What to expect at your child's neurological exam

Child Neurologist Jane Tavyev Asher, MD, shares advice for parents on what to expect when taking your child to a neurological exam in order to help parents and their child know what to anticipate
What To Expect At Your Child's Neurological Exam
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What to expect at your child's neurological exam

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Transcription: 
A neurological exam or neurological visit is quite similar to any other doctor visit where you come in to see the doctor and a history is taken and an exam is done. The difference is that the history we take at the neurologist's office might include more details about the child's development, when they achieved specific milestones and what the parent's concerns are about the child's behavior, development, or any other neurologic issues such as headaches, tics or other areas of concern to them. The other thing we do is a complete neurologic exam. So we do the standard physical exam, but we focus more on the neurologic exam than the pediatrician might. We test reflexes. We test strength in all of the different muscle groups. We test sensation. We test eye movements and facial movements. We often test balance and gait, or how the child is able to walk. If they're younger, we have to modify some of those things because they can't fully cooperate with the testing. For example, they can't understand instructions to resist when we're testing their muscles. Or make a muscle and don't let me pull your arm out. So we have to other techniques that we use. Sometimes a lot of the exam can be observational. So neurologists are trained to pay attention to the child out of the corner of their eye even while they're talking to the parents and pick up behaviors and differences, for example, in how the child is using one arm versus the other or observe their gait or their walking while the doctor is talking to the parents because children don't always want to cooperate in that moment. As a developmental neurologist, or a specialist in developmental disabilities, I often also follow my neurologic exam up with developmental testing. So under the age of 3, I have a set of toys that I have the child play with, and based on how they play with their toys, I'm able to assess information about their cognitive level and their fine motor skills. I'm also able to use similar techniques to assess their language. I do always promise the patients no owies. I don't do any shots or anything in the visit, which is something they might expect from their pediatrician.

Child Neurologist Jane Tavyev Asher, MD, shares advice for parents on what to expect when taking your child to a neurological exam in order to help parents and their child know what to anticipate

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Jane Tavyev Asher, MD

Division of Child Neurology - Cedars-Sinai Medical Center

Dr. Jane Tavyev Asher is a board certified Child Neurologist and Director of the Division of Child Neurology at Cedars-Sinai Medical Center.  Upon attaining her medical degree from Baylor College of Medicine, she completed residency/ fellowship training in Child Neurology and Neurodevelopmental Disabilities at Baylor College of Medicine/ Texas Children’s Hospital, where her clinical training focused on behavioral neurology, specializing in autism and other developmental disorders, and her research focused on epigenetic factors in autism.  She currently maintains a clinical practice at Cedars-Sinai Medical Center in Los Angeles, where she sees patients with a variety of neurologic conditions such as Autism Spectrum Disorders, developmental delay, ADHD, learning disabilities, tics, headaches, and cognitive/ behavioral management in neuromuscular disorders.  She holds an academic/ research appointment as Assistant Professor at UCLA in the Departments of Pediatrics, Psychiatry and Biobehavioral Sciences.  Her current research interest remains in the area of autism.  Dr. Tavyev Asher is proud to contribute to the training of the next generation of physicians including those specializing in Pediatrics, Child Psychiatry, and Child and Adult Neurology, and she enjoys giving talks on various neurologic topics locally and nationally.  She is a member of the Child Neurology Society, American Academy of Child and Adolescent Psychiatry, UCLA CART (Center for Autism Research and Treatment), and The Help Group-UCLA Autism Research Alliance.  She also serves on the Advisory Board of Healthy Child Healthy Child Healthy World.  She enjoys art, music, yoga, skiing, and relaxing with her family.

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Transcription: 
A neurological exam or neurological visit is quite similar to any other doctor visit where you come in to see the doctor and a history is taken and an exam is done. The difference is that the history we take at the neurologist's office might include more details about the child's development, when they achieved specific milestones and what the parent's concerns are about the child's behavior, development, or any other neurologic issues such as headaches, tics or other areas of concern to them. The other thing we do is a complete neurologic exam. So we do the standard physical exam, but we focus more on the neurologic exam than the pediatrician might. We test reflexes. We test strength in all of the different muscle groups. We test sensation. We test eye movements and facial movements. We often test balance and gait, or how the child is able to walk. If they're younger, we have to modify some of those things because they can't fully cooperate with the testing. For example, they can't understand instructions to resist when we're testing their muscles. Or make a muscle and don't let me pull your arm out. So we have to other techniques that we use. Sometimes a lot of the exam can be observational. So neurologists are trained to pay attention to the child out of the corner of their eye even while they're talking to the parents and pick up behaviors and differences, for example, in how the child is using one arm versus the other or observe their gait or their walking while the doctor is talking to the parents because children don't always want to cooperate in that moment. As a developmental neurologist, or a specialist in developmental disabilities, I often also follow my neurologic exam up with developmental testing. So under the age of 3, I have a set of toys that I have the child play with, and based on how they play with their toys, I'm able to assess information about their cognitive level and their fine motor skills. I'm also able to use similar techniques to assess their language. I do always promise the patients no owies. I don't do any shots or anything in the visit, which is something they might expect from their pediatrician.