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Investigation

  • DEVELOPMENTAL SCREENING DEVELOPMENTAL SCREENING

    A child’s growth is more than just physical. Children grow, develop, and learn throughout their lives, starting at birth. A child’s development can be followed by how they play, learn, speak, and behave.

    What is a developmental delay? Will my child just grow out of it?

    Skills such as taking a first step, smiling for the first time, and waving “bye bye” are called developmental milestones. Children reach milestones in playing, learning, speaking, behaving, and moving (crawling, walking, etc.). A developmental delay is when your child does not reach these milestones at the same time as other children the same age. If your child is not developing properly, there are things you can do that may help. Most of the time, a developmental problem is not something your child will “grow out of” on his or her own. But with help, your child could reach his or her full potential.

    What is developmental screening?

    Doctors use developmental screening to tell if children are learning basic skills when they should, or if they might have problems. Your child’s doctor may ask you questions or talk and play with your child during an exam to see how he or she learns, speaks, behaves, and moves. Since there is no lab or blood test to tell if your child may have a delay, the developmental screening will help tell if your child needs to see a specialist.

    Why is developmental screening important?

    When a developmental delay is not recognized early, children must wait to get the help they need. This can make it hard for them to learn when they start school. Children have a developmental or behavioral disability such as autism, intellectual disability (also known as mental retardation),or Attention-Deficit/Hyperactivity Disorder (ADHD). In addition, many children have delays in language or other areas. But, less than half of children with problems are identified before starting school. During this time, the child could have received help for these problems and may even have entered school more ready to learn. I have concerns that my child could have a developmental delay. Whom can I contact to get a developmental assessment for my child? Talk to your child’s doctor if you have concerns about how your child is developing. If you or your doctor think there could be a problem, you can take your child to see a developmental pediatrician or other specialist for help. If there is a problem, it is very important to get your child help as soon as possible.

    How can I help my child’s development?

    Proper nutrition, exercise, and rest are very important for children’s health and development. Providing a safe and loving home and spending time with your child – playing, singing, reading, and even just talking – can also make a big difference in his or her development.

  • ELECTROENCEPHALOGRAM (EEG) ELECTROENCEPHALOGRAM (EEG)

    An electroencephalogram (EEG) is a test used to evaluate the electrical activity in the brain that may be associated with certain brain disorders.

    What are the prerequisites before doing an EEG?

    • Wash your hair the night before the EEG, and don’t put any products (such as sprays or gels) in your hair on the day of the test.
    • Ask your doctor if you should stop taking any medications before the test. You should also make a list of your medications and give it to the technician performing the EEG.
    • Avoid consuming any food or drinks containing caffeine for at least eight hours prior to the test.

    Your doctor may ask you to sleep as little as possible the night before the test if you’re required to sleep during the EEG. You may also be given a sedative to help you to relax and sleep before the test begins.

    What is the procedure in doing an EEG?

    An EEG may be done at a hospital, at your doctor’s office, or at a laboratory by a specialized technician. It usually takes 30 to 60 minutes to complete.

    • You’ll be asked to lie down on your back in a reclining chair or on a bed.
    • The technician will measure your head and mark where the electrodes will be placed. These spots are then scrubbed with a special cream that helps the electrodes get a high-quality reading.
    • The technician will put a sticky gel adhesive on 16 to 25 electrodes. They will then be attached to various spots on your scalp.
    • Once the test begins, the electrodes send electrical impulse data from your brain to the recording machine. This machine converts the electrical impulses into visual patterns that can be seen on a screen. These patterns are saved to a computer.
    • The technician may instruct you to do certain things while the test is in progress. They may ask you to lie still, close your eyes, breathe deeply, or look at stimuli (such as a flashing light or a picture).
    • After the test is complete, the technician will remove the electrodes

    What is an EEG Test?

    The test tracks and records brain wave patterns. The electrodes analyze the electrical impulses in the brain and send signals to a computer, where the results are recorded. The electrical impulses in an EEG recording look like wavy lines with peaks and valleys. These lines allow doctors to quickly assess whether there are abnormal patterns. Any irregularities may be a sign of seizures or other brain disorders.

    There are no risks associated with an EEG. It is a painless and safe procedure.

  • BRAIN-STEM EVOKED RESPONSE AUDIOMETRY (BERA) BRAIN-STEM EVOKED RESPONSE AUDIOMETRY (BERA)

    Brain-stem Evoked Response Audiometry (BERA)Bera is an objective way of eliciting brain stem potentials in response to audiological click stimuli. These waves are recorded by electrodes placed over the scalp. Even though BERA provides information regardi

    How is the BERA test conducted?

    Bera is an objective way of eliciting brain stem potentials in response to audiological click stimuli. These waves are recorded by electrodes placed over the scalp.  Even though BERA provides information regarding auditory function and sensitivity, it is not a substitute for other methods of audiological evaluation. It should be always viewed in conjunction with other audiological investigations.

    How is the BERA test conducted?

    The stimulus either in the form of click or tone pip is transmitted to the ear via a transducer placed in the insert ear phone or head phone. The wave forms of impulses generated at the level of brain stem are recorded by the placement of electrodes over the scalp.

    What are the uses of BERA?

    • BERA is an effective screening tool for evaluating cases of deafness due to retrocochlear pathology i.e. (Acoustic schwannoma). An abnormal BERA is an indication for MRI scan.
    • Used in screening newborns for deafness
    • Used for intra-operative monitoring of central and peripheral nervous system
    • Monitoring patients in intensive care units
    • Diagnosing suspected demyelinated disorders

    What are the criteria for screening newborn babies using BERA?

    • Parental concern about hearing levels in their child
    • Family history of hearing loss
    • Pre and post natal infections
    • Low birth weight babies
    • Hyperbilirubinemia
    • Cranio facial deformities
    • Head injury
    • Persistent otitis media
    • Exposure to ototoxic drugs

  • VISUAL EVOKED POTENTIAL (VEP) VISUAL EVOKED POTENTIAL (VEP)

    A visual evoked potential is an evoked potential caused by a visual stimulus, such as an alternating checkerboard pattern on a computer screen. Responses are recorded from electrodes which originate from the occipital cortex – the area of the brain involv

    What are the Indications of doing a VEP test ?

    • Loss of vision (this can be painful or non-painful);
    • Double vision;
    • Blurred vision;
    • Flashing lights;
    • Alterations in colour vision; or
    • Weakness of the eyes, arms or legs.

    What are the prerequisites for doing a VEP?

    • Wash your hairthe night before, but avoiding hair chemicals, oils and lotions.
    • Make sure you get plenty of sleepthe night before.
    • If you wear glasses, make sure you bring these along with you to the test.
    • You are usually able to eat a normal mealand take your usual medications prior to the test. However any medications that may make you drowsy should be avoided.
    • Arrive on time and try to relax before the test.
    • On the day of the test, you should also let the technician know if you have any eye conditions such as cataracts or glaucoma as this can affect the test and should be noted in your records by the doctor.

    The procedure is very safe and non-invasive.

    What are the prerequisites for doing a VEP?

    • Firstly, some wireswill be glued to the top of your head to detect the brain waves.
    • A technician will give you further instructions on what to do during the test. Normally, each eye will be tested separately.
    • It is very important that you co-operate with the technician who conducts the test and be able to fix your vision in a certain spot. You will be asked to look at a screen similar to a television screen, with various visual patterns.
    • Readings will be recorded through the wires on top of your head.
    • After the procedure, the glue and wires are removed from your head. The doctor may discuss the results of the test with you after they have been analysed; otherwise the referring doctor will.
    • Usually the procedure takes about 45 minutes.