pediatric consultations
Medical Consultations

Medical Consultations consist of discussions on any topic or review of materials that are not typically covered in depth during a regular office visit.

Consultations are typically scheduled for discussions and review of:

  • Prenatal questions, evaluations, & concerns
  • Adoptions
  • ADD/ADHD concerns
  • Eating Disorder concerns
  • Sexual Activity concerns
  • Teen Pregnancy issues
  • Tobacco Usage concerns
  • Drug Usage concerns
  • Emotional Issues
  • Behavioural Issues
  • Developmental Delay concerns

Consultation timeframes usually range from 15 minutes to 2 hours depending on the matters to be discussed and materials to be reviewed.

Prenatal Consultation

Are you pregnant and expecting to deliver soon? Selecting a pediatrician for your baby is an important step. A good time to start looking for a pediatrician is about seven-and-a-half or eight months into your pregnancy. We believe that it is important to have a pediatrician you've already met and respect, because you have enough going on after the baby is born without having to worry about finding a doctor.

The World of Pediatrics provides complimentary prenatal consultations, so you can meet your prospective doctor, to ask any questions that you may have about the physician, learn about the office, our staff, and make sure our practice will suit your needs.

Please understand that we certainly do not require prenatal visits. These visits are for your benefit only, so please only schedule a visit if you think it would be helpful to you. We want all our parents to feel comfortable with their child’s doctor and many times this is the only opportunity that you may have to meet Dr. Vayman before she sees your child for the first time in the hospital. Let us reassure you that all prenatal visits are free of charge and we look forward to meeting you and joining in your excitement of the impending arrival of your child!

At your prenatal visit, you will be able to discover many of the features that make The World of Pediatrics exceptional. The prenatal consultation includes a discussion of any concerns that you may have, so that parents can be informed about the medical care their child will need from an infant into childhood. You will, also, have the opportunity to discuss all of the early tests, labs, and examinations that will take place immediately after your child is born. You can discuss any concerns that you may have and ask any questions about how to care for your child after they are born.

Dr. Vayman visits newborns at Northside Hospital (Atlanta location), North Fulton Hospital, and Northside Hospital (Forsyth location). This means that your baby will be given all the care and attention that he or she deserves from the very first day after delivery.

Call us to schedule your appointment today. We know how important it is to you to be as informed and prepared as possible both before and after your baby is born. The World of Pediatrics looks forward to helping you through this wonderful experience.

Adoption Consultations
We provide detailed consultations and services for International, Domestic, and Foster Care Adoptions. Visit Our Adoption Page and our Consultation Page for detailed information on these services.

We provide detailed consultations and services for International, Domestic, and Foster Care Adoptions. Please, see the Adoption page of our website for detailed information on these consultations and services.

ADHD / ADD Consultations

The World of Pediatrics offers a comprehensive assessment process in order to determine if your child truly has a diagnosis of Attention Deficit Hyperactivity Disorder.

Our program is structured to actually determine if a child has ADHD before deciding on a treatment course. Many children sometimes have other medical or co morbid conditions that may mimic ADHD, further complicate ADHD, or significantly impact the course of treatment decided upon once an ADHD diagnosis has been determined.  Unfortunately, all too often other medical conditions are overlooked and therefore the best treatment can not be determined.

Dr. Vayman looks at the patient as a whole, including their environment and outside influences, as well as, obvious physical or medical issues. During the comprehensive evaluation process, all other co morbid conditions and medical problems must first be ruled out before a diagnosis of ADHD is made for your child and medication management or another course of treatment is implemented.

Children with ADHD

Children with ADHD do not intentionally choose to be the way they are. They are not lazy, unmotivated or "willful". Children with ADHD are biologically different. Often, it is hard for them to do what is expected of them; they'd rather do what is interesting to them.

Ultimately, it is our desire to work with parents to find the best course of treatment that helps the child feel happy, instills confidence, and makes them successful regardless of their ADHD. It is a process, but in the end we are confident that you and your child will be able to manage their ADHD symptoms.

What is Attention Deficit-Hyperactivity Disorder (ADHD)?

Attention Deficit-Hyperactivity Disorder (ADHD) is a treatable condition that affects about 5 percent of all children in the United States. It is usually first diagnosed in childhood, and is characterized by inattention, impulsivity, and, in some cases, hyperactivity.

These symptoms usually occur together, however, one may occur without the other(s). The symptoms of hyperactivity, when present, are almost always apparent by the age of 7 and may be apparent in very young preschoolers. Inattention or attention-deficit may not be evident until a child faces the expectations of elementary school. ADHD is found in boys more often than girls and ADHD symptoms can manifest themselves differently in different children.

Many parents of children with ADHD experienced symptoms of ADHD when they were younger. ADHD is commonly found in brothers and sisters within the same family. Most families seek help when their child's symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.

Associated with both the central nervous system and environmental factors, ADHD is characterized by one or more of the following core symptoms:

  • Inattentiveness in children.
  • Distractibility in children
  • Impulsiveness in children
  • Excessive activity in children.

What are the different types of ADHD?

Three major types of ADHD include the following:

  • ADHD, combined type - This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.
  • ADHD, impulsive/hyperactive type - This, the least common type of ADHD, is characterized by impulsive and hyperactive behaviors without inattention and distractibility.
  • ADHD, inattentive and distractible type - This type of ADHD is characterized predominately by inattention and distractibility without hyperactivity.

ADHD without Hyperactivity

Some children may have ADHD without hyperactivity. In such cases, the condition is more difficult to detect, because these children do not "act up" in class or at home. They may seem lethargic and fail to complete work, or they may show signs of confusion, forgetfulness and disorganization.

What are the symptoms of attention-deficit/hyperactivity disorder?

Most symptoms seen in children with ADHD, also, occur at times in children without this disorder.
However, in children with ADHD, these symptoms occur more frequently and interfere with learning, school adjustment, and, sometimes, with the child's relationships with others. Listed below are the most common symptoms of ADHD. However, each child may experience symptoms differently.

The three categories of symptoms of ADHD include the following:

inattention:

  • short attention span for age (difficulty sustaining attention)
  • difficulty listening to others
  • difficulty attending to details
  • easily distracted
  • forgetful
  • poor organizational skills for age
  • poor study skills for age

impulsivity:

  • often interrupts others
  • has difficulty waiting for his/her turn in school and/or social games
  • tends to blurt out answers instead of waiting to be called upon
  • takes frequent risks, and often without thinking before acting

hyperactivity:

  • seems to be in constant motion; runs or climbs, at times with no apparent goal except motion
  • has difficulty remaining in his/her seat even when it is expected
  • fidgets with hands or squirms when in his/her seat; fidgeting excessively
  • talks excessively
  • has difficulty engaging in quiet activities
  • loses or forgets things repeatedly and often
  • inability to stay on task; shifts from one task to another without bringing any to completion

The symptoms of ADHD may resemble other medical conditions or behavior problems that is why it is always wise to rule out other possibilities before rendering a diagnosis or determining a treatment plan.

How is attention-deficit/hyperactivity disorder diagnosed?

ADHD is the most commonly diagnosed behavior disorder of childhood. A pediatrician, child psychiatrist, a qualified mental health professional, or a combination of the aforementioned professionals usually identifies ADHD in children. A detailed history of the child's behavior from parents and teachers, observations of the child's behavior, and educational testing contribute to making the diagnosis of ADHD. Further, because ADHD is a group of symptoms, often diagnosis depends on evaluating results from several different types of evaluations, including physical, neurological, and psychological. Certain tests may be used to rule out other conditions, and some may be used to test intelligence and certain skill sets.

What is the treatment for ADHD?

If your child is diagnosed with ADHD, we will outline an appropriate treatment program using a variety of treatment methods, such as a combination of medication, individual counseling and parent coaching. If the diagnosis is not ADHD, we will treat the underlying medical condition or refer you to the appropriate specialist after the workup is completed.

Treatment for attention-deficit/hyperactivity disorder:

Specific treatment for attention-deficit/hyperactivity disorder will be determined based on:

  • your child's age, overall health, and medical history
  • extent of your child's symptoms
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference

Major components of treatment for children with ADHD include parental support and education in behavioral training, appropriate school placement, and medications. Treatment with a medication is highly effective in 75 to 90 percent of children with ADHD.

Treatment may include:

stimulant medications or non-stimulant medications.

Medications, used for their ability to balance chemicals in the brain that prohibit the child from maintaining attention and controlling impulses, may be used to reduce the major characteristics of ADHD, which include the following:

  • inattention
  • impulsivity
  • hyperactivity

There are many different medications that are commonly used to treat ADHD.

psychosocial treatments

Parenting children with ADHD may be difficult and can present challenges that create stress within the family. Classes in behavior management skills for parents can help reduce stress for all family members. Training in behavior management skills for parents usually occurs in a group setting which encourages parent-to-parent support. There are, also, many books that discuss behavior management skills for parents.

Behavior management skills may include the following:

  • use of "time out"
  • point systems
  • contingent attention (responding to child with positive attention when desired behaviors occur; withholding attention when undesired behaviors occurs)

Teachers may also be taught behavior management skills to use in the classroom setting. Training for teachers usually includes use of daily behavior reports that communicate in-school behaviors to parents.

Behavior management techniques tend to improve targeted behaviors (such as completing school work or keeping the child's hands to himself/herself), but are not usually helpful in reducing inattention, hyperactivity, or impulsivity.

Could it be something else?

In some cases, what appears to be ADHD may actually signal another problem such as medical and other behavioral problems.

Teachers can detect ADHD in children.

If you or your teachers suspect that your child may have attentional problems, difficulties in school, or just has more energy than his peers, speak with one of our staff members about scheduling a ADHD consultation appointment with Dr. Vayman.

Our ADHD Evaluation and Treatment Program was designed to:

  • Find out if the symptoms of ADHD are there.
  • Rule out other possible causes of the symptoms.
  • Discover if there are any other conditions or concerns to treat.

Things to bring with you to an ADHD/ADD consultation:

  • Completed Vanderbilt Teacher / Parent Assessments (found under forms)
  • Emails or written incites from teachers
  • What subjects is your child having the most trouble with?
  • Be prepared to discuss examples of behavioral issues that you are experiencing.
  • Be prepared to discuss any social issues that your child may be having.
  • Be prepared to discuss how symptoms are affecting your child’s life and how they are impacting the family.
  • Is your child having organizational issues, forgetfulness issues, focus issues, etc.?
  • Examples and how often are these occurring.
  • Be prepared to discuss sleeping and eating habits.
Eating Disorder Consultations

Anorexia Nervousa, Bulemia Nervosa, Binge Eating, Obesity

The term eating disorders refers to a variety of disorders. The common feature of all the eating disorders is abnormal eating behaviors. Eating disorders are serious mental health problems and can be life threatening. People with eating disorders are often misunderstood and seen as simply making bad decisions, but research and clinical experience show that an eating disorder can become such an overwhelming part of a person's life that they will need professional help overcoming the condition and getting back to a happy, healthy life.

If left untreated, a person with an eating disorder can suffer medically and emotionally, with a very real possibility of death.

Anorexia nervosa, bulimia nervosa, and binge eating disorder are common eating disorders among adolescents and young adults. Obesity may, also, be included as an eating disorder and can affect individuals of all ages, including children, adolescents, and adults.

There are several types of eating disorders that require the clinical care of a psychiatrist or other mental health professional.

If you are concerned about your child’s eating habits, please, contact us for an Eating Disorder Consultation. If it is determined that your child does indeed have a serious disorder, then we will discuss what the most appropriate plan of action is and determine the next steps in the course of treatment.

Signs and Symptoms of Bulimia Nervosa

  • eating a large amount of food in a short period of type
  • feeling unable to stop eating
  • purging through vomiting, laxatives, diuretics, enemas, fasting, or excessive exercise
  • swollen glands
  • broken blood vessels in eyes or face from vomiting
  • teeth marks, scabs, or scars from using fingers to induce vomiting
  • going to the bathroom shortly after eating
  • mood swings
  • gastric complaints
  • sore throat
  • preoccupation with food and weight
  • other addictive behaviors (drinking alcohol, smoking, shopping, drugs, etc.)

Signs and Symptoms of Anorexia Nervosa

  • weight loss
  • feeling fat
  • denial of hunger
  • excessive exercise
  • restriction of calories
  • restriction of fats
  • restriction of certain food groups
  • making excuses why not eating
  • cooking for others
  • pushing food on others
  • preoccupation with food and weight
  • fear of gaining weight
  • loss of menstrual cycles (amenorrhea)
  • food rituals
  • distorted body image

Signs and symptoms of a binge eating disorder

People with binge eating disorder are embarrassed and ashamed of their eating habits, so they often try to hide their symptoms and eat in secret. Many binge eaters are overweight or obese, but some are of normal weight.

Behavioral symptoms of binge eating and compulsive overeating

  • Inability to stop eating or control what you’re eating
  • Rapidly eating large amounts of food
  • Eating even when you’re full
  • Hiding or stockpiling food to eat later in secret
  • Eating normally around others, but gorging when you’re alone
  • Eating continuously throughout the day, with no planned mealtimes

Emotional symptoms of binge eating and compulsive overeating:

  • Feeling tension that is only relieved by eating
  • Embarrassment over how much you’re eating
  • Feeling numb while bingeing—like you’re not really there or you’re on auto-pilot.
  • Never feeling satisfied, no matter how much you eat
  • Feeling guilty, disgusted, or depressed after overeating
  • Desperation to control weight and eating habits

Definition and Symptoms of Obesity

Obesity refers to an increase in total body fat. The easiest and most widely accepted method of determining whether you are obese is by measuring your Body Mass Index, or BMI. To calculate your BMI, follow these steps:

  • Multiply your weight in pounds by 705; divide by your height in inches; divide this number by your height in inches a second time.
  • You may also use an online BMI calculator at the National Heart, Lung, and Blood Institute. Go to Online BMI Calculator.
  • A normal BMI = 18.5-24.9; obese = 30 or greater; overweight = 25.0-29.9; and morbidly obese = 40 or greater.

Signs and Symptoms

Being a little bit overweight tends not to cause too many noticeable problems, but once you are carrying a few extra stones, symptoms will affect your daily life.

Day-to-day, obesity causes problems, such as shortness of breath. However, the long-term health risks that you cannot see are far more serious, such as heart-related illnesses.

The immediate symptoms of obesity include:

  • breathlessness
  • sweating a lot
  • snoring
  • difficulty sleeping
  • inability to cope with sudden physical activity
  • feeling very tired every day
  • back and joint pains

In the longer term, obesity greatly increases your risk of:

  • high blood pressure
  • heart disease and stroke
  • high cholesterol levels (fatty deposits blocking up your arteries)
  • breast cancer in women
  • gall bladder disease
  • gastro-esophageal reflux disease (when acid from the stomach flows up into the gullet) and associated problems
  • arthritis of the back, hips, knees and ankles
  • diabetes, and difficulty controlling existing diabetes
  • polycystic ovarian syndrome (PCOS - multiple cysts within the ovaries)
  • reduced life expectancy

In addition to the immediate and short-term problems of obesity, many people may also experience psychological problems, such as:

  • having low self-esteem (self-worth) - or poor self image
  • having low confidence levels
  • feeling isolated in society
  • having reduced mobility leading to a poor quality of life
Other Consultations

Dr. Vayman consults on many topics as needed by parents or patients themselves.

Below are just a few examples:

  • Tobacco Use
  • Drug Abuse
  • Sexual Activity
  • Teen Pregnancy
  • Emotional Issues
  • Behavioral Issues

If you have a concern about your child or you are concerned about your child’s current activities, please, call and schedule a consultation to discuss the issues with Dr. Vayman.

If your teen is having difficulty discussing issues with you or you are having trouble discussing sensitive topics with them, consultations can be set up for Dr. Vayman to discuss issues with your child directly. Sometimes it helps to have an outside source step in to discuss sensitive issues.

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3005 Royal Blvd. S., STE 110, Alpharetta, GA 30022
Office Hours Monday through Friday 9:00am - 7:00pm, Saturday for sick only 10:00am - 12:00pm
Call 770-442-5437 for an Appointment
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