything. Worst time of my life. AT this point the health visitors decided to ring to check up on us and to see how LP’s walking was coming along! She’s just broken her leg , obviously her walking wasn’t going that well! She ended up not walking until 18 months but I wasn’t worried at all.

    When it came to her 2 year check we again didn’t receive a letter or anything but friends had questionnaires saying that a 2 year old should know a certain number of words. LP didn’t know that many words but I had faith that she’d develop in her own time and now at 2 and a half she chats away constantly.

    I hate tick box exercises and pigeon holing children. They’re not all the same!!! x

  • Reply Me_andthe_tiny3 18/04/2014 at 4:21 pm

    All our development checks have been done at home with the HV playing with the kids, a questionnaire seems so impersonal and as if they can’t be bothered, and that’s not good at all!

  • Reply Rh1annonb 18/04/2014 at 4:24 pm

    My twins have recently had their 10 month developmental check which was done with us at home so they could be seen in their own environment. Neither are crawling so scored low on gross motor but high on everything else and no issues were raised. A tick box is not a true reflection of a child & is so subjective. More observation & discussion is needed. That’s the first time I’ve seen a HV since the 6 week check despite being a first time mum to twins x

  • Reply Kate @ Family Fever 19/04/2014 at 10:43 am

    Don’t get me started…..
    I have lost all faith in health visitors after one wrote ‘Failure to thrive’ in big red letters over Max’s growth chart. This was after me explaining to her that he was premature, breastfed baby with reflux. Previously the midwives and paeds had been adapting his chart to take this into consideration, and he was slowly creeping along the growth line. This health visitor took NO notice of what I said and instead decided he was losing weight and I was failing to nourish him. She actually advised me to give him formula before he ‘became unwell’. I politely told her to f**k off.

    You are so right though – you have NO reason to be concerned. Your little man is just perfect and doing everything he should be. I can’t imagine any child ever ticking every stupid little box on their charts? They are ALL DIFFERENT! The sooner they understand that the better!

    Sorry, rant over ;)

  • Reply @unpreparedmum 19/04/2014 at 4:43 pm

    Argh your post is so frustrating it makes me want to scream, I don’t want to be negative because I haven’t had much interaction, but I base my negativity on:
    (a) when our HV came to visit she pointed at my husband (who was stood right next to me) and asked if I suffered any domestic violence…because of course if I had I would feel ok about saying in front of him…presumably!!!
    (b) my baby was initially not feeding and we had midwife visits every day for first 5 days (his weight was absolutely fine, lost only 7% of birth weight – massive overreaction) but as feeding was still an issue I was told to go at 2 weeks and have him weighed again at the clinic to be on the safe side…at that weigh in I was told I was having him weighed too much!
    (c) After taking my baby to A&E with a head injury following a fall from our bed, the follow up from the HV was a 30 second call saying essentially don’t put him on the bed…had she read anything written by the Dr at hospital she would have realised that I was aware not to put him on a bed, I was not looking after him when he fell, and I had already had advice…if she were actually worried about my child’s care she should have come and seen us rather then essentially telling me in a call that she didn’t have time to do a proper check and I was pretty much wasting her time.

    Fortunately (or not…) our local area don’t do 1 year check ups so I will not have the delight of being told that my baby (who also is not walking) is not reaching his milestones as per the tick box…

  • Reply Stacey Guilliatt 29/05/2014 at 10:49 pm

    We didn’t have to fill in a questionnaire for either his 1 year or 2 year check. The HV watched him playing etc. and took it from that. We’ve had quite a good experience with ours, but I’ve heard lots of people have bad ones x

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