Other Services

Children may experience a range of medical conditions that could benefit from the expertise of a pediatric specialist in a particular field. We emphasize the coordination of all healthcare providers involved in a child's treatment. Our role involves working with specialists to ensure the best care for your child, including providing guidance on when specialty care is recommended.

In order to facilitate a productive relationship between the patient, primary care provider, and specialist, it is typically essential for us to conduct an initial assessment at our office before making a referral. This step enables us to furnish the specialist with comprehensive and current information regarding the child's health condition, as well as details about their recent physical examination. Additionally, this allows us the opportunity to potentially consult with the specialist via phone while the patient is present in our office, especially if the health concern requires urgent intervention. Patients consistently derive advantages from the constructive collaboration between primary care providers and specialists.

DOES YOUR CHILD NEED A BEHAVIORAL EVALUATION?

WHAT WE DO

In cooperation with community based mental health providers, we evaluate and treat children for behavior concerns and school problems including:

• Inattention and lack of focus
• Anxiety
• Depression

If you have concerns about your child's behavioral development, please call our office  and ask to speak to our Behavioral Health Coordinator. We will discuss your concerns and gather information that will be used to determine how we can best help your child. If a Behavioral Evaluation with one of our providers is needed, we will schedule this visit for you and provide you with assessment tools that you can complete prior to the your visit.

Assessment tools to complete for children ages 5-12:

• Vanderbilt Assessment - Parent Initial
• Vanderbilt Assessment - Teacher Initial
• Screen for Child Anxiety Related Disorders (SCARED) - Parent
• Screen for Child Anxiety Related Disorders (SCARED) – Child
• Center for Epidemiological Studies Depression Scale for Children (CES-DC)

Assessment tools to be complete for children ages 13-18:

• Vanderbilt Assessment - Parent Initial
• Vanderbilt Assessment - Teacher Initial
• Screen for Child Anxiety Related Disorders (SCARED) - Parent
• Screen for Child Anxiety Related Disorders (SCARED) – Child
• Center for Epidemiological Studies Depression Scale for Children (CES-DC)
• Patient Health Questionnaire 9 (PHQ9)
• CRAFFT screening tool

Assessment tools used on a case by case basis include: 

• Child Obsessional Compulsive Inventory- Parent and Child (CHOCI)

Completing the Assessments

• You will be directed to complete the Parent Assessments through the patient portal.
• Your child will be given a portal account so that they can complete their assessments through their private patient portal. 
• You will be directed to invite your child’s teacher to complete their assessment through the patient portal as well.

Important! All Assessments must be completed before the day of your child’s appointment.

At least one week prior to your appointment, complete assigned assessments noted above. On the day of your child's behavioral evaluation, please arrive 10 minutes prior to your scheduled appointment time. Ideally, your child should eat a nutritious meal prior to the appointment and be well-rested.

You and your child will meet with a nurse. Your nurse will spend approximately 20 minutes with you obtaining pertinent medical and behavioral history. Both you and your child will then meet with the doctor who will perform a thorough assessment and develop a behavioral health management plan for your child. Our providers may recommend additional counseling to best serve your child.  

If the doctor prescribes medication, he/she will want to follow up with your child within 28 days to assess your child's progress and to determine if the medication can be refilled. A patient coordinator will schedule this appointment with you before you leave the office.

Ongoing Medication Management

After your child's initial evaluation, if medication is started, your child must be seen within 28 days in order to continue the medication. If your child is doing well with his/her medication, subsequent appointments will be scheduled every 3 months. If a  medication or dosage change is needed, your child must be seen within 1 month to assess your child's progress and to determine if the medication can be refilled.

Breastfeeding Support

Breastfeeding provides essential nutrition for infants birth to one year and older. As with learning anything new, most breastfeeding mothers and babies (and dads too!) need some instruction and support during this learning period.

That's where we come in!

We have a high number of breastfeeding families. We will do our best to help you meet your breastfeeding goals. Any breastmilk you feed your infant is a gift of health for your child that lasts their lifetime.

We respect each family's feeding decisions. We do encourage moms to breastfeed exclusively or give only  breastmilk for the first four months then continue to breastfeed and give solid foods until your baby is a year old.

We love babies and enjoy helping families learn how to breastfeed! We will help you as little or as much as you need. We provide in-office feeding evaluations for hands-on help as well as phone support for any questions you may have along your breastfeeding journey.

Some areas we can provide guidance include:

• Positioning your baby at the breast
• Latching
• Caring for your breasts and nipples
• Assessing milk transfer
• Assuring adequate nutrition
• Assembling and using a breast pump, including sizing for the right size flange
• Storing milk
• Returning to work/school while breastfeeding
• Traveling and breastfeeding
• Training a breastfeeding baby to a bottle
• Teething while breastfeeding
• Breastfeeding premature babies
• Managing slow weight gain babies
• Breastfeeding twins
• Breastfeeding babies with special medical needs such as cleft palate, Down Syndrome, and heart conditions
• Managing medications, medical tests or surgery while breastfeeding

Please call our office to schedule an appointment.

We know the options for ear piercing in the community are limited for kids and Einstein Pediatrics offers a safe, clean, and developmentally appropriate environment to have this done. We recommend piercing be done AFTER 6 months of age.  This ensures children have had their first set of vaccines and the ears have grown big enough for accurate placement of the jewelry.  

Ear piercing is done by appointment only and not as an "add-on" to another sick or well visit. This allows enough time to perform the procedure, explain and answer questions about the aftercare, and allows the application of a numbing cream which takes time to work.  

We charge $200 to pierce up to 2 ears. This price includes topical numbing cream, medical-grade plastic piercing studs, and a take home care kit & certificate.

Evaluate And Diagnosis Of Symptoms

Our medical providers will do the initial evaluation if you think your child is having problems with focusing and attention.  We also continue to treat your child after the initial diagnosis has been made.  

The ultimate goal in the treatment of ADHD/ADD is to make your child as successful as possible in all aspects of his/her life.

ADHD FAQs

WHAT IS ADHD?

Children with attention-deficit hyperactivity disorder or ADHD have differences in their brains than those who don’t have ADHD. Certain areas of their brain may mature more slowly. Additionally, children with ADHD have imbalances in neural networks and neurotransmitters, the chemicals that nerves use to communicate.

Knowing that ADHD has a neurological basis is important because it helps parents understand that their child isn’t disobedient or oppositional on purpose. Instead, children with ADHD need help to learn to control their behavior.

The brain differences are also important because they occur in specific areas responsible for skills such as self-regulation, organization, working memory, problem-solving, reasoning, and time perception. The brain areas affected determine your child’s ADHD symptoms.

WHAT SYMPTOMS DEVELOP DUE TO ADHD?

ADHD symptoms fall into three categories: inattentiveness, hyperactivity, and impulsivity. Some children may only struggle with inattention, while others have trouble with two or three categories.

Each child has a different range and severity of symptoms. However, their symptoms are severe enough to affect their performance at school, at home, and when socializing.

When children struggle with inattention, they:

• Can’t pay attention at school or while playing
• Have difficulty organizing tasks
• Avoid tasks requiring mental effort
• Lose important items
• Forget to do homework and chores

When children struggle with hyperactivity and impulsivity, they:

• Fidget, squirm, or get out of their seat during class
• Run or climb when it’s inappropriate
• Talk excessively and interrupt conversations
• Have a hard time waiting for their turn
• Act or speak without thinking

Children and adolescents with ADHD also have problems with working memory. Working memory allows them to hold several pieces of information in their head long enough to use them to plan, do calculations, or to coordinate one activity with another.

HOW DO YOU DIAGNOSE AND TREAT ADHD?

To evaluate and diagnose ADHD, our providers use tools such as a checklist of symptoms, talking with parents and children about their challenges, and questionnaires completed by parents and teachers. Your child also has a thorough physical exam to be sure another problem is not the cause of their symptoms.

Once your child has an ADHD diagnosis, the provider prescribes treatment and schedules regular follow-up appointments to monitor their progress every 3 months.

If you or your child’s teacher are concerned about your child’s inattentive, hyperactive, or impulsive behaviors, call our office to schedule an ADHD evaluation.

Asthma & Allergy Management

Our practice provides a comprehensive care for asthma and allergy. Our pediatricians are trained in the diagnosis and management of childhood asthma and allergies. Diagnosis is usually made during a sick visit when a child is wheezing or exhibiting symptoms of allergies. Occasionally, we may diagnose your child with asthma or allergies during a preventive care visit based on patient or parent concerns or our exam findings.

Pulmonary Function Testing

Pulmonary function testing is done at least annually and may be done when monitoring medication changes. The test results are interpreted by our providers to help guide your child’s treatment. This is a non-invasive test performed in all patients age 5 or older with asthma to assess lung function and response to medication and to assess overall asthma control. 

Asthma Education

We teach about environmental controls and avoidance of triggers. We also watch your child using his/her inhaler to confirm it is being used correctly. Information about caring for the medication devices that your child uses is provided and reviewed at every visit. We will provide an Asthma Action Plan for your child for school and will provide a Food Allergy Action Plan if needed.

Maintence Visits

Children with asthma should be seen in our office every 3-12 months depending on their severity of illness and their asthma control. Regular visits are required in order for us to evaluate your child prior to medication refills.

HELPFUL RESOURCES:

• Asthma Overview 
• How to Use a Diskus Inhaler - video and instructions
• How to Use a Diskus Inhaler - PDF Download
• How to Use a Flexhaler - video and instructions
• How to Use a Flexhaler - PDF Download
• How to Use a Metered Dose Inhaler (MDI) - video and instructions
• How to Use a Metered Dose Inhaler (MDI) - PDF Download
• How to Use a Twisthaler - video and instructions
• How to Use a Twisthaler - PDF Download

Please use our patient portal to request medication refills.  If you do not have a patient portal set up, please call our office for help or request that the pharmacy send us a refill request.

Medication refills for ADHD, depression, anxiety, or other mental health issues requires a visit every 3 months in our office.  Refills will be denied if more than 3 months has elapsed since the last visit.  If your child is in danger of running out of a medication prior to the next visit, we will complete a refill to bridge this time for a  $20 fee.  Please schedule follow up at the end of visits to avoid these situations whenever possible.  

Refills are usually completed within 2-3 business days.