What's Offered?:  We will review, explain, and re-interpret written reports of evaluations conducted elsewhere.  This might include any or all of the following:

• Medical Records
• Early Intervention Records (including assessments and IFSP's)
• Psychological, Neuropsychological, or Cognitive testing
• Educational or Achievement Testing
• Speech & Language, OT, or PT evaluations
• Public School Records (including SPED/CORE testing and IEP's)
• Progress reports (from school, EI, or therapists)

We will also take a brief history from the parent(s), and combine this with our prior knowledge of the child from routine physicals.  We will then discuss with the parent(s) what it all seems to mean, and make recommendations for further workup, evaluation, management and/or treatment.

What's Involved?:  All the records to be reviewed must be received by our office prior to booking an appointment.  Depending on the complexity of the situation, either a 30 or 60 minute visit with the parent(s) will be booked, and this is usually covered by insurance.

What's It Good For?:  This is best when a child's diagnosis is already known and guidance on its further management is the main goal.  This is also the choice when there has already been extensive evaluation carried out elsewhere (either by the schools or private professionals) that may be confusing to the family or have failed to fully settle the diagnostic questions.  (Note: If your purpose is to determine whether your child as ADD ~ ADHD, please click here.)

What are it's Limitations?:  We do not do any direct assessment ourselves as part of this service.  The accuracy of the conclusions we draw therefore depends on the quality of the testing we are reviewing.  This is usually not a problem if the testing has been done by professionals we know or have referred you to, but it can be a problem when this is not the case, especially if the only testing comes from the public schools.  If we have doubts about the quality of what we are reviewing, one of our recommendations is likely to be further testing of one sort or another.

What's Offered:  A diagnostic consultation consists of everything described under #1 above PLUS a much more detailed history (usually taken from a parent) and a thorough physical exam (including a complete neurologic exam).  

What's Involved?:  Depending on the specifics of the individual situation, diagnostic consultation may be accomplished in a single 60-minute appointment with both parent(s) & child present, or it may require two separate visits, one with the child present and one with the parent(s) alone.  Both these visits will usually by covered by insurance.  Relevant records (see above) should in our office BEFORE the first visit is booked (bringing them with you to the first visit does not leave enough time for our review).

What's It Good For?:  This type of consultation is most appropriate when the diagnosis is unknown or in question, and when a medical diagnosis or cause of the problem is suspected.  Developmental problems are far more likely to have a medical cause when they begin at a young age (<3y) or when they are accompanied by physical abnormalities.  It may be an initial assessment, or a 2nd opinion.  Examples of medical causes of developmental problems which may be diagnosed with such a consultation include (but are not limited to) Cerebral Palsy, Autism, Genetic Disorders (Down Syndrome, Fragile X, etc.), Hypothyroidism, and Epilepsy.  In older children able to talk about their feelings, this sort of evaluation may also be able to identify major psychological disorders such as Depression or Obsessive-Compulsive Disorder.

What are it's Limitations?:  This type of assessment is medically based - we look at history & physical exam data and may order medical tests such as bloodwork, MRI's, or EEG's.  While we will review other sorts of testing done elsewhere and take those results into account, we do not do neurodevelopmental testing or other psychometric work ourselves as part of this assessment.  Therefore, unless adequate testing along those lines has already been done, this kind of consultation will NOT be adequate to accurately diagnose such things as ADD/ADHD, Learning Disabilities, or Dyslexia.

What's Offered:  Once they have been adequately diagnosed (see above), we will prescribe and manage medication treatment for a variety of developmental, neurological, and psychological conditions.  We will also provide simple behavior management advice for parents or design/supervise behavioral treatment programs for a variety of problems.  

What's Involved?:  This type of visit is normally booked on an ongoing periodic basis: usually 15 or 30 minutes every 1-to-3 months, usually in followup after an initial evaluation of type #'s 1-3 above.  These visits are covered by insurance.

What's It Good For?:  Conditions we may treat with medications include (but are not limited to) Attention, Mood, Tic, Seizure, Sleep, Anxiety, and Autism Spectrum Disorders.  Behavior management advice can be helpful for parents facing normal disciplining challenges.  Behavioral treatment programs are useful for bedwetting (over age 6), fecal soiling, and sleep difficulties.

What are it's Limitations?:  Although we are very experienced and do have specialized training (far beyond that of most pediatricians) in managing psycho-pharmacologic & behavioral treatments, we are not psychiatrists or psychologists.  We therefore cannot do "psychotherapy" or "counseling", and if your situation seems to need that level of service we will need to refer your child to an appropriate mental health provider.  Similarly, if your child does not respond to medication we prescribe in the expected way, or seems to need medications or medication combinations with which we are not comfortable or experienced, we will refer you to a Child Psychiatrist.  Finally, we are not equipped to deal with psychiatric emergencies - if a child becomes suicidal or out of control we well need to refer you to a psychiatric hospital or ER facility.