Jordan Developmental Pediatrics

Care Plan

What Happens When Patients Come into Our Office?

Parents bring their children to our office for many different reasons. The following are examples of different types of visits and what usually occurs during and after that first visit.

All children

When parents bring their children for office, they first fill out a brief questionnaire. They are then interviewed by the doctor; the interview is either fairly brief or extensive depending on the complexity of their child's symptoms. If they have reports, test results, or evaluations from other providers these are reviewed at this time by the doctor. The bulk of the evaluation is usually taken up by a neurodevelopmental testing that last from one half to 21-hour and assesses the child's functions in language, attention, memory, and motor skills. If the child has specific learning problems, such as reading, more time is devoted to that subject. A brief physical is performed and the results of the testing are discussed with the parent(s), along with information from the interview and history. If it is possible to make specific conclusions, those are conveyed to the parent(s) and a brief written summary is provided. Most of the time, the doctor will provide handouts that deal with a particular neurodevelopmental weakness, or will refer a parent to low cost resources for dealing with particular problems such as language problems. If the child has a disorder such as autism, referrals are made to agencies that can assist the child and his or her family. If medications are appropriate or recommended, prescriptions are usually given out at this time. If speech, occupational, or other therapies are recommended, the patient is either given a prescription, or a bias that our office will make the referral for them. If the patient requires an evaluation by another professional, they are usually given a prescription for this. If follow-up visits are required, they are usually made at this time.

1. Children who have developmental delays, such as a two-year-old who is not walking, or a three-year-old who is not talking

We attempt to determine if the child has a neurological problem, such as steerable palsy, that requires further studies such as an MRI and blood tests. We would usually refer such a child to a neurologist for such testing and perhaps for continuing care. If the child has a disorder such as autism that affects their ability to talk and to and interact with others, we will provide the patient's family the core services that they need, including medication, counseling, and coordination of their care. In most cases, families are referred to the Division of Developmental Disabilities for provision of the actual therapy. Most parents want advice about what type of therapy works best and whether or not to stare at their child is improving. We usually need to see such patients every two to three month's to assess their progress. If medications are necessary, we will need to see the child fairly frequently at first to ensure that the medications are safe and effective.

2. Children who have attention and or learning problems

When a child is having difficulties at school, it is important to determine all of the factors that are important. For example, if the child does not pay attention when he reads and writes, he he could have Dyslexia and not attention problems, or they could have both. We try to tailor our evaluations to the patient's needs but even with an hour to test a child it is sometimes necessary to bring the child back for additional testing. This is particularly true when a child has not only attention and or learning problems, but neurological problems such as Aspergers Syndrome. Once a complete assessment of all the factors that are affecting a child's learning have been done, it is important to give the parent appropriate strategies, possibly including medication, and to see how they work. It is advisable to see the patient again in one to two months, sooner if medications are prescribed.

3. Children who have behavior problems

As with attention and learning problems, it is important to determine the underlying reasons for behavior problems. We often find that when children's learning problems are addressed, that the behavioral problems disappear or are lessened significantly. We also find children who have undiagnosed autism spectrum disorders. We find in general that children, unlike adults, usually have identifiable reasons for being anxious or depressed. We also find that there is no particular reason for some behavior problems other than a child's challenging temperament. It is important to determine the underlying cause in order to make the treatment as straightforward and easily understood as possible. Some children require counseling, although as noted above this is sometimes difficult to obtain. When medications are necessary, we strive to treat specific symptoms with as few medications and at the lowest dose possible.

4. Children who do not have any problem, but parents want a second opinion

Some children are referred because someone has told their parents that there is a problem, and the parents, although they do not think your child has a problem want to be sure. We find that about half the time these children really do have a problem of some type that has not been noticed by the parents. About the same number of times we do not find anything at all wrong with the child. It is very important to do these types of evaluations for the reassurance of the parents. In a world where there are many children's experts, some of whom are not reliable, it is important for parents to get an objective assessment so they can make up their own minds and be reassured one way or another about their children's function. When a parent has such confidence, they are not talked into unnecessary therapies, and are better able to discuss their children's educational and therapeutic programs with professionals. In most cases, we only need to see such children once, but are happy to consult with such parents at any time in the future if they have additional questions.