Other Services

Initial ADHD assessment (40min)

• Discuss Teacher and Parent Vanderbilt findings.                                            
  (Behavioral assessment, Education and Social functioning assessment, Mental health assessment, Family dynamic assessment)
• Possible referral to Clarity Pediatrics for Behavioral Parent Training (BPT), or 
• Dr. Patricia Gisbert for Neuropsychological testing.
• Incorporation of ADHD and learning accommodations into 504 plan.

If ADHD diagnosis has  been confirmed and medication is indicated, a medication start appointment will be scheduled (30-40min).

ADHD/Depression/Anxiety Medication Policy

Treatment for ADHD includes a variety of medications with some possible side effects. The medications are safe if monitored closely. The following policies are designed to avoid confusion and will help to ensure your child’s safety while he/she is being treated.

1. Due to the side effects of the drugs used to treat ADHD, rechecks are mandatory every three months and well child physicals once yearly - or more often as needed. Refills will NOT be given if your child is behind on a recheck or well-check. It is the parent’s responsibility to ensure that these appointments are made - we do not send reminder notices.

2 . Due to Federal Law, controlled substance prescriptions (ADHD medications) cannot be called in to the pharmacy, nor can we fax prescriptions refills. We are allowed to dispense up to 3 months of single-month prescriptions at a time. These will be given at each recheck or well-check.

3 . Running out of medication is not an emergency - please remember to schedule rechecks in a timely manner and allow 72 hours for refill prescriptions to be sent electronically or written. These will be done by your child’s primary care physician. 

4. Not all health insurances will cover follow-up visits for ADHD. The parent bringing the child to the office for the visit is responsible for any charges not covered by insurance. Regular copays are due at the time of service.

5. Stimulant medications are controlled substances. Any patient/parent caught selling or giving their medication to another person can no longer receive ADHD medication from our practice. Please carefully monitor your child’s use and discuss openly with your child the seriousness of sharing or selling these medications.

6. Mental Health Forms will be sent via Phreesia 72 hours in advance via text or email. Forms MUST be completed at least 24 hours prior to appointment. Non-compliance will result in a no-show fee and your appointment will be rescheduled. It is the parent’s responsibility to complete the pre-registration from Phreesia in a timely manner.

7. There is a $125 “No Show” fee for missed appointments (this includes late cancellations less than 24-hour notice)

In cooperation with community based mental health providers, we evaluate and treat children for behavior concerns and school problems including:

• Inattention and lack of focus
• Anxiety
• Panic Disorder
• Depression
• Suicidality
• Disordered Eating

We coordinate and work closely with Psychologists, IOPs, PHPs, and Residential Programs when needed. In addition, if your child is ever experiencing a mental health crisis, we will assist and help faciliate obtaining appropriate care. 

**If your child is experiencing a mental health emergency, please call 911 or go to the nearest emergency room, and then call the Mia Bella Pediatrician on call once they are safe.

Most medication management can be done by a Mia Bella Pediatrician and does NOT require a referral to a psychiatrist (6-12 month waiting list and often not covered by insurance).

An Autism evaluation is a comprehensive assessment process used to determine if an individual meets the criteria for Autism Spectrum Disorder (ASD). This evaluation typically involves several components to assess different areas of functioning and behavior, such as:

1. Developmental History: Gathering information about the individual's developmental milestones, medical history, family history, and any concerns from parents, caregivers, or teachers.

2. Observational Assessments: Conducting structured observations and interactions to assess social communication, play, and repetitive behaviors. This may involve standardized tools like the Autism Diagnostic Observation Schedule (ADOS) or Canvas DX, an innovative AI-powered, FDA-authorized digital diagnostic tool.

3. Parent and Teacher Questionnaires: Administering surveys and questionnaires to those who know the individual well to gather insights into their behavior across different settings.

4. Interviews: Engaging in interviews with parents or caregivers to understand the individual's behavior patterns, strengths, and areas of concern.

5. Cognitive and Psychological Testing: Evaluating cognitive abilities, language skills, sensory sensitivities, adaptive functioning, and other psychological aspects to understand the individual's strengths and challenges. If needed, this will be completed by our Neuropsychologist.

6. Multidisciplinary Team Assessment: In many cases, evaluations are conducted by a team of professionals, including psychologists, speech-language pathologists, occupational therapists, and other specialists to get a holistic understanding of the individual’s needs.

The goal of an autism evaluation is to provide a detailed profile of an individual’s abilities, challenges, and support needs, and to make appropriate recommendations for interventions, therapies, or educational services tailored to their unique needs. 

Evaluations #1-4 above are completed by a Mia Bella Pediatrician, and does NOT need a referral to a Neurologist (which can take 6-12 months!).

Initial 1 hour telemedicine appointment with Dr. McNulty:

1. Review of parent and teacher concerns, development, and social skills
2. If IEP testing has not been completed detailed IEP packet will be provided.
3. Review IEP plans and testing if already completed, discuss accommodations.
4. Accommodation letter will be provided if needed.
5. Evaluations might be recommended,  including, but not limited to:

• Functional behavior assessments
• Psychological evaluation
• Psychoeducational evaluation
• Neuropsychological evaluation
• Speech and Language evaluation
• Occupational therapy evaluation
• Audiology evaluation
• Optometry or Neuro-optometry evaluation

Follow-up school evaluation telemedicine appointment with Dr. McNulty (40-60 min):

1. If IEP has been denied, information for requesting an IEE (Independent Educational Evaluation) will be provided. 
2. If IEE is being requested, a follow up school evaluation via telemedicine (40min-1hr) should be scheduled once the IEE testing date/s are known.

Our practice provides a comprehensive asthma and allergy management program for our patients. Our pediatricians are trained in the diagnosis and management of childhood asthma and allergies. 

We see our allergy and asthma patients every 3-6 months either in-person or via telemedicine appointments to maximize symptom control and minimize medication use. During these visits is when we send any refills of current medications, or prescribe new ones.

Patients usually do NOT need to be followed long term by an Allergist (or rarely a Pulmonologist), as medication management can be done with a general pediatrician.

Mia Bella Pediatrics embraces an inclusive care model designed to reduce the need for outside referrals and long waiting times. We bring expert, comprehensive care directly to you, ensuring your child receives timely and personalized attention when they need it most.

Our Care Coordinator, Cindy Hernandez, works closely with our pediatricians and families to facilitate appropriate and timely scheduling, appointment preparation, medication management, follow-up care, and, when necessary, referrals to outside specialists. With Cindy’s dedicated support, we ensure a seamless and coordinated care experience for every child and family we serve.

Every effort will be given to refill chronic medications at your child's annual well exam or med check appointment.

If for some reason, a refill was inadvertinately missed, we kindly request that you give our office a call for any prescription refill needs you may have. Our team is dedicated to providing outstanding patient care and ensuring that your medications are readily available when you need them.

A Mia Bella physician will see you and your newborn in the hospital each day. For infant boys, if desired, we will perform the circumcision before you are discharged home. Once discharged, we do NOT perform circumcisions in the office, and it is very rare to find any Pediatrician who will perform a circumcision out of the hospital setting.

We like to begin your newborn care in the hospital and continue in the office as an integral part of the comprehensive care provided to our Mia Bella families.

Breastfeeding provides essential nutrition for infants birth to one year and older. As with learning anything new, most breastfeeding mothers and babies (and dads too!) need some instruction and support during this learning period. We provide hands-on help for lactation in the office, including use of MyBreastFriends, help with latch and positioning, pre and post feed weights, assessment of nipple pain, and more!

High School Sports Physicals are required prior to the start of the summer sports training programs/tryouts per  California Interscholastic Federation Southern Section (CIF-SS) . 

A sports physical gives our physicians the opportunity to examine your child, evaluate their health and fitness, discuss injuries, pre-existing conditions and signs of overtraining, establish pre and post workout nutrition, and ultimately determine whether or not it is safe for them to participate in any sports  activities.

If any concerns are found during the sports physical, a plan for addressing the issue will be formed, with every intent to allow the athlete to participate safely.

Sports physicals are completely SEPARATE from the annual Well Child Checkups, and will not be combinded together. They are usually NOT covered by insurance, unless an injury or illness is found and addressed at the appointment, in which case, if deemed appropriate, would be billed as a sick visit. 

We recommend ear piercing to occur after 3 months old. Waiting until this age ensures that they have had their first set of vaccines and allows the ear to grow big enough to allow for accurate placing of the earring. We want to make sure that this elective procedure carries as little risk to your child as possible.