Toddlers Infants Preschoolers Clinic (TIPS)
The TIPS Clinic serves children under age 6 with emotional, behavioral and developmental difficulties. Families are referred to the clinic by their existing pediatricians, schools or therapists, but self-referrals also are accepted. Children can suffer from the same psychiatric illnesses as adults – such as anxiety disorders, depressive disorders or attention deficit hyperactivity disorders – but children┐s presentation is often widely different. Children are not simply little adults. Special training and expertise is required when evaluating younger children for psychiatric disorders. Evaluations are often more lengthy that those in adolescents or adults and involve gathering information from collateral sources such as the child┐s day care, school or existing therapists. It is natural for children to have tantrums or meltdowns, but when the distressing behavior occurs frequently or causes impairment at home or at school, then parents are encouraged to look further into causes by either talking to their pediatrician, school or other health care providers. Listed below are some of the signs of behavioral and emotional difficulties in younger children:
- School refusal
- Frequent crying spells
- Difficulties with transitions
- Difficulties soothing
- Temper tantrums
- Refusing to speak in public
- Difficulties separating from family
- Not reaching age-appropriate milestones
- Loosing skills that was already developed
- Aggressive behaviors to self or to others
Listed below are some of the psychiatric diagnosis in children:
- Developmental delays
- Autism and autism spectrum disorders
- Attention deficit hyperactivity disorders
- Oppositional defiant disorders
- Learning disorders
- Mood disorders (depression and bipolar disorder)
- Anxiety disorders
- Separation anxiety disorders
- Obsessive compulsive disorders
- Intermittent explosive disorders
- Tic disorders
- Attachment disorders
Listed below are some of the therapeutic interventions used for treatment of psychiatric disorders in children:
- Medication management
- Child parent training
- Individual psychotherapy
- Speech therapy
- Occupational therapy
- Social skill therapy
What to expect at the time of appointment:
Initial assessments are on average for 90 minutes. Mojgan Makki, MD, will meet the child and the child’s family together at first but will spend time alone with the parent or, if needed, with the child. At times children may be too anxious to do this, which will be honored and respected. We understand that by the time children and families come to us often they are under great deal of stress, and we hope to make the process as peaceful and non-stressful as possible.
During the initial visit you will be asked a broad range of biological, psychological and developmental clinical questions, because many factors such as genetics, environmental, social and family dynamics, or past exposure to trauma can affect children’s growth. If needed, further laboratory, psychological and educational tests will be ordered.
Families are encouraged to arrive 30 minutes prior to the appointment to complete the initial paperwork. They should bring all available documentation pertaining to any prior psychiatric, medical or school evaluations and treatments to the appointment. If the child has an existing Individualized Educational Plan ("IEP"), families are encouraged to bring a copy. Families should also bring a list of medications the child has taken currently or previously, including prescription and over-the-counter medications along with supplements.
Referrals and Consultations:
For referrals and consultations, sources are encouraged to clarify whether the referral is for comprehensive psychiatric evaluation, treatment recommendation and medication management or a one-time consultation. Referrals are encouraged to mention any specific issues they would like to have addressed. Referral sources also are encouraged to include their contact information and preferred method of communication at the time of referral. Makki will contact the referral source after the initial appointment is completed. For a preselected fee, the clinic will provide the referral sources with a comprehensive summary of evaluation, impression and any treatment recommendations if required.
End of initial evaluation:
At the end of the initial evaluation, Makki provides a summary of her impression and her treatment recommendations. She may need more time for assessment or to talk with those involved in the child's care, such as the existing therapist, schools or family members. She may ask to meet with the family for the second appointment before she finalizes her impression and recommendations. She may also recommend further testing including a laboratory blood test, EEG or EKG.
For treatment, Makki may recommend psychotherapy, medication management or a combination of treatment options. The child will continue to see Makki in her clinic for medication management for as long as needed.
If medication is started, Makki will request to see the child in her office in one to two weeks. She also encourages families to call for a quick telephone follow-up in between the appointments and as needed. Once the child is stabilized, visits are scheduled with more time in between the appointments.
Makki may refer the child and the family to one of our therapists at Rush. If the family is already working with a psychotherapist, speech or occupational therapist, Makki will continue to work with that therapist.
How to make your initial appointment:
To make your initial appointment or if you have any other questions, please call Alejandro Mora at (312) 942-KIDS.
Mojgan Makki, MD, is assistant professor and director of the TIPS clinic. Clinical services include assessment and treatment of children ages 6 and under with severe emotional, behavioral and developmental difficulties. Her expertise includes complicated psychiatric evaluations and medication management. She has special interest in forensic, school and child custody evaluations.