Coronavirus Updates for Developmental Behavioral Pediatrics (DBP) Outpatient Clinic

Last updated 3/19/21

As the coronavirus pandemic has evolved, the medical community continues to learn more about the virus and how it is spread. Michigan Medicine continues to monitor community spread of the COVID-19 virus as well as CDC recommendations in order to adjust policy accordingly.

We are taking a number of measures to keep our patients safe from exposure to COVID-19. Read more about how we are keeping our patients safe during COVID-19.

Everyone should practice basic infection control preventions to minimize the risk of getting or spreading coronavirus. Please read about basic prevention guidelines.

For the latest information on COVID-19 vaccines, please visit our COVID-19 Vaccines for Children and Adolescents page.

Appointment Information:

Since March 2020, we have significantly expanded our virtual health capacity and many of our patients can be seen via a virtual visit. However, there may be a specific reason your child may need to be seen in person. For example, it may be necessary when measurement of heart rate and blood pressure, a physical exam, and/or in-person developmental assessments are necessary to provide optimal care. Reasons for in-person assessments include, but are not limited to, the following:

• New patient evaluation and/or direct testing (e.g. ADOS, Mullen, etc.)
• Medication management
• Complex medical issues

To schedule a virtual video visit, you will need to sign up for the patient portal at MyUofMHealth.org prior to your appointment being scheduled. If you need assistance in this process, please call Health Information Management at 734-615-0872 during normal business hours Monday-Friday 7:30 am - 4:00 pm.

Important: If you, your child, or anyone in your household have been ill in the past 2 weeks, we ask that you notify the clinic ahead of your child’s in-person appointment to determine if it is necessary to postpone the visit. If you or your child comes to the clinic with active symptoms (i.e. cough, sneeze, fever, rash), you will be asked to leave and reschedule 10-14 days after the resolution of your symptoms. If you or your child have been in contact with someone who has been diagnosed with coronavirus or who is suspected of having come in contact with coronavirus, we recommend you be tested for coronavirus. Regardless of test results, it is recommended that you self-isolate for 14 days and reschedule any DBP appointments until after the 14-day period.

Caregiver Policy:

•  In accordance with Michigan Medicine policy and to help keep families safe, only one parent/guardian may accompany a pediatric patient to an appointment, unless an additional aide or assistant is required. Siblings are not permitted. This policy has been changing in response to our community infection rates, so please see our Visitor Policy for COVID-19 for additional and the most updated information.  https://www.mottchildren.org/mott-patient-visitor-guide/family-visitors

Face Mask Policies:

• As of 4/24/2020, the state of Michigan recommends masks for any entry into enclosed public spaces.
• The Center for Disease Control is recommending mask use for infection protection for clinical encounters.

• A mask or face covering is required to be worn by all patients and visitors on Michigan Medicine grounds, including in parking lots and while in our health care facilities. Masks are required for children over the age of 5, but we encourage masks for children over the age of 2, if possible. Masks are provided at each entrance if you do not have one. Our health care teams do not provide exemptions to the mask requirements at our hospitals and health centers. Please note that masks with valves are not allowed as they allow droplets to be released into the air around you.
• Visit our Mask-Wearing to Prevent COVID-19 page on uofmhealh.org for more about the why, who, and how of mask-wearing.

School/Day Care/Therapy Recommendations:

• In-person versus virtual schooling options remain available on a county-by-county or district-by-district basis. School closures could occur if there are mandates by executive order in Michigan. Therefore, we recommend that all families have a plan in place for when or if this happens.
•  Some daycares remain open while others are not. We do not have any specific recommendations regarding attendance at daycare.  Decisions regarding daycare attendance should be made on an individual basis, taking into account factors such as family health risks, child needs, and parent capacity/work requirements. If you have specific concerns about your child attending daycare, please contact your child’s pediatrician office.
• Many therapy offices continue to offer a mix of in-person and virtual visits. If you are not able to schedule an in-person visit with your child’s therapist, please call the therapy office to request a virtual visit if available. We anticipate that there may be changes in the coming months. We encourage families to be as flexible and open-minded as possible during this time.

Additional guidance from the DBP team:

• Continue medications - Continuing medications at current doses is recommended to help children cope with the changes resulting from COVID-19.  If you feel that your child’s current dose of medication is not helping control their symptoms, please contact their prescriber (either their DBP provider or primary care provider).
• Expect that behavior will change - Behavior changes can be anticipated whenever there are changes in routine or daily expectations. A change in behavior during this time does not necessarily indicate a change in medication dose or type will help. For all children, being out of the predictable structure of school and having limited opportunities to socialize with others is difficult and stressful. When in doubt, gather data on how often a certain behavior is happening, what changes in the environment seem to be causing it, and what helps it resolve. Recording this information can allow you to see patterns such as activities or times of day that create a greater risk for the behavior.  Sometimes, changing the routines, or putting in a snack time can help. Sharing a you-tube about yoga or other calming strategies with your child might help teach them helpful strategies to use. However, if such behaviors are getting worse and/or creating an unsafe environment for you or others around, contact your pediatrician to discuss further.
• Establish a routine - Routine is important and can help children feel more safe and secure in the uncertainty of COVID-19. In school, children often have visual schedules, predictable times of day when activities happen, and orderly transitions from one activity to the next. Try to set up a similar schedule for the weekdays and weekend days at home, even if it is just for the first few hours of each day. Also, screen time is unavoidable, but try to keep screen time positive, educational, at consistent times of day, and time-limited. For more information about media use while kids are home, see “Screen Time Tips When Stuck at Home”.

• Sleep, eating and exercise – Remember to keep your routines for bedtime, wake time and meal/snack times too.  Being tired and/or hungry can make it harder to cope with all the changes. Make time for your child to be up and moving. This can help to balance the hours of on-line learning many children are being asked to do and help to break up the day into a good routine.

• Get help from the teachers and therapists who know your child - If your child has a behavior therapist or counselor, ask to arrange “telehealth” video visits, so that you or your child can continue to work on coping strategies and behavioral management approaches. If your child is refusing to do assigned schoolwork, then ask your child’s teachers how to help motivate him/her. School social workers, speech-language pathologists, occupational therapists, and special educators may be available to talk with you about the approaches that work to keep your child calm and focused during the school day.

• If your child is struggling with virtual schooling - talk to teachers about modifying the amount of school work, ask for more 1-to-1 virtual meetings for your child with the teacher or aide to complete tasks, and prioritize just the learning tasks your child needs to practice the most. For example, if your child is struggling with reading, keep up daily practice by reading together and completing online reading tasks. Some children do better with written assignments, rather than online, so it’s OK to ask teachers for printed packets of materials or workbooks.

Additional resource: Effective Remote Learning Strategies for Parents of Elementary Students, Sunfield Center for Autism, ADHD and Behavioral Health (or view video here)

Contact your child’s health provider if you have specific questions about medications or behavior during this new and changing scenario.