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Developmental-Behavioral Clinical Services
Developmental-Behavioral Pediatrics is an area of expertise concerned with the developmental, learning, and behavioral problems of children and adolescents. Some of the most common concerns addressed by the Division of Developmental-Behavioral Pediatrics include:
- Delayed development in speech, language, motor skills, and thinking ability
- Developmental disabilities, including cerebral palsy, spina bifida, intellectual disability, autism spectrum disorder, and visual and hearing impairments
- Behavioral and developmental problems complicating the full range of pediatric chronic illnesses and disabling conditions, including genetic disorders, epilepsy, traumatic brain injury, prematurity, diabetes, asthma, and cancer
- Learning disorders, including specific learning disabilities in reading, writing, and math, as well as other school-related learning problems
- Attention and behavioral disorders including Attention-Deficit/Hyperactivity Disorder (ADHD) and associated conditions such as Oppositional-Defiant Disorder, depression, and anxiety disorders
- Tics, Tourette’s Disorder, Obsessive Compulsive Disorder and other habit disorders
- Regulatory disorders including sensory concerns, sleep disorders, feeding problems, discipline difficulties, complicated toilet-training issues, enuresis (bedwetting), and encopresis (soiling)
- Adjustment to medical illness or developmental disability
MUSC Division of Developmental-Behavioral Pediatrics is comprised of a collaborative, interdisciplinary team of providers with a range of expertise, representing the disciplines of developmental-behavioral pediatrics, psychology, psychiatry, social work, and nursing. Our team collaborates with other health care and educational teams when indicated and provides services for children and adolescents (birth to 21 years of age) referred for a variety of developmental, medical, psychosocial, adjustment and/or educational concerns.
Michelle Macias, M.D. , Division Director
Angela LaRosa, M.D., MSCR, Medical Director
Jane Charles, M.D.
Michelle Lally, M.D.
Jennifer Poon, M.D.
Catherine Bradley, PhD
Laura Carpenter, Ph.D., BCBA
Kasey Hamlin-Smith, Ph.D.
Pam Ingram, EdS, LPES
Mary Kral, Ph.D.
Alyssa Schlenz, Ph.D.
Eve Spratt, M.D., MSCR
Karen van Bakergem, LMSW
Heather Dolan, RN
Savannah Galloway, BSN, RN
Your child's initial visit typically involves a developmental pediatrician, psychologist, psychiatrist, or social worker. The initial visit will include an extensive review of concerns related to your child’s developmental, medical, social, and educational histories. Consultation with teachers, therapists, and other healthcare professionals also helps define the scope of current concerns. Physical and neurological examinations may be part of the evaluation process, as well as a variety of standardized tests, questionnaires, observations, and demonstrations. These evaluations may be formal, with the child, or informal, by observing the child at play and interacting with parents and the examiner.
After this extensive evaluation, the healthcare provider will discuss their impressions and recommendations with you, which may involve referrals to other medical specialists within the MUSC network (audiology, cardiology, gastroenterology, neurology, ophthalmology, otolaryngology, pulmonary medicine, nutrition, radiology) or an allied health professional (physical, occupational, and/or speech therapist, behavioral interventionist). The goal is always to understand your child’s strengths and needs, to determine what is typical and what is not, and to access services to help your child grow, learn, and develop to the best of their ability.
MUSC Division of Developmental-Behavioral Pediatrics has established a number of specialty clinics to address the needs of special populations:
ADHD Evaluation Clinic provides evidenced-based evaluation and treatment for children and adolescents with suspected Attention-Deficit/Hyperactivity Disorder (ADHD). In addition, medical consultations for children with diagnosed ADHD who have failed previous management strategies are provided. A detailed history and assessment are completed to address comorbid disorders, such as depression, anxiety, oppositional defiant disorder, conduct disorder, and tic disorders.
Autism Spectrum Disorder Evaluation Clinic utilizes clinical interview, state-of-the art tests, and consultation with teachers and other professionals for the evaluation of autism spectrum disorder and/or differential diagnoses. The refined diagnostic process guides effective, evidenced-based treatment planning, often including referral to allied health professionals. The CHAT Clinic (named for an autism screening tool) provides evaluation of young children who present with primary concerns for autism spectrum disorder. Interactive structured play sessions, autism-directed history, and neurodevelopmental testing are conducted to determine diagnosis or need for more in-depth diagnostic testing.
Cardiac Neurodevelopmental Follow-Up Clinic addresses the care of infants and children with complex congenital heart lesions by following the state-of-the art guidelines of the American Heart Association. The team of providers – including cardiology, developmental-behavioral pediatrics, psychology, nutrition, and occupational therapy – conduct medical, developmental, and behavioral assessments at every visit. These children are followed regularly through school age to ensure early identification and intervention of potential developmental, behavioral, or school related difficulties.
Down Syndrome Clinic focuses on the special needs of children with Down syndrome through an interdisciplinary team of providers, representing developmental-behavioral pediatrics, genetics, otolaryngology, speech language therapy, occupational and physical therapy, and social work. In depth evaluations are completed, often in an arena setting.
Developmental-Behavioral Evaluation Clinic (DBEC) is a multidisciplinary clinic designed to evaluate children with developmental disabilities and significant behavioral or psychiatric problems. Children seen in this clinic are quite complex, and the referring provider is seeking an additional, expert opinion regarding differential diagnosis. The DBEC team of providers includes developmental-behavioral pediatrics, child psychiatry, school psychology, and social work.
High Risk NICU Follow-Up Clinic addresses the routine follow-up of high-risk infants discharged from the NICU. The team of providers – including neonatology, developmental-behavioral pediatrics, and psychology – conduct medical, developmental, and behavioral assessments at every visit. These children are followed regularly until school age (6 years of age) to ensure early identification and intervention. Common outcomes include cerebral palsy, failure to thrive, hydrocephalus, hypoxic-ischemic encephalopathy, periventricular leukomalacia, global developmental delays, vision and hearing impairments, learning disabilities, language disorders, sleep disorders, behavioral disorders, and ADHD.
Infant and Toddler Evaluation Clinic evaluates children ages 0-3 years with concerns for delayed development in one or more developmental domains, including gross motor, fine motor, language, problem-solving, and/or social-emotional. Children sometimes present with primary behavior concerns. Diagnostic evaluation includes history, physical, and neurodevelopmental screening.
International Adoption Clinic offers a multidisciplinary team evaluation with a developmental-behavioral pediatrician, a pediatrician with expertise in tropical and international medicine, and an occupational therapist. Previously institutionalized internationally adopted children are at risk for developmental delays, psychosocial growth failure, fetal alcohol spectrum disorders, attachment disorders, and other behavioral disorders as a result of possible abuse or neglect.
Neurodevelopmental Psychiatry Clinic provides second opinion evaluations for youth with complex disorders. A developmental-behavioral pediatrician and child psychiatrist interview the family and screen for pre-academic and cognitive concerns to evaluate potential learning and behavioral concerns.
Neuropsychology Clinic evaluates children and adolescents with complex medical and developmental histories, for whom thorough assessment of the range of thinking skills and behavior may assist with differential diagnosis and effective treatment planning. Children with a history of epilepsy, traumatic brain injury, sickle cell disease, cancer and brain tumor treatment, genetic syndromes, and other medical conditions benefit from this type of evaluation that can help explain brain-behavior relationships. In addition, children with learning disabilities, ADHD, and autism spectrum disorder, for whom previous evaluations and/or interventions proved ineffective, may benefit from a thorough neuropsychological evaluation.
Parent-Child Interaction Therapy (PCIT) is an evidence-based treatment for young children with emotional and behavioral disorders that places emphasis on improving the quality of the parent-child relationship and changing parent-child interaction patterns. Developmental-Behavioral Pediatrics offers PCIT services to children (ages 2-7) who are followed in the division and have oppositional, defiant, and aggressive behavior. An initial visit is aimed at gathering information about presenting concerns and history. Subsequent, weekly visits typically involve observation and guided behavioral intervention in the context of parent-child play.
Preschool Clinic evaluates children ages 4-6 years who present with a range of concerns, including developmental delays, behavior problems, language disorder, fine motor dyspraxia, intellectual disability, autism spectrum disorder, ADHD, oppositional defiant disorder, and anxiety disorders. Developmental-behavioral pediatricians and/or psychologists evaluate this broad range of referring concerns to inform effective, evidenced-based treatment, including referral to allied health professionals.
School-Age Clinic evaluates children and adolescents who are 6 years of age and older with concerns for academic difficulty and/or behavior problems, such as ADHD, autism spectrum disorder, learning disability, and intellectual disability. Developmental-behavioral pediatricians and/or psychologists evaluate this broad range of referring concerns to inform effective, evidenced-based treatment, including referral to allied health professionals.
Spina Bifida Clinic is an interdisciplinary clinic representing developmental-behavioral pediatrics, pediatric orthopedics, pediatric neurosurgery, pediatric urology, physical therapy, and nursing. All patients followed in this clinic receive annual developmental-behavioral screening and general pediatric care addressing the special needs associated with spina bifida.
MUSC Rutledge Tower
135 Rutledge Avenue
Charleston, SC 29425