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Scoliosis

Summary

Adolescent idiopathic scoliosis (AIS) is a condition that causes an abnormal curve in the spine, usually developing between the ages of 10 and 18. It is the most common form of scoliosis, making up about 90% of cases where the cause is unknown.

Most children and teens with AIS do not experience significant problems and never require treatment. However, in cases where the spinal curve becomes severe, there is a risk that it could worsen over time. This may lead to posture changes, back pain, or, in rare cases, breathing difficulties. While bracing may be recommended for some cases, its effectiveness in severe scoliosis is still debated. In cases where the curve is very pronounced, modern surgical techniques offer a safe and effective option to correct the spine’s alignment.

Definition

AIS is a structural condition where the spine gradually curves in an abnormal way during a child’s growth. It is not caused by underlying conditions such as neuromuscular or genetic disorders. The curvature can affect the spine’s natural balance from front to back and side to side, sometimes causing noticeable asymmetry in the shoulders, ribs, or waist.

Diagnosis and When to Seek Help

Signs of AIS may include:

  • Uneven shoulders or waist
  • One hip appearing higher than the other
  • A visible curve in the spine
  • Back pain (though this is not always present)

If you notice these signs in your child, consult a doctor. A healthcare provider will conduct a physical exam and may order an X-ray to assess the degree of the curve.

Management

Treatment depends on the severity of the curve:

  • Mild cases: No treatment is needed, but regular monitoring may be recommended.
  • Moderate cases: A brace may be prescribed to prevent further progression of the curve.
  • Severe cases: If the curve is significant and continues to worsen, surgery may be considered to correct spinal alignment and prevent future complications.

Follow-Up and Monitoring

Children with AIS typically have periodic check-ups to track the curve’s progression. Early detection allows for better management and, in most cases, prevents the need for invasive treatment.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Age >10 years
  • 6 to 12 months post puberty
  • Postural asymmetry

Other diagnostic factors

  • Shoulder asymmetry
  • Waist-line asymmetry
  • Thoracic wall or breast asymmetry
  • Normal gag reflex

Risk factors

  • Positive family history
  • Peak adolescent growth spurt

Diagnostic Investigations

1st investigations to order

  • Clinical exam

Investigations to consider

  • Standing PA (posteroanterior) X-rays of cervical, thoracic, and lumbar spine, and pelvis
  • Standing lateral X-rays of cervical, thoracic, and lumbar spine, and pelvis
  • MRI of cervical, thoracic, lumbar, and sacral spine, and brainstem

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com