What is a developmental pediatrician?
Developmental pediatricians, or developmental-behavioral pediatricians, are board-certified pediatricians (MDs) who complete their medical school training and specialty training in pediatrics and then complete 2-3 additional years of subspecialty training. Developmental and Behavioral Pediatrics is now the newest recognized pediatric subspecialty and those who wish to obtain board-certification must sit for a board sub-certification examination.
What is a pediatric nurse practitioner?
A pediatric nurse practitioner (PNP) is a registered nurse with advanced training in diagnosing and treating illness in children and adolescents. Pediatric nurse practitioners provide care for children and adolescents, treat illnesses, and prescribe and monitor medications and therapies. They may also order and interpret diagnostic tests, and refer to other healthcare providers. PNPs also provide education to families in order to allow them to make informed decisions about their child’s health care. At the Arizona Child Study Center, the PNPs work in collaboration with the developmental and behavioral pediatrician to provide continuity of care for each child we see.
Why do children visit the AzCSC?
The reasons children visit our program are varied. For young children, 18 months to 5 years of age, it might be because they have been slower to achieve developmental milestones seen in children of the same age. They may not be speaking as well or as clearly as other young children at a similar age. Parents may be concerned about difficulties in their child’s play or interaction with other children. Children who have difficulties communicating or relating to others may also have problems with their behavior or may be more aggressive to other children and adults because of frustration.
For older children (kindergarten to high school), generally, it is because someone (such as a parent, a teacher, a physician etc.) is concerned that the child is not learning or acting as well as might be expected for his or her age, or that child might be having feelings of failure or frustration in or out of school.
Feeding disorders (children who have a hard time eating and gaining weight) and children who are in foster or adopted homes may also be seen by the Arizona Child Study Center.
There are many reasons for a child and family to visit the AzCSC. We are here to help you and plan an appropriate evaluation strategy and review, or provide the best available treatments and interventions. We often play a strong advocacy role with regard to the schools to assure that kids and families receive the services they are entitled to.
What will my child's evaluation consist of?
All first appointments for new patients are scheduled with one of the pediatric nurse practitioners (PNPs). This first appointment consists of an intake history, review of existing concerns and, if indicated, a physical and neurological examination. The child and family are seen together in a large play area allowing for developmental observation and review of behavior. First visits might best be seen as an opportunity for a family to discuss the concerns that they or others have had concerning their child's behavior, abilities, reactions, or performance at school or home. It provides for the sharing of information, ideas, concerns, and questions.
The second visit will be conducted by the developmental-behavioral pediatrician. The second evaluation visit allows us to integrate information obtained at earlier evaluations and questionnaires you might be asked to complete after the first visit with our own observations of child and family.
Will you be "testing" my child?
Formal “testing” or developmental assessments that involve the child sitting and being tested for an extensive period of time are generally not performed during our initial evaluation visits. Between the first and second evaluation visit it is often necessary to collect or obtain additional information. This might involve the referral back to the school or to other providers in the community for formal psychoeducational or psychological testing. We are also likely to request that you and other members of your family complete and return behavioral questionnaires. Similar questionnaires may also be provided for teachers, therapists or other child care providers. The child may be asked to complete some questionnaires.
Do you do psychological or psychoeducational testing?
At the present time we do not do psychological or psychoeducational testing. Though we may do a “screening” (or brief testing) for academic or cognitive (intelligence) concerns, more definitive testing often require referral to a child’s school district or a psychologist in the community.
Do you provide counseling or therapy services?
No. Though parents and children find the process of identifying the cause for their concerns and difficulties to be helpful, we are not doing therapy or counseling.
Do you use medication to treat children with learning or behavioral problems?
Medication does not treat a learning problem. However, children with attention deficit/hyperactivity disorder, autism, anxiety problems, depression, and emotional or mood difficulties often benefit from medication as one component of a multimodal treatment program. Other recommended interventions might include behavioral management, special education help in school, counseling, parent support and training, speech, physical and occupational therapy, social skills training, coaching, and organizational skills help. These services are generally available in the community and we will help you locate them.
Do you use "brain mapping" as a diagnostic tool or use alternative treatments?
At the present time brain mapping and certain alternative treatments such as secretin and special diets are considered experimental. There is no agreement about their benefit or value. We practice “evidence-based medicine” so before we use a procedure or treatment, there needs to be significant scientific evidence that it works and that it helps children.
Do you test for Dyslexia?
Dyslexia or developmental reading disorder requires specialized psychoeducational testing and should be performed by the school district or qualified professional such as a psychologist or learning disabilities specialist in the community. Some schools say they do not test for dyslexia specifically. In those situations you may need to ask for testing to determine your child’s eligibility for special education and related services. This should include testing for a reading disability.
Do you treat children who have or are suspected or having bipolar disorder?
Once thought to be rare in childhood, bipolar disorder (manic depression) is now believed to not only begin in childhood but to be more common than previously thought. Child psychiatrists should care for children with bipolar disorder. Children who have bipolar disorder or who may grow to develop bipolar disorder are also commonly diagnosed with ADHD or other mood or emotional difficulties. Therefore we are sometimes asked to see children who may have bipolar disorder but for whom the diagnosis has not been made. Since child psychiatrists should be involved in diagnosing and treating children with this disorder, we will refer families with this concern directly to a child psychiatrist rather than delay the proper diagnosis.
How do I schedule an appointment?
First appointments are scheduled when you have completed the necessary pre-registration packet, including a psychosocial questionnaire, insurance information, and registration packet.
Second appointments are generally scheduled some time after the initial visit is completed. Your provider may request that parents or other professionals complete and return a series of structured behavioral questionnaires before scheduling a second appointment. Once we have received the completed series of behavioral questionnaires, an office staff member will call you to schedule your second visit appointment. Or, you are welcome to call our office to schedule this appointment if you have mailed in the series of questionnaires and have allowed enough time for it to be received at our office. If additional testing is necessary or referral for other consultations are suggested this second appointment might need to be postponed.
Follow-up appointments are scheduled at the conclusion of your office visit. Or you can call the main number to schedule your next appointment. Always be sure to schedule a follow-up visit promptly, if needed.
What insurances do you accept?
We accept a wide range of private insurance. However, it is important to realize that even though we may be providers with certain insurance companies, whether the evaluation performed here is covered or not may depend on the type of coverage/benefits that your particular policy provides (PPO, HMO, etc). Sometimes the same insurance company will exclude certain diagnoses (usually described as “behavioral” or “mental health” benefits), whereas another plan under the same insurance company may cover such diagnoses. We encourage parents to inquire about their benefits ahead of time. We will not inquire about your benefits and medical eligibility until approximately one week prior to your appointment.
Do you accept AHCCCS?
We do accept the following AHCCCS plans: Mercy Care Plan, AP/IPA and Phoenix Health Plan. AHCCCS patients must have a referral through their primary care physician (PCP). Their referral department will need to request an authorization number from AHCCCS Managed Care, Prior Authorizations Department. If the primary care provider has not seen your child, it is important that you schedule an appointment to discuss your concerns and your request to have your child seen by a developmental and behavioral pediatrician (specialist). There are times when a child’s appointment visits are delayed or even cancelled because the PCP office has failed to obtain a Prior Authorization. We cannot be responsible for these delays and suggest you speak to your providers’ referral staff if you have any questions.
AHCCCS will sometimes authorize only consultation visits and up to three follow-up visits. You may be referred to Magellan of Arizona Network Providers after a diagnosis has been made. That is because AHCCCS employs a “behavioral health carve-out” and children with certain behavioral health concerns must use the Regional Behavioral Health Authority (RBHA) provider for ongoing care and the prescription of most medications. In Maricopa County, the RBHA is Magellan of Arizona. If you have both a private insurance and AHCCCS, the private insurance is considered primary and AHCCCS secondary.
Failure to report third-party liability is considered fraud.
How do I get a prescription refill?
Routine prescription refills will only be handled during regular office hours. Please do not page the provider after hours for prescription refill requests. All prescription refill requests must be made on our prescription refill line by calling 602-406-3543 and following the prompts. Always call 7 to 10 days before medication runs out. In some instances, your child may need to be seen by the physician before receiving a refill.
What if I have an emergency?
In a true medical emergency, call 911 or go to the Emergency Department of the nearest hospital.
If you have concerns about your child’s general health or medical questions, we encourage you to call your child’s Primary Care Provider. If your child has an urgent problem related to the behavioral or other issue for which we are seeing them, please call our office for instructions. If it is after hours, please call the on-call pager by dialing 602-746-0581, and follow the indicated instructions.
