Other Services

  • ADHD/ADD

    EVALUATE AND DIAGNOSIS OF SYMPTOMS


    Our trained professional staff 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 professional team 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, their pediatrician at our office prescribes treatment and schedules regular follow-up appointments to monitor their progress.


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


    Please complete the ADHD Initial Evaluation Packet prior to your appointment. Please do not bring any sibling to the visit.


    Important! We request assessment forms be available to the provider for review 5 days prior to your child's appointment.


    Ongoing Medication Management


    After your child's initial evaluation, if medication is started, your child must be seen within 21-28 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.



  • Anxiety/Depression

    If you believe your child has a psychiatric emergency, call 911, or go to the nearest emergency room.


    HELP IS AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK:



    WHAT WE DO


    In cooperation with community based mental health providers, we evaluate and treat children, teen and young adult with anxiety and depression concerns. Please complete the age-appropriate evaluation forms:




    Anxiety


    Assessment tools for anxiety for 8-12 years old:


    • Screen for Child Anxiety Related Disorders (SCARED) - Parent

    • Screen for Child Anxiety Related Disorders (SCARED) - Child

    • Both you and your child will need to complete the appropriate SCARED assessment.

    Assessment tools for anxiety for 13 years old and older:


    • General Anxiety Disorder-7 (GAD-7) - Child

    Depression


    Assessment tools for depression for age 6-12 years old:


    • Center for Epidemiological Studies Depression Scale for Children (CES-DC)

    Assessment tools for depression for age 12-18 years old:

    • Patient Health Questionnaire 9 (PHQ9)​

    What to Expect at a Mental Health Evaluation 


    On the day of your child's evaluation, please arrive 10 minutes prior to your scheduled appointment time.



    Both you and your child will then meet with the provider who will perform an assessment and develop a behavioral health management plan for your child. Our providers may recommend additional counseling to best serve your child.



    If the provider prescribes medication, a 7-day telephone or MyChart follow-up is expected to assess for any side effects and to answer any concerns/questions you may have. An in-person follow up within 21-28 days will be required to assess your child's progress and to determine if the medication can be refilled. 


    Ongoing Medication Management 


    • After your child's initial evaluation, if medication is started, your child must be seen within 21-28 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.

  • Asthma and Allergy

    Asthma & Allergy Management

    Our practice provides care to our patients with 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. 


    Asthma

    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 and refill medications if needed.


    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.


    Please remember to bring all the asthma medications to the visit and complete the age appropriate Asthma Control Test (ACT).


    Allergy

    Please talk to your provider if you are concerned your child may have food or environmental allergies, The provider may order blood test or recommend your child to see an allergist. Our providers will discuss on how to manage your child's allergy and prescribe the appropriate allergy medication/s including EpiPen if needed. 


    If your child has food allergy, we will provide you with a Food Allergy Action Plan and instruction on the proper use of EpiPen.


    Helpful Resources:



  • Medical Home Care Coordination (MHCC)

    We are here to support you!


    If your child has a disability or a chronic illness, your journey may feel like the road less traveled. You probably have interactions with many different professionals and specialists. You need information, assistance, understanding, and support.


    We're here to help.


    If your child has significant medical needs, we will partner with you to help you manage your child's condition. We look forward to getting to know you and your child, and will be your dedicated point of contact through this journey.


    Please complete the MHCC Request Form or send us a MyChart message to request the form.


    Completed form can be returned by mail, MyChart attachment or fax 781-289-4485.

  • Newborn Care

    Newborn Care Begins From The Moment Your Baby Arrives


    Here at TLC Pediatrics, we like to begin your newborn care at Melrose Wakefield Hospital and continue as an integral part of the comprehensive care provided by our team from birth until young adulthood.


    Newborn Care FAQs


    WHEN DOES MY NEWBORN HAVE THEIR FIRST CHECKUP?


    Your new baby has their first checkup within 1-3 days after leaving the hospital.


    Your newborn’s checkup is a comprehensive exam to be sure they’re growing and developing normally. During the checkup, the pediatrician:

    • Checks your baby’s weight, length, and head circumference
    • Evaluates your baby’s feeding, bowel, and sleeping habits
    • Does a physical examination
    • Answers any questions or concerns you may have

    WHAT IS A NEW ENGLAND NEWBORN SCREENING ?


    The New England Newborn Screening Program routinely screens all newborn for rare genetic and medical conditions. The program started in 1962 screening for just one disease which has now expanded to at least 30  

    diseases and a "pilot study." The goal is to identify and treat diseases early enough to prevent serious complications such as growth problems, developmental delays, intellectual disabilities, blindness, deafness, and seizures. Between 24-48 hours hours after birth, small amount of blood is drawn from the baby's heel to run the test. Our office will contact you if the screen is abnormal or if it needs to be repeated.


    WHAT IS A NEWBORN HEARING SCREEN?


    Within 24-48 hours after birth, your baby will have a hearing screening called otoacoustic emissions (OAE) test.

    During this test, a soft earphone is inserted into your baby's ear canal. It plays sounds and measures an "echo" response that occurs in ears with normal hearing. Baby who failed hearing screen in the hospital will have repeat hearing test within 2-3 months.


    WHAT ARE WELL-CHILD VISITS?


    Well-child visits are ongoing checkups for children that follow a specific schedule. After the initial visit, most newborn will be seen within 1-2 weeks to ensure adequate weight gain and to address any questions or concerns. Your newborn will then be seen at one and two months.


    During each visit, their pediatrician will evaluate their growth, developmental milestones, and behaviors.


    Just like the two-week newborn care visit, every well-child checkup is an opportunity to talk with the pediatrician about baby care and your baby’s health and safety.


    Your pediatrician also gives immunizations at the two-month visit to protect your baby from:

    • Diphtheria
    • Tetanus
    • Pertussis (whooping cough)
    • Polio
    • Hepatitis B
    • Rotavirus
    • Haemophilus Influenzae
    • Pneumococcus

    Small doses of the same immunizations are repeated several times over the first 18 months to be sure your infant is fully immunized against contagious diseases.


  • Meet and Greet

    Meet and Greet is a great way for prospective parents and new patients to ask questions, see how we work, and meet one of our providers.  We want to help you make the best decision for your family.


    Please call either of our offices to schedule a Meet and Greet 


  • Sports Physicals

    Sports physicals are different from the typical well-child checkup because their goal is to be sure your child can safely play sports without risking harm to their body.


    OBJECTIVES OF SPORTS PHYSICALS:

    • to obtain a detailed athlete's medical history
    • to detect any medical or musculoskeletal conditions that may predispose an athlete to injury or illness during sports
    • to detect any potentially life-threatening medical condition
    • to ensure your child is prepared for vigorous physical activity
    • to counsel the athlete

    WHY IS A CHILD’S MEDICAL HISTORY IMPORTANT?

    A complete medical history helps your doctor determine if your child has a condition that sports activities might aggravate or concerns that could reappear during sports activities, such as previous fractures, sprains, concussions, skin infections, a past history of pain or dizziness, and chronic health conditions.


    CHILDREN AND PARENTS USE A MEDICAL HISTORY FORM TO PROVIDE INFORMATION ABOUT:

    • Chronic illnesses such as asthma, diabetes, or epilepsy
    • Hospitalizations or surgeries
    • Past injuries such as concussions, sprains, or fractures
    • Problems with dizziness, chest pain, or breathing during exercise
    • Medications and supplements
    • Allergies
    • Family history of serious illnesses 

    Ideally, sports physicals should be performed at least 6 weeks prior to pre-season practice to allow time to correct or rehabilitate any idenitfied problem.


    Please call our office to schedule an appointment.