Dear Amy: I am a physician and live far away from my family. My niece has a 3-year-old daughter. Between distance and COVID, I have seen my grand-niece only rarely.

About six months ago, while I was visiting, my family united at my sister's house. Our cousin is a speech pathologist and is familiar with signs of autism. She recognized specific signs in my grand-niece.

My family debated whether we should bring this up with my niece, and ultimately her mother (my sister), told her about our concerns. It did not go well. It was viewed as an invasion of privacy and as ill-intentioned negativity.

Since then, we've learned that the child is in speech therapy (with a very young therapist we fear might not have enough experience to recognize the broader issues). Meanwhile, both parents contribute to the denial and wall of privacy. In family gatherings, when my grand-niece doesn't engage, it is brushed off as "She likes to be in her own world" or "she wasn't interested in what you were doing."

Because I am a physician (but not with relevant experience), I struggle with whether I should discuss this with my niece and her husband, and if so, how to approach them. Do you have any suggestions about what we could do?

Amy says: Your family's concern and your sister's choice to convey it to her daughter has not backfired. The parents might have reacted poorly and defensively, but the child is seeing a speech therapist, and that is a positive first step. (And I assume this therapist is fully trained and accredited, so your concerns about her youth could be considered insulting. Weren't you a young doctor once? And didn't you feel insulted if people rejected your training simply because you didn't look old enough?)

You and your family members should not put these parents in a defensive crouch by judging their child's behavior and diagnosing her during brief holiday visits.

As a physician and the child's great-uncle, you are in an ideal position to continue to express interest in this young girl's development. You can do this through gentle and supportive questions posed to the parents.

You start by noting positive aspects: "Look at how well she's growing. Six months makes such a big difference!" Then you can consider taking it further: "My sister said she's seeing a speech therapist. What's that like? How do you think it's going?" You might then add, "Have you ever run this past cousin Rachel? You know that she is a speech pathologist. She might be helpful if you have questions."

You also can say, "We doctors don't always communicate so well; is your pediatrician good at answering your questions?"

If you present yourself as a supportive, interested and objective family member, these parents might lighten up and utilize you as a sounding board and resource.

Truth is in the texts

Dear Amy: My husband has been involved with a former college classmate (female) who he reconnected with at a reunion a couple of years ago.

They are in touch every weekend, sometimes texting back and forth for hours. When I have expressed alarm about this, he offers to show me their text exchanges, but I don't want to start a fight. Then he accuses me of not trusting him.

Can you help me find a way out?

Amy says: You don't seem to trust him, so his accusation is correct.

The next time the opportunity arises, take your husband up on his offer to view his text exchanges. You should be brave enough to risk discovering whatever answers emerge from discussing this with your husband.

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