Altonaga, Myra Villacarlos (Developmental Pediatrician)

While I do not disagree with her recommendations on how to engage with and support my son’s development, what I found deeply unsettling were the remarks that felt less like guidance and more like judgment directed at me as a mother. Receiving an official diagnosis is already emotionally heavy; being met with implications of parental fault only compounds that burden. I may not be a doctor, but it is evidence-based that autism is a neurodevelopmental condition with a strong genetic basis. Current evidence does not support the idea that parenting style, maternal availability, or parental choices cause autism or speech delay. I did not appreciate assumptions that my son’s challenges might stem from me being “too busy,” despite the fact that I am a stay-at-home parent, nor the unnecessary personal remarks questioning why I had just recently decided to pursue further studies—especially when that decision was rooted in the practical need to help sustain my family. To suggest that this automatically equates to having "even lesser time" or "zero time" for my child disregards the reality of intentional, engaged parenting. When I tried to explain that this was not the case—that I do not compromise my son’s time and that I am the one who is mostly with him—she persisted, asking in a doubtful tone, “You’re with him ALL day?” I responded firmly, “Yes," without needing to expound on the fact that my classes for such further studies are held at night, when he is already winding down for bed, if not already asleep. I did not have the energy to say more. Equally disheartening was the implication that his speech delay could be due to the way I speak to him—suggesting I might be “too structured”—as if I have not spent countless hours researching, learning, and deliberately coordinating with his occupational and speech therapists to apply evidence-based strategies at home. It is all documented in his patient file. What these remarks conveyed felt less like empathy and more like blame. And I don't know why there was so much of that. As a developmental pediatrician, I expected sensitivity and partnership with parents would be foundational—especially at such a vulnerable moment for families. And as a FEMALE developmental pediatrician, I had hoped for a more nuanced understanding of how often the responsibility for a child’s development is unfairly placed solely on mothers. My husband was present throughout the entire consultation, yet every implied shortcoming was directed at me alone (schedule, speaking manner, etc.) and every responsibility (sacrifice more, manage your time more, "overtime") was addressed to me alone. This is particularly painful given that I am the person who has consistently observed, studied, and sought to understand and advocate for my child long before seeking professional help and while everyone else shrugged it off as simple delays. Like many parents in this position, I am doing my best—thoughtfully, intentionally, and with love. What parents need in these moments is support and respect, not assumptions of neglect. I have met with her twice—once during my son’s initial assessment and again at his recent follow-up. On both occasions, she made remarks that I felt were unnecessary and better left unsaid. Recommendations and guidance on how to support my child can be given without making assumptions or scrutinizing aspects of my personal life that are irrelevant to his care. She also did not need to say things such as, "Nah! Wa paka na tagam, mommy." or (non-verbatim) "Ngano paka ni skwela ana? Ako di ko ganahan ana.", "Samot nagyud ka wala'y time sa imong anak." All assumptions. After sharing these experiences with family and fellow mothers, they agreed that her comments were out of line and reflective of an outdated mindset. More importantly, they felt that she should reconsider how she approaches parents, as careless words—especially in such a sensitive context—can leave a lasting and bitter impression. Again, I appreciate her suggestions for my child's development, but we will not be returning.