4 days working in Hoan My Cuu Long Hospital (Behn Vien Hoan My)’s Developmental Diagnostic Clinic

I met Can Tho pediatrician, Dr. Quyen Lam, around 10 years ago through the then-pediatric rehab department head at Can Tho Children’s Hospital. Dr. Quyen has two neurodiverse young adult children herself, and was running a diagnostic/intervention/family support system program out of her home at the time. Since then, she has held pediatric positions at Can Tho General Hospital and is currently at a smaller hospital in Can Tho, Hoan My Cuu Long Hospital. 

Hoan My Cuu Long Hospital seems like a bit of an experiment— it is a private hospital, which is not the norm (couldn’t quite get to the bottom of where $ came from for its construction and ongoing operations). In this hospital, families pay full-price for services. It is well-kitted out and has updated technology. However, most of the hospital was not busy. Dr. Quyen mentioned that they have not yet established ongoing speech therapy services, nor did they have any pediatric rehab therapists, despite having a designated area (see photo below :) ).  

This hospital was interested in Dr. Quyen’s connection to me as an opportunity to bring families in for diagnostic services, and then decide what intervention services they should begin to offer. One of the department heads introduced me in my lecture as “someone that can help the hospital serve its customers,” which will sound familiar to folks who are familiar with health care in the US 😖 . Despite the hospital not being busy typically, it was a busy 4 days for us in the (newly-operational) developmental diagnostic clinic. Dr. Quyen and I did 10-12 diagnostic evaluations and family feedback sessions each day. I also gave a lecture to the department’s pediatricians about Early Indicators of Autism. 

Here are photos and more photos! I have permission from the hospital and from these families to share with you all-

Dr. Quyen, in black. Dr. Pham on the other side of me.
Two pediatric nurses that were our child wranglers and schedulers behind us. 

Posters advertising consultations with me for “children under 3” were in a lot of places in the hospital, which was more than slightly embarrassing. The children that I worked with were actually “under 15.” 

Do I look like I had just wrestled with toddlers all morning and then gave a professional lecture immediately afterward? I’d say yes.

I love being reminded how similar these appointments are to what I do every day at home. Similar toys, similar diagnostic activities, similar parent questions, and similar child presentations. The biggest differences, that make this project the most difficult, are big gaps in what kind of resources exist for any child in need of additional support and perspectives on disability and developmental differences. There are also differences from an American majority culture's expectation that children and parents will play together and that play is a way that children learn. Dr. Quyen has an enormous task in helping parents move from hearing a diagnosis, to understanding a diagnosis, and then figuring out what to do next. 

This child constructed this great way for the cars to go down the track along the xylophone, make music, then go down the track and land in the basket. His mother explained that he also understands how to take a selfie— this is him posing for a selfie with his mom’s phone. 

Dr. Quyen had requested some Time Timers (IYKYK) for her work with kids, and I brought her a range of sizes and colors. They were very appreciated!

This is my modified documentation/feedback planning sheet that Dr. Quyen and I completed together after each assessment. Then she used this information to talk with the child’s parents. She is knowledgeable about autism characteristics and she and I always agreed on our diagnosis (autism, language delay, cognitive impairment, etc.). She was less familiar with a more standardized way to organize observations, compare a child’s performance against criteria, and how to share diagnostic information in an affirming and family-friendly way.
We were a good team, as always!

One child was feeling impatient as we talked with his parents. His parents mentioned that he liked to draw, so I gave him a pencil and paper. He doesn't use his voice to speak very often, but pulled my hand to direct me to look at his drawing:

He first drew a frog, and when I nodded and said, "Wow!!!", he drew the life cycle of a frog! From tadpole to frog. What a guy! It was a great opportunity to talk to his mother about how he shows what he understands and what he knows in different ways, and how they can support him. 

                                   

Lastly, here are some videos of kids and parents in action.

We met with a parent and her child and talked about how her child had a lot of difficulty participating in back-and-forth interactions and play. He has an older sister that he likes to be near, so we discussed some ideas for how his older sister could be a good play and interaction partner with him. We were not sure how well his mother received these suggestions, but later that evening, she sent Dr. Quyen these videos of how the siblings started to play together after she shared some of the ideas with her daughter. It was great to see! As a bossy older sister, I appreciate another bossy older sister! :) 

Here is a parent who has attended some local parent trainings for supporting communication with your autistic child. 

Dr. Quyen and I worked 4 10+ hour days together. We were sustained by the delicious hospital food (honestly, the vegetarian hospital food is amazing). Here's proof:

Next up, wrapping up in Can Tho and heading to Ho Chi Minh City, where I will be doing clinical teaching with speech therapists at the Pediatric Hospital #1!