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Programs...we got programs!
The Child and Adolescent Clinic offers a variety of programs and services to help your child maintain optimal health. Our services range from comprehensive well child evaluations that include hearing and vision screening to more specialized evaluations for conditions such as ADHD and asthma. Here are our current Programs and Services (click to jump to a more detailed description, or just scroll down to look at all of the programs and services):
Adolescence can be a confusing time for both teens and their parents. As the adolescent matures both physically and psychologically, he or she may have an increased desire for privacy and an increasing number of questions about themselves and their place in the world around them. At the Child and Adolescent Clinic, we acknowledge and respect this increasing independence by changing the structure of our visits to include time with the adolescent alone as well as time with the adolescent and his/her parent. We try to be focused listeners, responding respectfully to the concerns of our adolescent patients.
The transition from adolescence to adulthood takes many forms. For some, this will include going to college. At the Child and Adolescent Clinic, we offer pre-college visits to ensure that the adolescent has received appropriate vaccinations, including the new meningitis vaccine, Menactra, and the new Tetanus/Pertussis (whooping cough) booster vaccine. We also emphasize age-appropriate safety information, including personal safety and the dangers of alcohol and drug use. If the adolescent has chronic conditions that require ongoing prescriptions, we work with the adolescent to ensure continued access to those medications, either by providing the prescriptions through our clinic or by coordinating the transition to another provider, such as student health, by transferring the necessary medical records and information. For young adults with complex medical conditions, we work with them to make the transition to adult caregivers a successful one.
Asthma, Spirometry, and Allergy Immunotherapy
The incidence of childhood asthma and allergic disease has been increasing over the last 50 years, resulting in billions of health care dollars spent and millions of lost school days annually for children with these diagnoses. At the Child and Adolescent Clinic, our goal is to offer coordinated care to maximize activity and minimize symptoms for our patients with these diagnoses. We offer regular asthma review visits with spirometry (up to date, computerized assessment of asthma severity and response to treatment) and communicate this information to caregivers and school through personalized asthma action plans. Because asthma and its treatments may be complex, we offer each asthma patient at our clinic a special asthma care binder filled with information regarding asthma, how it is diagnosed, what medicine may be used to treat it, and how those medicines work to treat asthma. The binder also serves as a place to file those asthma action plans and peak flow meter readings. Our asthma patients also receive priority for flu shots each fall at our flu shot clinics.
The Child and Adolescent Clinic physicians manage many kinds of routine allergic conditions such as seasonal allergies and eczema; however, we offer prompt referral to a pediatric allergy specialist when necessary for evaluation and treatment of more complex allergic conditions. Similar to our asthma action plans, we offer personalized anaphylaxis action plans for caregivers and schools that include detailed information on how to respond in case of a potentially life threatening allergic reaction, such as to peanuts. We also work with our patients to ensure that they have the necessary medicines, including Epi-pen epinephrine shots, available to them both at home and at school.
The physicians, nurse practitioners, and staff at the Child and Adolescent Clinic are committed to helping you and your infant succeed as a breastfeeding team. We offer consultations with an Internationally Certified Lactation Consultant routinely. In fact, we believe that each breastfeeding mother should meet with our Lactation Consultant once around the time of the baby's first clinic visit, to help prevent problems before they occur. We have Medela breast pumps for rent or sale at near cost. If you choose to breastfeed your infant, we will be there to help you!
Community Child Health Education
The Child and Adolescent Clinic believes that education is one of the key components of ensuring optimal child health – education not only for parents, but also for its own doctors and other professionals who take care of children. That is why we offer educational programs for both our families and their doctors.
One of the ways we support parent education is through Telemedicine. This allows us to broadcast lectures from Children’s Hospital, Seattle that would otherwise be unavailable to our parents. Past lectures have included discussions on Diabetes, Autism, and ADHD. Many exciting topics will be offered on a monthly basis. In addition, our own pediatricians along with Debra, our lactation specialist, are holding free newborn classes every month which will go over breastfeeding basics and what to expect with a new child. If you are a parent, you can find out the educational events being offered by looking under the “Events” section on the left column of the homepage www.candac.com.
Educational offerings for professionals include weekly grand rounds televised from Children’s Hospital, Seattle during which experts from the medical field discuss the latest discoveries in the field of pediatrics, and monthly Pediatric Fine Rounds at St. John Medical Center where speakers are invited to talk on many subjects. If you are a medical professional and would like the Grand Rounds schedule, follow this link: http://www.seattlechildrens.org/health_care_professionals/education/grand_rounds.asp Please call us if you are interested in the Pediatric Fine Rounds schedule.
Dental Health, Topical Fluoride
Dental cavities are the most common disease caused by infection in children. At the Child and Adolescent Clinic, we assess dental health at each well child visit and provide guidance for parents regarding cavity prevention at each well child visit through the first few years of life. We promote dental health by providing fluoride prescriptions for children living in homes without fluoridated water. In fact, we will soon be providing topical fluoride applications at regular intervals for children under the age of 2. We also offer referrals to pediatric dentists when necessary for evaluation and treatment of childhood dental disease. Finally, we perform presurgical evaluations for patients requiring dental care under general anesthesia.
The Child and Adolescent Clinic believes strongly in preventative care. We follow the American Academy of Pediatrics guidelines for vaccine schedules. All vaccines except the influenza shot designed for children older than three are now thimerisol free.
By the age of three, your child should be protected against the following diseases:
Some premature infants need a monthly injection during the winter months to protect them from RSV, a viral lung infection that can be especially dangerous for these more fragile babies. We provide this vaccine as well.
Children over the age of 10 will receive the vaccine to help protect them from Meningococcus, a disease that can be rapidly life-threatening. They will also receive boosters to continue their protection against Tetanus and Whooping Cough.
The state of Washington provides most vaccines free of charge, so you or your insurance will usually be responsible only for a handling and injection fee.
The Child and Adolescent Clinic is enrolled in CHILD PROFILE, a nationwide organization that allows confirmation of your child's immunizations to follow them from state to state, even if other records are unavailable.
The Child and Adolescent Clinic fully participates in the Washington State Newborn Hearing Screening Program. All newborn babies undergo painless Otoacoustic Emmissions (OAE) testing either at the hospital shortly after birth or at the clinic. Infants who do not pass the initial screening are retested at the clinic at one of their early appointments. Babies with persistent difficulties or risk factors for hearing loss are referred to experienced hearing professionals so that interventions and therapies can begin early for hearing-impaired infants.
In addition to newborn screening, all school-aged children undergo audiometric hearing screening during their annual well-child visits.
Our patient education program relies heavily on material written by our own doctors and nurse practitioners. This information is kept up-to-date by regular review and revision. We also have available to you handouts produced by the American Academy of Pediatrics and others. Our goal is to give you as much information as possible so you can be an active, knowledgeable partner in managing your child's health.
If you have a particular topic that you would like to learn more about, ask us for book suggestions.
Pediatric Subspecialty Outreach Clinics
The Child and Adolescent Clinic believes in comprehensive care for your child. When we feel that an issue is beyond our area of expertise or could benefit from the experience a subspecialist can offer, we provide prompt referrals. Most of our pediatric subspecialist colleagues are not located in the Longview/Kelso area, however, and this often presents a transportation challenge. Recognizing this, we have partnered with some of our subspecialist colleagues so that they come to our office to see patients, therefore saving a long car ride. Currently, subspecialty outreach clinics exist for Asthma/Allergy, Cardiology, Endocrinology, and Neurology. These specialists visit on the following schedules:
We are continually working to get other subspecialists to establish outreach clinics in our office.
If is often jokingly said that about half of what a person learns in medical school will be outdated by the time he starts practicing medicine. While this may be somewhat of an exaggeration, the truth is that medical knowledge changes and evolves rapidly. At the Child and Adolescent Clinic, we recognize this and strive to make sure we provide you and your child with the most up-to-date and evidence-based management and treatment options.
We continually review our policies and procedures to ensure that they comply with current practice standards. In fact, we have a weekly meeting dedicated solely to reviewing our existing practice guidelines and incorporating the latest research and literature on a given topic. Our Child Nurturing Guide is reviewed and updated on an annual basis, and our patient handouts undergo the same review process. We do all this to ensure that the care your child receives is not only standard of care but the best care that they can get.
Every year, an increasing number of children participate in individual or team sports. The clinicians at C&AC are happy to evaluate your child or adolescent athlete’s acute and overuse injuries. We can help to clarify the diagnosis and to establish treatment plans, and we work closely with local physical therapists, orthopedic surgeons, and radiologists when referrals are appropriate. We also perform annual or biannual Preparticipation Physical Evaluations for children and adolescents participating in organized athletics.
The Child and Adolescent Clinic staff is committed to helping our adolescents stop smoking. We strongly urge all household members to stop smoking as well. Prevention of second hand smoke exposure has been shown to be an important way of preventing frequent ear infections and pneumonias and decreasing the chance of developing childhood asthma.
We have staff trained as Prevention/Intervention Specialists who work with our doctors and nurse practitioners to help you stop smoking. They offer brief counseling sessions using handouts and practical suggestions to aid you. We encourage follow-up visits with one of our doctors or nurse practitioners if there are questions or struggles. We won’t give up if you don’t!
The Child and Adolescent Clinic offers free telephone advice service to its patients. For parents who have questions about what to do next, or who aren’t sure whether their child needs to be seen at the clinic, help is available 24/7. Our advice aides follow established guidelines to answer questions, and there is always a physician available to address more complicated concerns.
In this day and age, parents are often using the internet as a source of medical information. The Child and Adolescent Clinic has recognized this and established a presence on the web at www.candac.com. Through this website, parents will be updated on upcoming events and clinic announcements, and will be guided to websites that have been reviewed by our pediatricians so that they know they will be getting reliable medical information from the internet.
The Child and Adolescent Clinic has X-Ray facilities located conveniently on-site. Many of the X-rays used to make common pediatric diagnoses can be obtained during a child’s appointment at the clinic. When other studies are needed, including more complex X-rays, CT scans, or MRI, we will make arrangements for your child to get them promptly.
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