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Children's Health Testing Overview

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and

Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient's names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Children's Health Testing

A. Mental Status Examination

What is a Mental Status Examination?

A mental status examination is used to assess the cognitive skills of the patient. It involves a series of questions that evaluates the mental function, thought process and the behavior of the patient. The following are categories that are used in evaluating conditions such as Alzheimer's Disease, depression, ADD-ADHD and memory loss:

• Appearance
• Behavior
• Speech
• Mood and affect
• Thought processes and content
• Perception
• Attention and concentration
• Orientation
• Memory
• Judgment
• Intelligence and information
• Insight

Indications and Contraindications:

A Mental Status Examination is done to patients when conditions such as Parkinson's Disease, Alzheimer's Disease, ADD-ADHD, neurological trauma, psychological diseases, depression and memory loss is suspected.

How does it feel? How long will it take?

A mental examination may take approximately 1-2 hours to be completed. During the test, the patient will asked simple questions regarding the date, month, year, time of day, events, numbers, personal experiences, and objects. Short term memory will also be assessed through repetition and recall exercises. Language and speech will also be evaluated, as well as moods such as anxiety, depression, emotional distress and attitude. 

Effects after the test:

There are no side-effects to a neurological examination. In some cases, the patient may feel exhausted from the physical and mental tests by the end of the examination. 

Results:

Normal Findings: All tested functions are found within the normal range

Abnormal Findings:

• The patient is having trouble staying alert and oriented
• The patient is not able to converse properly (delayed/rapid speech)
• The patient cannot follow instructions given 
• Reduction in spontaneous movements and fidgeting. You may also have reduced facial expressions, less blinking, small handwriting and slow, soft speech.
• Stooped posture.
• Mental state examination may reveal evidence of dementia and impaired memory or concentration. These changes are seen in over half of patients over 65 years.
• Mood: euphoric/dysphoric
• Impairment of the senses
• Memory Loss

Neurological Examination

What is the Neurological Examination?

A neurological examination is a noninvasive procedure that evaluates a child's intelligence, motor system, sensory system, reflexes, coordination, grip and muscle tone through physical and intelligence tests.

Indications and Contraindications

A neurological examination is done to patients when conditions such as Parkinson's Disease, Cerebral Palsy, Alzheimer's Disease, ADD-ADHD, neurological trauma, psychological diseases, and memory loss is suspected. 

How do you prepare for a Neurological Examination?

There are no special preparations required for a neurological examination.

How does it feel? How long will it take?

A neurological examination may take approximately 1-2 hours to be completed.

The doctor will be conducting an observation of the patient that will check for development, motor skills, muscle tone, posture, reflexes, and intelligence.

Effects after the test:

There are no side-effects to a neurological examination. Depending on the patient's mental and physical health, the patient may feel exhausted from the tests by the end of the neurological examination.

Results:

Normal Findings: All tested functions are found within the normal range

Signs that brain damage is present and is suggestive of cerebral palsy are:

• Evidence of abnormalities in posture
• Abnormalities in reflexes
• Developmental delay
• Motor dysfunctions- lack of coordination and balance, slow movement, trembling, asymmetries of movement
• Weak senses
• Muscle tone changes

Diagnostic and Statistical Manual of Mental Disorders- 4th Ed.  (DSM-IV) Criteria for Autistic Disorder

What is theDSM-IV Criteria for Autistic Disorder

The DSM-IV Criteria for Autistic Disorder is the standard for assessing a child's social behavior, attention span, imagination, motor and sensory skills, development and communication as related to autism. 

Why is the test done?

If you suspect that your child has symptoms of autism, obtain an autism questionnaire recommended by your physician from publishers or from the internet. As soon as you complete the questionnaire, bring a copy of the questionnaire to your physician for a consultation and qualification for diagnosis.

There are no medical tests for autism. Diagnosis of autism is based on the observations of a child's behavior by a physician and the scores on a series of autism questionnaires and symptom checklists. The DSM-IV Criteria for Autistic Disorder is used to assess these questionnaires to identify autism in children.

The following presents the diagnostic criteria for autistic disorder from Diagnostic and Statistical Manual of Mental Disorders: DSM IV:

Diagnostic Criteria for 299.00 Autistic Disorder (DSM-IV)

(I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)

(A) qualitative impairment in social interaction, as manifested by at least two of the following:

1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
4. lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids )

(B) qualitative impairments in communication as manifested by at least one of the following:

1. 1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects

(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play

(III) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

The Right Diagnosis and Treatment for Children's Health

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical's Personal Approach to Children's Health

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer's, Diabetes, Parkinson's, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.