Pediatric Medical Services

Sick child visits usually take around 15 to 30 minutes. During the appointment, a pediatrician will check the child’s symptoms, determine their cause, prescribe treatment, and discuss other important details as needed with families. Parents should be ready during the visit to answer questions about:

• The child's symptoms
• When the symptoms began
• The child and the family's medical histories
• Various situation-specific questions that may help in diagnosing the child's illness

Any parent understands how tricky it is to know exactly when to call a doctor. In many cases, particularly during cold and flu season, children can recover from an ailment with fluids and rest. However, pediatricians do recommend calling promptly if serious symptoms develop. These include:

• High fever in children younger than one year of age
• High fever in children older than one year old accompanied by other symptoms such as vomiting, rashes, confusion, headache, or stiff neck
• High fever or persistent fever that lasts more than three days in a row
• Widespread rash
• Rashes that look like chicken pox
• Rashes that are accompanied by heavy breathing
• Regular, repeated vomiting
• Diarrhea
• Any unusual symptom that lasts for more than three days in a row
• Persistent pain, such as stomach ache, sore throat, headache, or an earache

Newborn screening is a public health service done in each U.S. state. Every newborn is tested for a group of health disorders that aren’t otherwise found at birth.

With a blood test, your pediatrician can check for rare genetic, hormone-related, and metabolic conditions that can cause serious health problems. Newborn screening lets your pediatrician diagnose babies quickly and start treatment as soon as possible.

Adolescence is a unique period of time where our children begin to transition into adulthood. As our children hit their adolescent years, they experience tremendous physical, psychological, and social development changes. Keeping up with and addressing these changes is extremely important. Families and pediatricians need to work together to treat immediate health problems; to influence the habits and health goals of teenagers; and to provide actionable recommendations that will help teens mature into a healthy picture of adulthood.

At All Around Pediatrics, we offer care via a team of pediatricians who understand the sensitivities and challenges of treating young adults. We encourage families to maintain a relationship with our practice until their children turn 21. Doing so will allow us to work with families to improve the healthy development, health, safety, and well-being of your children as they march into adulthood.

Acne

Acne (zits, pimples spots) can cause discomfort and embarrassment and affects most people at some point during their lives. About 4 out of every 5 people experience acne outbreaks between the ages of 11 and 30.

What is Eczema?

Eczema is a term for several different types of skin swelling. Eczema is also called dermatitis. Most types cause dry, itchy skin and rashes on the face, inside the elbows and behind the knees, and on the hands and feet. Scratching the skin can cause it to turn red, and to swell and itch even more.

Eczema is not contagious. The cause of eczema is unknown. It is likely caused by both genetic and environmental factors. Eczema may get better or worse over time, but it is often a long-lasting disease. People who have it may also develop hay fever and asthma.

The most common type of eczema is atopic dermatitis. It is most common in babies and children, but adults can have it too. As children who have atopic dermatitis grow older, this problem may get better or go away. But sometimes the skin may stay dry and get irritated easily.

Treatment for Eczema

Treatments may include medicines, skin creams, light therapy, and good skin care. You can prevent some types of eczema by avoiding

• Things that irritate your skin, such as certain soaps, fabrics, and lotions
• Stress
• Things you are allergic to, such as food, pollen, and animals

Mental health issues do not discriminate when it comes to age. This means it can affect prepubescent children as well as our teenagers. Teenagers, however, are somewhat more vulnerable to this concerning health issues. Even in healthy children, puberty is a time of massive change. Hormonal changes, physical changes, sexual changes, and social changes can all combine to create mood swings and other upsetting symptoms. It can be challenging for parents of teens to differentiate between the typical moodiness of puberty and mental health conditions that require professional attention.

No matter their age, if you are wondering about the source of your child’s behaviors, we encourage you to contact your pediatrician to discuss your concerns. Identifying mental disorders and treating them in children can be very tricky, but we at All Around Pediatrics are prepared to help you and your child. We are more than happy to assist with making a diagnosis; with providing care for common mental health conditions; with making a referral to specialists as needed; and with basic medication management.

Attention Deficit Hyperactivity Disorder

Is it hard for your child to sit still? Does your child act without thinking first? Does your child start but not finish things? If so, your child may have attention deficit hyperactivity disorder (ADHD). Nearly everyone shows some of these behaviors at times, but ADHD lasts more than 6 months and causes problems in school, at home and in social situations.

ADHD is more common in boys than girls. It affects 3 to 5% of all American children.

The main features of ADHD are

• Inattention
• Hyperactivity
• Impulsivity

No one knows exactly what causes ADHD. It sometimes runs in families, so genetics may be a factor. There may also be environmental factors.

A complete evaluation by a trained professional is the only way to know for sure if your child has ADHD. Treatment may include medicine to control symptoms, therapy, or both. Structure at home and at school is important. Parent training may also help.

What is QbTest?
QbTest is a computer-based test that combines a test of attention ability with a movement analysis based on an infrared measurement system. Test results are assembled into a report and compared with norm data from other people of the same sex and age. This way you can see how you react when you concentrate on a task in comparison with people who do not have ADHD.

How should QbTest be used?
Assessing ADHD may be complicated and there is no single clinical tool that is able to give you all the answers. The QbTest provides objective data that together with other infor­mation will help your clinician assess you for ADHD.
QbTest also provides a valuable baseline measurement that can help to evaluate any future changes in your activity, attention and impulsivity.

How is a QbTest performed?
The test is performed in front of a computer screen. The test equipment consists of an infrared camera, a head-band with an infrared marker attached to it and a responder button.

During the test a number of symbols are shown on the computer screen. The task is to push the responder button when a certain symbol appears on the screen. The test takes 15 minutes to complete and is not dependent on your language, reading or mathematic skills.

What do the results look like?
The QbTest reports below show the results from a seven year old boy with ADHD. The two graphs at the upper part of the reports show activity level and the third graph shows attention and impulsivity control. The green circles represent correct presses and the red squares represent incorrect presses. The vertical position of the symbols show the reaction time. At the bottom of the report all test results are summarized as numerical values.

Sample reports:

Report (7 Years Old)
Report (43 Years Old)

When children do not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder.

Types of anxiety disorders include

• Being very afraid when away from parents (separation anxiety)
• Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
• Being very afraid of school and other places where there are people (social anxiety)
• Being very worried about the future and about bad things happening (general anxiety)
• Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

As a child grows, doctors and parents are watching closely to make sure they hit their developmental milestones. All missed milestones are important, but some are more serious than others. Some missed milestones can be an isolated delay, often easily addressed with targeted therapy. Other complex medical problems or genetic conditions are associated with developmental delays that can be anticipated and addressed. A constellation of specific delayed milestones may indicate a diagnosis of autism: a serious developmental disorder that impairs a child’s ability to communicate and interact with others.

Autism – or, by its proper name, autism spectrum disorder (ASD) – affects 1 in 68 children. To ensure that they receive care and treatment, the American Academy of Pediatrics now recommends that a child’s 18- and 24-month wellness exams also include developmental screenings for autism spectrum disorders (ASDs). Without intervention and support, an autism diagnosis can make it challenging for a child and their family to thrive.

Early screenings for autism and other early developmental issues are just one example of the care available at All Around Pediatrics. To better support families that are experiencing developmental challenges, our team also wants to hear concerns from parents during their child’s visits. By mentioning symptoms or specific behaviors to us during your visit, we can better recognize and address the signs of developmental delay or other behavioral concerns.

Depression is characterized by a persistently depressed mood or loss of interest in activities. Depression is a mood disorder, and is therefore very different from a normal period of feeling sad. Its symptoms cause significant impairments in daily life. Examples of behaviors often seen when children are depressed include:

• Feeling chronically sad, hopeless, or irritable
• Children not wanting to participate in or enjoying previously fun activities
• Changes in eating patterns (i.e. eating a lot more or a lot less than usual)
• Changes in sleep patterns (i.e. sleeping a lot more or a lot less than usual)
• Changes in energy, being tired and sluggish, or tense and restless, a lot of the time
• Having a hard time paying attention
• Feeling worthless, useless, guilty, helpless, or hopeless
• Self-injury and self-destructive behavior
• Extreme depression can ultimately lead a child to think about suicide or plan for suicide.

Children and adults can both suffer from asthma – but children face unique challenges when living with this health issue. Patients with asthma suffer from inflammation within the air passages of the throat and lungs. This inflammation creates a temporary narrowing of a patient’s airways, keeping oxygen from reaching the lungs. And to complicate matters, children have smaller airways than adults. This makes asthma especially serious for them.

About 1 in 10 children live with asthma, and it is one of the most common reasons why children are absent from school, go to emergency rooms, or are admitted to hospitals. Research has even found that children ages 1 to 3 years account for as high as one-fifth of emergency room visits caused by complications from asthma. That’s the largest proportion of visits among asthma patients under age 21.

Many things can cause asthma, including

• Allergens - mold, pollen, animals
• Irritants - cigarette smoke, air pollution
• Weather - cold air, changes in weather
• Exercise
• Infections - flu, common cold

At All Around Pediatrics, we take asthma care extremely seriously. We can help make and/or confirm the diagnosis of asthma, as well as help create a personalized action plan and instruct children and families on the proper way to administer any necessary medications.

Long-lasting sneezing, with a stuffy or runny nose, may signal the presence of allergic rhinitis – the collection of symptoms that affect the nose when you have an allergic reaction to something you breathe in and that lands on the lining inside the nose.

Allergies may be seasonal or can strike year-round (perennial). In most parts of the United States, plant pollens are often the cause of seasonal allergic rhinitis – more commonly called hay fever. Indoor substances, such as mold, dust mites, and pet dander, may cause the perennial kind.

Up to 40 percent of children suffer from allergic rhinitis. And children are more likely to develop allergies if one or both parents have allergies.

The U.S. Food and Drug Administration (FDA) regulates over-the-counter (OTC) and prescription medicines that offer allergy relief as well as allergen extracts used to diagnose and treat allergies. Take care to read and follow the directions provided when giving any medicine to children, including these products.

A healthy diet helps children grow and learn. It also helps prevent obesity and weight-related diseases, such as diabetes.

To give your child a nutritious diet

• Make half of what is on your child's plate fruits and vegetables.
• Choose healthy sources of protein, such as lean meat, nuts, and eggs.
• Serve whole-grain breads and cereals because they are high in fiber. Reduce refined grains.
• Broil, grill, or steam foods instead of frying them.
• Limit fast food and junk food.
• Offer water or milk instead of sugary fruit drinks and sodas.

Learn about your children’s nutrient requirements. Some of them, such as the requirements for iron and calcium, change as your child ages.

Use your children’s food and beverage choices as teaching moments. Speak up when you see unhealthy choices. Direct children to healthier options or say, “You can have a little of that, but not too much.” Talk to them about why an overly salty or heavily sugared snack is not the best choice. Avoid making them feel guilty about their food or beverage choices. You can also praise your children when they choose a healthy item like fruit.

All Around Pediatrics offers sports physicals for children involved in sports or other extracurricular activities who require validation from a doctor that they are healthy enough to participate in the specific activity.

If your child requires a specific form for their activity, please bring it with you to your appointment.

Whether your child is gearing up for his first season of Little League, just made the Varsity team, or is captain of the Cheerleading Squad, All Around Pediatrics can provide the documentation your child needs before they can participate.