When to consult an ENT Doctor for my child?

"Your child's Pediatrician is the primary care provider and incharge of your child's health."

Parents should consult a Pediatric ENT only if the child's Pediatrician has suggested them to do so.

Pediatric otolaryngologists are concerned with treatment of medical and surgical ENT disorders in children. They have been trained to take care of children from newborn period to teenage years.

Children are not just small adults.The disease presentations and management can differ from adults.Right from the clinical approach for diagnosis differs in children.It needs specialised training and experience in working with children to keep them comfortable while examining them.

A child will not always be cooperative and will not be able to answer medical questions or express their problems. Sometimes they have their own ways of expressing concerns. I cannot forget a 3 year old telling me her ears are "singing" and we did go ahead and found a cause.

If we learn to interact with kids, they are also capable of giving information.They may not answer direct questions or get overwhelmed with questioning.

Interaction with the child is a must for a pediatric otolaryngologists as child is the one who needs attention.This is especially useful in diagnosing social and communication disabilities.Many times parents are in denial or do not know age appropriate behaviours,in these situations direct interaction with the child is a must.

All of the above requires experience,skill and judgement with the team including the primary treating pediatrician.

Finally be a child with the child....and the doctor for the family.

Preschool Health Screening: Is it necessary and what does it involve?

Schools have started and I have started getting visits of little ones whose parents are advised to see ENT doctor following the childs health screenings in school.

 Preschooler

There are a few points about school/pre school health screenings,I would like to discuss here.

Before we start, lets talk about "Neural Plasticity" and 'Critical Period" 

During early period of life, neurons in brains are moldable (plastic) and it is easy to teach any skill to a child. Once the child is above 5 years,it is difficult to do rehabilitaton and bring them age appropriate. Hence we say that the critical period is the early infant or toddler years.

Let me take you through some common questions asked by parents:

1. Preschool screening: Is it mandatory? Should it be made mandatory by law?
My toddler has been visiting pediatrician regularly,why another screening?

The pediatrician is definitely your child's primary physician.When you visit a pediatrician in well baby clinics/immunization clinic, usually they record the growth and development of the child.
However, there are other aspects of development like speech,language,cognition,social and emotional behaviour.
In many parts of the world,it is mandatory by law.

2. Parent permission is compulsory for any screening.

3. Child's birth records and health records should be available during screenings.This is for the screening practioner to understand the child's growth (age appropriate) or to make provisions for any insults at birth and need extra time required to achieve age appropriate milestones.

4. Who should do it?
A health practitioner or a registered nurse trained in screening.

5. What does it involve?
Apart from physical examination and interacting with the child, they may also plan some activities (like blocks/scribbling etc age appropriate)

6. What are the components in a standard screening?

Eye contact, motor control and body language in a typical kindergardener

Any screening should involve hearing and vision tests.Apart from this: motor development,language development (mother tongue or a language which is spoken at home around the baby),social emotional development and cognition is informally checked.

7. Will they "label" or diagnose my child?
No! its only a screening.If there is any concern, child will be sent to appropriate specialists for confirmatory diagnosis or sometimes only a re screening is advised.

8. Should I be rest assured if my child passes screening for any future health or disability issues?
No.If at any time parents have concerns about the child's growth or development, tey should bring it to the notice of pediatrician who can advise you further.

9. Finally and most important, screening should be done as early as possible,We have better chance of correction and treatment early, best being a child below 3 years of age.
This will give us enough time for intervention and make the child school ready.

10. My child is shy and will not allow screening?
The health practitioners are trained to handle kids and very well trained that each child is different.