Welcome to the Breakwater Center!

Developmental and Behavioral Pediatricians (DBPs) have the medical expertise and advanced subspecialty training to evaluate, diagnose, and manage developmental, learning, and behavioral concerns.

DBPs have completed four years of medical school, three years of pediatrics residency, board certification in general pediatrics, and an additional three years of subspecialty training in developmental and behavioral pediatrics.

DBPs are able to diagnose, manage, and treat the following conditions:

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• Learning disorders including dyslexia, writing difficulties, math disorders, and other school-related learning problems

• Attention and behavioral disorders including attention-deficit/hyperactivity disorder and associated conditions including oppositional-defiant behavior, conduct problems, depression, and anxiety disorders

• Tics, Tourette syndrome, and other habit disorders

• Regulatory disorders including sleep disorders, feeding problems, discipline difficulties, complicated toilet-training issues, enuresis (bedwetting), and encopresis (soiling)

• Developmental disabilities including cerebral palsy, spina bifida, intellectual disability, autism spectrum disorder, and visual and hearing impairments

• Delayed development in speech, language, motor skills, and thinking ability

• Behavioral and developmental problems complicating the full range of pediatric chronic illnesses and disabling conditions (for example, genetic disorders, epilepsy, prematurity, diabetes, asthma, cancer)

There are some DBPs who have built practices based on delivering comprehensive care that includes general pediatrics, but this is not currently offered at our clinic.

It is imperative that you continue to engage with your child's Pediatrician for routine care and sick visits, and we look forward to being part of the medical team.

This question is difficult to answer without gathering a lot of information; which is why the mandatory initial consultation is so important. We really need to understand a child's medical and developmental history, as well as review previous documentation from therapists, physicians, prior evaluations, in order to make the judgement about an assessment.

Ultimately, the goal of the caregiver consultation ( which includes thorough review of all submitted documents ) is intended to help guide families to the most efficient and economical option to obtain care and services. Sometimes that leads to an evaluation with us; but sometimes the best first step is a community resource.

If together we decide to wait on scheduling the comprehensive assessment, the intake from the caregiver consultation is valid for 6 months ( under 5 years ) or 1 year ( 5+ years). After the respective amount of time has passed, we would need a separate appointment to update important information, before scheduling an assessment.

We will see infants as young as 4 months of age if they are at high risk of developmental delay. We do not generally take new referrals for evaluations if older than 16 years; however we do provide medication management for our current patients until they can be transitioned to a physician who cares for adults.

While we conduct comprehensive assessments and cognitive testing when appropriate; we do not conduct formal IQ testing. Our testing will reveal information about school readiness, autism risk, relative learning strengths, possible risk for learning disability, and often gives us global view of abilities that can guide recommendations and inform next steps. We DO partner with an incredible neuropsychologist who can complete higher level cognitive assessments if we feel this testing is indicated.

While DBP has some overlap with Psychiatry and Neurology; we are not able to manage or coordinate:

psychiatric conditions such as bipolar disorder or schizophrenia

• active suicidal ideation

• inpatient hospitalization

• epileptic conditions

• eating disorder treatment

• substance use disorder
  

While we do perform extensive testing when indicated, to include the ADOS and all measures required for medical eligibility for state services in South Carolina, we do not perform forensic or court-ordered custody evaluations.

While we encourage collaboration with you child's healthcare team, we do not order or interpret labs/imaging/tests requested by other clinicians. We also do not make medical decisions based off of external labs. We will order labs that we feel are medically necessary and may alter our intended treatment plan.