So what’s the an­swer? Do all par­ents rou­tinely give their child an MRI?

Wellness Update - - CLEVLAND CLINIC -

It’s just not that easy. Dr. Singh cau­tions by say­ing, “you just can’t start ran­domly do­ing MRIs on ba­bies. That’s a bit ag­gres­sive and given the rar­ity of the disease, un­nec­es­sary. It would make more sense to take a more log­i­cal ap­proach by work­ing with the child’s pe­di­a­tri­cian to watch the bench­marks of de­vel­op­ment. Some chil­dren are a lit­tle slower in de­vel­op­ing. But if there is con­cern, start­ing by com­mu­ni­cat­ing with a pe­di­a­tri­cian. If a pe­di­a­tri­cian feels there are con­cerns, most likely he or she will consult a pe­di­atric neu­rol­o­gist. In gen­eral, an MRI scan to eval­u­ate a child sim­ply be­cause there are some mild de­lays in de­vel­op­ment would have a low prob­a­bil­ity of show­ing any­thing use­ful and would be ex­pen­sive. An MRI is ap­prox­i­mately $2,500 to $3,500 if the cost of se­da­tion is in­cluded. Imaging has come a long way from the equip­ment we had in the 80s and 90s and that’s why so many cases were missed or mis­di­ag­nosed. But hav­ing this new equip­ment doesn’t mean we should abuse its ca­pa­bil­i­ties.” But at what point does the par­ent be­come over­bear­ing and at what point does the pe­di­a­tri­cian lis­ten more closely? In one case, a fa­ther in Vir­ginia told his pe­di­a­tri­cian he was con­cerned that his first child wasn’t walk­ing by the age of one. The pe­di­a­tri­cian re­sponded by telling the fa­ther to re­lax be­cause in some cases it takes up to 18 months for a child to be­gin walk­ing. That same fa­ther had a third child who, at 15 months wasn’t walk­ing or talk­ing. He was con­cerned, but re­mem­bered the con­ver­sa­tion with the pe­di­a­tri­cian about his first son. For­tu­nately his wife, who has a mas­ter’s de­gree in ed­u­ca­tion and an un­der­stand­ing of child de­vel­op­ment bench­marks, be­gan to ques­tion their son’s in­abil­ity to meet those bench­marks. She was sure their son was be­hind and in­sisted on fur­ther test­ing. Once again, the re­ha­bil­i­ta­tion center tried to con­vince the par­ents that they were be­ing a lit­tle over­cau­tious. Still, they in­sisted. When the test­ing was done, their son was di­ag­nosed with se­vere ACC. He was al­ready three months be­hind and none of the med­i­cal ex­perts could pre­dict whether or not their child would ever walk or talk. Op­ti­misti­cally, ev­ery­one agreed he was di­ag­nosed early enough to be able to max­i­mize his po­ten­tial to de­velop— what­ever that po­ten­tial. Sadly, ACC has its ranges of progress. What the ul­ti­mate out­come will be typ­i­cally isn’t known un­til the child is about five years old.

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