When parents have questions of this kind, it is always worthwhile to have a second opinion from a health care expert in the same area of specialty. Your son has been operated on and is being cared for by an orthopedic surgeon, has had casting and worn braces, has worn prescribed night shoes, and is receiving physical therapy from a physical therapist.

Below is an ideal process to get your concerns addressed. I hope you will be able to do this. Unfortunately, your health insurance may not be willing to pay the costs involved; you may have to pay.

Talk with your child's primary care physician, his pediatrician, or family practice physician about your concerns. Ask the pediatrician to convene a meeting (perhaps using a conference telephone call arrangement) that includes you and your husband, your son's pediatrician, the orthopedic surgeon, and the physical therapist.

At this meeting, explain your disappointments or frustrations with the results of your son's treatments. Remind them that going through two surgical procedures in his young life has not been easy for him or for his parents and that now, you want to be sure that your expectations and his are appropriate. Then, you have several specific questions to ask. You may want to tape record the meeting because most of us are likely to forget details, which may be important. Are the results thus far as good as they could be? If they are, what can you expect in the coming months and years? Are the special shoes properly designed, do they need to be adjusted for your child's growth? Is the amount of physical therapy (number of times/week) sufficient? What can parents do to help the treatment process?

From the child development perspective, I would also want to know if your son is making progress with getting around the neighborhood and making friends? Is he able to participate in preschool programs?

In this context, you have the right to request a second opinion from another team of similar health care experts -- an orthopedic surgeon and a pediatric physical therapist. You may also want to suggest that a pediatric physiatrist also be involved. Physiatrists sometimes have a different perspective from their colleagues in orthopedic surgery.

Finally, my experience with Shriners' hospitals and their staff members has been excellent. I believe they would be open to a second opinion and to working with you to determine if anything further needs to be addressed.

As a clinical psychologist and not a physician, I want to suggest the importance of attending to your young child's psychosocial needs. When a child has a physical disability like your son, it is understandable for parents to focus on the child's physical disability -- sometimes, a child's other needs also require attention.

I wish you the best.

Stanley D. Klein, Ph.D.
Licensed Clinical Psychologist