My aha moments:
I had a student that everyone else on the team was convinced was neglected. Underweight, listless, inattentive. My gut told me right away something else was going on. I made a home visit. Mom was not June Cleaver, but she was OK, fed the child, the place was clean. I documented what I felt were soft neuro signs and suggested a medical evaluation. She turned out to have a mild hydrocephalus with cerebellar atrophy that had not been noted or treated. After that day I trusted myself and my expertise to persist.
An early intervention early childhood program, one twin healthy, the other undernourished, listless, again, every one suspected abuse, lack of bonding. Everyone on the team had only met the one twin. I made a home visit, and noticed the other twin was a LOT bigger than the child who came to school. I had worked neonatal ICU, and started asking questions about the birth, and the undernourished twin was tiny tiny at birth. The children had been born in a VERY rural hospital and had recently moved to town. I called the kids new pediatrician and we started talking, I told him I suspected the kids were not the same age. I felt the one twin was younger than the other. He agreed it could explain what we were seeing. Turned out , through paternity testing, twins were half brothers, two different dads, and according to mom's story of who was where when, the twins were 2 months apart in gestational age, one full term, one 8 weeks early, 32 weeks gestation.
Another was a child that came often to the health office, frequent flyer, who after investigation, had been bullied at lunch. We changed his assigned lunch table and, aha, he never came back to the health office. Not all pain is caused by illness.
The day I discovered that the "non-compliant" parent was illiterate.
Lessons learned (ahas): a home visit is irreplacable, trust your gut (and your expertise), look further than reported symptoms - something is bothering a frequent flier, even if they can't express it, and look further into "noncompliance".