Pediatrician, gastroenterologist, endocrinologist
Height, weight, and head circumference, nutritional evaluation
Poor growth, feeding difficulties, low levels of fat-soluble vitamins
Feeding therapy, behavioral feeding program, G-tube (inserted through the abdomen to deliver nutrients to the stomach), vitamins A, D, E, and K, amino acid-based formulas (elemental)
Otolaryngologist/ENT
Hearing testing, brainstem auditory-evoked responses
Hearing loss, deafness
Hearing aid, cochlear implant (device placed in ear)
Ophthalmologist
Ophthalmologic exam, visual fields, fundus photography, optical coherence tomography
Vision loss, eye injury, cataracts, glaucoma
Cataract removal, corrective lenses
Pediatric neurologist
Brain MRI, electroencephalogram, nerve conduction studies, developmental assessment
Muscle weakness, seizures, brain injury/abnormality
Anti-epileptic drugs
Hepatologist, gastroenterologist
Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, bilirubin, albumin, alkaline phosphatase, bile acids (intermediate C27 and mature C24 bile acids), prothrombin time, partial thromboplastin time, abdominal ultrasound
Liver injury/abnormality
Primary bile acid supplementation and vitamin K supplementation daily
Nephrologist
Serum creatinine, blood urea nitrogen, abdominal ultrasound, urine oxalate
Kidney injury/abnormality
Increased fluid intake, urine alkalinization
Endocrinologist
Adrenal function tests, early morning (8 AM) cortisol and adrenocorticotropic hormone (ACTH), ACTH stimulation test
Ongoing hormone imbalance
Hydrocortisone
Orthopedist
X-rays, dual-energy X-ray absorptiometry scan, serum calcium and phosphorus, alkaline phosphatase
Bone abnormality, low bone density, unexplained fractures
Vitamin D, calcium, bisphosphonate (prevents loss of bone mass)
Dentist
Dental exam, X-rays
Tooth defects
Bonding (applying a special plastic on damaged teeth), repair of permanent teeth
Developmental/behavioral therapist, teacher of the visually impaired
Developmental assessment for milestones
Delayed developmental milestones
Physical, occupational, speech, and vision therapy
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