can a pa-c diagnos Neuro issues??

We have a 4 YO grandson we are very concerned about. He is years behind on speech and overall development. Our concerns are that a PA-C had made a diagnosis of  speech delay disphagia/asphagia and speech language delay . - Our first question is a Pa-C qualified ? Secondly his Pa-C has prescribed a medication before bedtime that sedates him becasue he throws a fit at home. The major concern is that when he is with us and his other grandparents he behaves well in fact quite well.  His mother now says that this diagnosis is a disability which we do not understand he seems to learn quickly for us in the limited time we had with him- at age 3 I spent less than five mins on the floor showing him how to construct a tower with building blocks and then sat back and watched him construct towers that a five year old would have difficulty with.  I feel the PCP and pa-c  are really missing the boat and feel so bad for the child but dont know what to do- Any help would be appreciated- My personal opinion ( not really qualified in any way ) is that he just needs taught- another thing is that he is going to speech class once a week and the parents say they have NO homework- when i was 5 YO I had trouble with certain letters and my mother was instructed to spend at least 30 min every day wuth me on homework ( I remember that vividly )  Very confused.  What should we do???/

[William L. Holcomb, Ph.D., BCBA-D]

First, I think that the question of whether your health care professional is qualified to diagnose a particular condition is dependent upon their training, experience, and the local standards and regulations regarding diagnosis (but I would be most interested in the first two factors).  Second, it is always a difficult situation when a person has a concern about a child’s development, and the parent of that child doesn’t agree with what you are saying.  This isn’t any easier when it is a family member and therefore may be even more emotionally charged.  In your case, you clearly disagree with what the family’s PA - C is saying.  Perhaps you could find a way to calmly discuss your concerns regarding the diagnosis and suggesting that they see a specialist.  In your grandson’s case, I suggest starting with a qualified speech and language pathologist.  Alternatively, perhaps there is a mutual friend or, another family member who can speak with your grandson’s parents.  

Recently I posted a reply to a somewhat similar question (i.e., a big part of the question concerned delayed speech) and I found a website (below) at the National Institutes of Health that has a section on typical speech and language development.  It includes checklists that help you determine if your child is “on track” with communication development.  This information might be helpful in checking on your grandson’s progress and recommended treatments.  

http://www.nidcd.nih.gov/health/voice/speechandlanguage.html#mychild


As far as the behavioral problems are concerned, is your grandson being seen by a behavior analyst or other professional to help him and his parents manage the problems behaviors you describe?  Is your grandson enrolled in a local preschool program? In the USA, at age three and above children with any diagnosed special needs are entitled to at least an assessment and possibly services by their local educational authority (usually your local city or town school).  
For additional information about behavioral approaches to managing and teaching children with special needs, I have included the website address for the Cambridge Center for Behavioral Studies.  I think you may find information on behavior analytic approaches to behavior problems helpful (bedtime issues are common, often exasperating for parents, and very treatable).  
http://www.behavior.org/