Dr. Susan Cadzow

LIH Healthcare Pediatric Specialists Present at Children’s Healthcare Forum

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The “Forum on Current Topics in Caring for Children -Nutrition, Development & Parenting” was held at Shenzhen Bao An Maternity and Children’s Hospital on 14 May. Many well-known professors and international and local supervising physicians were invited to this forum, the theme of children’s health care issues. Dr. Susan Cadzow, Director of Developmental-Behavioral Pediatrics for LIH Healthcare and Kristi Troutman, Occupational Therapist and Clinical Manager of LIH Olivia’s Place Shenzhen, both presented at the event.

Baoan 1Dr.Susan Cadzow is an Australian-registered pediatrician and also a Fellow of the Royal Australasian College of Physicians. She has previously worked at Shanghai United Family Hospital and Royal Children’s Hospital, Brisbane. She is now the Director of Developmental Behavioral Pediatrics at LIH Healthcare.
First, Dr. Cadzow explained what a multi-disciplinary team model is and why it is necessary in the diagnosis of autism. Due to complexity in diagnosis of autism and the similarity of symptoms to many other conditions, precise diagnosis requires the engagement of a team which may include a child’s doctor andoccupational therapy, physical therapy, psychological consultation, speech-language therapy, Learning support, and behavioral therapy.
Next, Dr. Cadzow explained in detail the goal of diagnostic assessment. At the end of the presentation, she expressed that she is looking forward to the further development in specialized services for treatment of autism for children and multi-disciplinary assessment team to enable early diagnosis and early intervention in China, as well as further understanding of practitioners on genetic conditions.

Kristi Troutman, LIH Olivia's Place Clinical Manager, presenting on "Occupational Therapy and Developmental-Behavioral Disorders"

Kristi Troutman, LIH Olivia’s Place Clinical Manager, presenting on “Occupational Therapy and Developmental-Behavioral Disorders”

Kristi Troutman, OTR/L, Clinical Manager at LIH Olivia’s Place Shenzhen, has more than 25 years of occupational therapy experience; she has worked with children with a variety of diagnoses, including autism, ADHD, cerebral palsy, visual impairment, Angleman Syndrome, Noonan Syndrome, selective mutism, and developmental delay.

In her speech, she explained the concept and types of pediatric occupational therapy, and advocated the idea that “Family engagement is Essential in OT”- children, peers, family members, and adults work together on occupational activities such as feeding and eating, caregiver-child interaction in play, dressing, grooming, and personal hygiene. This joint effort is very important to infants, toddlers, children, and their families.

She put emphasis on the significance of occupational therapy, exemplified by how occupational therapy activities are designed to fit for the needs of every single child’s development. Her speech won applause from the audience from time to time, and was received very warmly. In the end, Ms. Troutman explained that the goal of treatment should be varied in terms of each individual, taking consideration of education at home and school, and also highlighted that treatment should be home-centered as appropriate.

SCMC Conference Focuses on Clinical Skills & Advances in Care

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Developmental behavioral pediatrics is a rapidly evolving field. However, in China it is still an emerging field with insufficient professionals and establishment of relevant programs. Both pediatricians and educators are confronted with serious challenges in diagnosis and treatment. In order to improve diagnosis of pediatric disorders and treatment quality, “Developmental Behavioral Pediatrics Conference,” a national continuing medical education program, was held in Shanghai from 22nd to 26th June 2016. This conference was held by Shanghai Children’s Medical Center, affiliated with the School of Medicine at Shanghai Jiaotong University, attracting more than 100 healthcare providers devoted to developmental behavioral pediatrics. LIH HealthCare played a key role during the conference through the participation of several of our experienced clinicians.

The conference focused on clinical practical skills including standard treatment of pediatric disorders and differential diagnosis. Lecturers explained complex theories clearly and concisely. From basic introduction to clinical treatment, the content was well organized with prominent themes and a high-level of precision. All participants showed strong enthusiasm and took part in discussions. The conference was well received and questions put forward by participants were satisfactorily answered. In addition, the conference summarized new advances in developmental behavioral pediatrics in China to encourage healthcare providers to promote best practices.

img_2910A few experts were invited for this conference: Dr. Mark Simms, Director of Developmental Behavioral Pediatrics at Children’s Hospital of Wisconsin, who has helped to establish and advance developmental behavioral pediatrics in China over the past ten years; Professor Jin Xingming, leader of the National Developmental Behavioral Pediatrics Group; and Professor Zhang Yiwen, Director of Developmental Behavioral Pediatrics at Shanghai Children’s Medical Center. Meanwhile, Nelson Chow, CEO of LIH Healthcare, gave a keynote address at the conference, highlighting the mission of LIH Healthcare to support to support the field of developmental behavioral pediatrics in China.

Also, Dr. Susan Cadzow, Director of Developmental Behavioral Pediatrics at LIH Healthcare, presented on Infant Mental Health. Dr. Cadzow is a Behavioral/Developmental and General Pediatrician from Australia, and has worked in China for more than five years, she has extensive clinical and teaching experience in the areas of developmental and behavioral pediatrics, general pediatric medicine, and neuro-disability. In addition, Dr. Cadzow undertook further training and research in child protection and infant mental health.

Clinical psychology in China is not as well developed as in the USA or Europe. When it comes to infant mental health, there are very few resources and research on this area here. Very few people are aware that babies may have mental problems and can benefit from mental health support as adults do. During Dr. Cadzow’s presentation, she introduced “What is Infant Mental Health?,” and “What is Attachment Theory” to an audience which included pediatricians, therapists, and other pediatric clinicians. Through case sharing, Dr. Cadzow explained the risk factors and effects of early adverse experiences. She also helped the audience to understand how to identify infant mental health problems and how to promote good infant mental health. With the data analysis, case sharing and demonstration, and theoretical explanation provided by Dr. Cadzow, the audience gained a better understanding what pediatricians and other clinicians who treat babies should know about infant mental health and where to find resources.

After the conference, Professor Mark Simms was invited by LIH HealthCare CEO Nelson Chow to visit LIH Olivia’s Place Shanghai. During the visit, Professor Simms was impressed by LIH HealthCare’s efforts to support the development of rehabilitation services in China. During the meeting, Professor Simms and Nelson had a great discussion on how to further Development Behavioral Pediatrics in China, how to support rehabilitative care, and how to work together to bring recent advances in theory and practice to China.

LIH Healthcare is dedicated to supporting the advancement of developmental behavioral pediatrics and will always contribute to the field of pediatric rehabilitation. We believe that pioneers in this field will apply what they have learned to clinical practice and attract more healthcare providers to improving children’s quality of life in China.

What is the Role of Medications in ADHD?

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by Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia's Place

by Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia’s Place

Children and adults with severe attentional difficulties are sometimes prescribed medications. This is generally only when their symptoms are having a significant impact on learning and general function.

Medications should only be considered after other non-pharmacological supports and strategies have been implemented and there are still major concerns that the child is functioning well below their ability level due to concentration deficits.

Before considering medications, a pediatrician will do a thorough medical history and examination. Co-existing medical conditions that might be affecting the child’s performance can be identified and treated if necessary. The evaluation will also focus on assessing the nature and the severity of the problem. Information will be gathered from parents, the child’s school, and the child him/herself if they are old enough. In some cases, another referral may be made during this process, for example, to a psychologist to undertake formal assessment of the child’s learning profile and abilities).

Regarding ADHD medications, it’s important to recognize that they are aimed at reducing specific “target symptoms,” namely hyperactivity, impulsivity, and distractibility. They generally do not have specific action in terms of behaviours such as defiance and aggression. However, there can be some positive benefits for behavior and social skills if the problems are resulting from impulsivity or poor self-regulation.

If everyone agrees that a trial of medications may be helpful and is appropriate for the individual child, generally a 1 to 2 month trial of a stimulant medication will be started as the “first line” treatment. If stimulant medications are prescribed appropriately, approximately 70-80 % of people show a beneficial response (that is, significant reduction in the target symptoms).

In general stimulant medications are very safe and have been in use since the 1980s for treating children with ADHD. Reduction in appetite during the day is a common side effect of stimulant treatment. Children must be monitored carefully to ensure intake is adequate and growth is not affected. The pediatrician will follow up on a regular basis to assess dose adequacy, ongoing effects, and side effects. ADHD medications do act on chemical transmitter levels in the brain so there are many other possible side effects involving the neurological system but fortunately these are very rare and normally immediately reversible when the medications are stopped.

Since the main time that the medication effects (improved concentration, planning, and focus) are needed is the school day many families choose to not give the medication on weekends and school holidays. If for any reason stimulant medication is not effective or not well tolerated there are some alternate medications that can be tried. For example, Strattera (atomoxetine), is one that is often used and which is also available in China. Occasionally this may be tried first, particularly in children with significant anxiety symptoms as it also has an anti-anxiety effect.

Key Points

1. ADHD medications should normally be considered only in children with severe symptoms who have already tried non-medication therapies.
2. Medications are only part of the treatment plan for children with ADHD. Behaviour management, school support, classroom strategies, and counselling are also very important.
3. Children need to be assessed thoroughly before a trial of medications and monitored closely during treatment.
4. The main aim of medication is to reduce specific target symptoms in order to allow the child to reach their learning potential. Improvements in social skills and relationships may be seen if impulsivity and self-regulation have been a problem.
5. Approximately 70-80% of people with a diagnosis of ADHD respond positively to treatment with stimulants.
6. Stimulant medications have been used in ADHD since the 1980s and are well-researched and generally very safe.

Dr. Susan Cadzow Lectures at Beijing Medical Association Pediatrics Conference

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Susan 2 (2)Dr. Susan Cadzow, Director of Developmental Behavioral Pediatrics for LIH Healthcare, attended the “2016 Beijing Medical Association Pediatrics Academic Conference held on 4 June in Beijing. She gave a lecture entitled “Best Practice for Assessing Children’s Developmental Problems: A Multidisciplinary Team Approach.”

Susan 1 (2)The conference attracted about 800 specialists, scholars, and medical staff. Dr. Cadzow’s lecture was included in a series of five parallel sessions. She specifically elaborated on developmental and behavioral pediatrics issues and shared her years of experience in multidisciplinary teamwork in this area with more than 100 pediatricians. At the end of the lecture, Dr. Susan Cadzow answered many questions from the audience, which won the praise of the pediatric doctors present.

Dr. Cadzow is a Behavioral/ Developmental and General Pediatrician from Australia. She graduated with a Bachelor of Medicine, Bachelor of Surgery from the University of Queensland in Brisbane, Australia and was admitted as a Fellow of the Royal Australasian College of Physicians (Pediatrics) in 2000. Dr. Cadzow completed her internship and residency at Royal Brisbane Hospital in Australia and her specialist pediatric training at Royal Children’s Hospital, Brisbane.

Dr. Cadzow has extensive clinical and teaching experience in the areas of developmental and behavioral pediatrics and general pediatric medicine in addition to leadership roles in multidisciplinary and interagency teams working with vulnerable and at risk children and families.


Clinician Profile: Dr. Susan Cadzow, Director of Developmental-Behavioral Pediatrics

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Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia's Place

Susan Cadzow, MD, Director Developmental-Behavioral Pediatrics, LIH Olivia’s Place

Dr Susan Cadzow is a Behavioral/ Developmental and General Pediatrician from Australia. She graduated with a Bachelor of Medicine, Bachelor of Surgery from the University of Queensland in Brisbane, Australia.  She was admitted as a Fellow of the Royal Australasian College of Physicians (Pediatrics) in 2000. Dr. Cadzow completed her internship and residency at Royal Brisbane Hospital in Australia and her specialist pediatric training at Royal Children’s Hospital, Brisbane.  She undertook advanced pediatric training in the sub-specialty of community pediatrics, with a focus on developmental and behavioral medicine, child advocacy, and infant mental health. She undertook further training in the United Kingdom in developmental pediatrics, neuro-disability, general pediatrics, and child protection.

Dr Cadzow has extensive clinical and teaching experience in the areas of developmental and behavioral pediatrics and general pediatric medicine in addition to leadership roles in mutildisciplinary and interagency teams working with vulnerable and at risk children and families. In Australia, Dr. Cadzow has made many contributions over the years to public health policy at a state and national level.  More recently, Dr. Cadzow has been practicing general and developmental pediatrics for over 5 years in Shanghai, China. Dr. Cadzow is committed to the progress of developmental and behavioral pediatric services in China and to the goal of ensuring quality medical and therapeutic services become accessible to all children with developmental difficulties or neuro-disability.


How long have you been in China?

I moved to China in December 2010. The initial plan was to stay for 2 or 3 years, but we felt we had only just started to settle in after 3 years, so decided to stay on. So 5 plus years later I am still here and still excited to be living and working here.

Why did you choose to work at LIH Olivia’s Place?

It was an easy decision to come to work for LIH Olivia’s Place when this opportunity arose. I’ve enjoyed collaboration with clinicians from LIH Olivia’s Place over the last 5 years and have admired the skills and dedication of the clinicians and the vision of the organisation. It is great to be able to jump onboard and help to develop a truly multidisciplinary pediatric developmental service.

Why did you choose your field?

I chose pediatrics after rotating for 3 years through all the major medical fields following graduation. Pediatrics appealed to me for many reasons, such as the chance to work with children ranging from newborns to young adults and to follow them through this time of rapid growth and development. I also had some very inspiring teachers in my early pediatric career. The field of developmental pediatrics was of particular interest to me throughout my training so was a natural path to take.


 What are some of the most rewarding experiences you have had in your profession?

Looking back some of the most rewarding experiences for me have been watching children who’ve come from an adverse or disadvantaged background thriving and making big gains towards reaching their health and developmental potential with appropriate support and intervention. Working as part of a team of highly trained clinicians to achieve goals like this is highly rewarding

What’s your favorite thing about living in China?

My favourite thing about working in China is probably working with people (colleagues and clients) from so many different cultures, although this can also be the most challenging thing as well.


What would you like to be doing in 5 years’ time?

In 5 years’ time I’d like to be still in a position to have an interesting and constantly challenging career, to travel, and to provide an open minded well rounded global framework for my kids moving forward into adulthood.


Promoting Lasting Change: How We Act on Our Mission

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In addition to directly serving children and their families, another large part of our mission has always been to promote and further rehabilitation and therapy in China. There are a many ways we are working towards this. Since the merger of LIH and Olivia’s Place our efforts toward this goal have become more intentional and faster paced. Lis Ringrose, a long standing member of the Olivia’s Place clinical team, was appointed Chief Therapy Officer across the company. She is tasked with ensuring clinical quality across the company and also to coordinate the work needed to underpin the expansion of services. Through development of LIH Olivia’s Place’s services, we can build clinics that demonstrate how best practice rehabilitation can be achieved in China.

Another element of this work is to develop training and teaching programs to up skill locally qualified staff. (Rehabilitation professional qualifications – OT, PT, SLT – in China are only just starting to be taught to a depth standard that is internationally accepted.) Due to culture differences and the fact that these programs are designed to be used with already qualified clinicians, a different approach to that of a western undergraduate program is needed. Lis has put together a team of experienced clinicians from across each profession to develop a structure and write the content for this program. The plan is that these programs can then be used in hospitals across the country which want to up skill their staff.

This month we also welcome Dr. Susan Cadzow. In the position of Director of Developmental Behavioral Pediatric Services, Susan’s role will be to develop a parallel fellowship training program for doctors who want to specialize in developmental pediatrics.

These training programs, while focusing on the individual skills that each profession brings, also emphasize a family centered team approach. All professionals have the opportunity to be supervised by an experienced clinician of their own profession while in an environment where they can learn about and from the other professions.

To support this training structure, a teaching program is being developed for participants to learn about common pediatric presentations and treatment approaches in multi-profession teaching sessions. Teaching resources are being developed to enable use of this program outside of LIH Olivia’s Place in line with the company’s mission to effect change within rehabilitation across China.

Beijing Training Event: How to Guide Parents to Get Good Care

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LIH Olivia’s Place is delighted to announce that our new Developmental and Behavioral Pediatrics Director, Dr. Susan Cadzow is starting with us this month! Dr. Cadzow has more than 20 years of experience in the field including nearly six years of experience working as the only international developmental and behavioral pediatrician in mainland China at Shanghai United Family where she was from 2010 until now. She will be seeing patients in Beijing every other week starting the week of 25 April 2016.


To introduce Dr. Cadzow to the Beijing international school community and Beijing healthcare providers and give her an opportunity to share some of her experience a complimentary training event will be offered on  evening of Wednesday, 27 April  2016.


Children with Developmental Behavioral Problems: How to Guide Parents to Get Good Care

This event is designed for teachers and school nurses at international schools as well as other healthcare professionals  to help provide guidance and tips on how to help parents get the services and help they need for their children when they find out their child has development behavioral problems.

DATE:  Wednesday, April 27

TIME: 5:00 pm to 6:30pm

LOCATION: Beijing LIH Olivia’s Place Pediatric Clinic 北京长和大蕴儿科诊所

13 Jiu Xian Qiao Road, Building 6-1, 2nd Floor, Chaoyang District, Beijing, China

中国北京市朝阳区酒仙桥路13号6-1楼2层 邮编:100016


Light sandwiches and soft drinks will be provided.


Please RSVP to john.giszczak@lih-oliviasplace.com by Monday, 25 April  2016. Please call John Giszczak at +86 135 1100 6282  if you have questions or if you have difficulty finding our clinic when you arrive. Our entrance is on the southwest side of the Orange Crystal Hotel. We are on the second story of the hotel’s building, but have our own separate entrance on the side of the building.