The main reasons for referral are diagnosis, second opinion, and educational/therapy/behavioural advice.
We aim to work closely with the child’s local team to ensure a shared understanding and to help implement recommendations. Following assessment recommendations are shared with the referrer so that the local team may continue to monitor and support the family.We do not provide ongoing therapeutic or medical intervention within this service.
Referrals should be made through the child’s secondary level Community Paediatric or mental health (CAMHS) services. Any member of the team can initiate the referral but ultimately this will need to be made via a Community Paediatrician or Child Psychiatrist involved in the child’s care.Referrals should outline clear questions to be addressed by the team and should be accompanied by reports that outline previous assessments and current support offered locally.
If a referral is received from another source, agreement from the child’s local Community Paediatrician or Child Psychiatrist is sought.
GP referrals are not appropriate for this clinic.
This service includes the following services:
Autism and Social Communication Disorder Service
In this service we see children with complex autistic spectrum and language disorders, especially where there is a need for a second opinion or uncertainty about the diagnosis.
Assessment will usually include a detailed history of early development especially of social interaction and communication, obtaining observations from school and observation of social interaction and communication using the Autism Diagnostic Observation Schedule in addition to the assessment of the developmental profile as set out below.
The Wolfson Neurodisability service also has expertise in the assessment of children with autistic spectrum disorder in the context of visual impairment, epilepsy and cerebral palsy and assessment for these children can be undertaken in the most relevant specialist clinic.
Developmental Disorder and Learning Difficulty Service
This service focus is on providing better understanding of children who have developmental disorders and general or more specific learning difficulties and includes assessment and advice for motor co-ordination and behavioural problems including concerns about attention and concentration.
The Neurodevelopmental Assessment Service aims to provide a holistic view of the child in the context of their developmental profile.
Assessment may be carried out in the following areas: cognition and learning potential, speech and language development including social use of language, gross and fine motor skills, visual perceptual skills and medical examination.
The clinic aims to work closely with local services to support children and families. Therefore, outreach visits to school and home are undertaken when necessary.
First appointments usually last for half a day and local professionals are welcome to attend with the family. We would be grateful if the clinic secretary could be informed if this is arranged.
Questionnaires are often sent out to parents before the appointment to gather additional information. The assessment is divided into three parts:
identifying questions and taking a history
assessment of the child
final discussion and answering questions
The multidisciplinary team that may include a consultant paediatrician and /or a paediatrician who is completing specialist training, a psychologist, speech therapist and occupational therapist will meet the family for the first session, clarifying questions from families and referrers and current concerns.
When the child is assessed, parents may accompany their child. However, usually a further more detailed developmental history will be taken from parent(s) while the child is being assessed.
Both formal and play-based assessment is undertaken by the psychologist, speech and language therapist and occupational therapist, and the paediatrician will undertake a medical examination as necessary.
Families are welcome to bring favourite toys along to the assessment if this is useful in making their child feel comfortable.
Once the assessment is completed, there is usually a short break for the child and family whilst the team finalise their conclusions and recommendations. These are then discussed with the family.
Future action will be identified as to whether the child needs further formal assessment or an outreach visit to school or home. In some cases, if these have not already been undertaken by the local team, investigations such as an MRI (brain scan), EEG (measuring electrical activity) or blood tests will be suggested. These may be arranged at Great Ormond Street Hospital or through the local paediatrician.
Should any of these be necessary, the family and/or child will be seen again to feed back and discuss the implications of the results.
A summary of the discussion with the team is provided on the day of the appointment, followed by a full report within four weeks, which will be sent to an agreed circulation list.
The team at the Neurodevelopmental Assessment Clinic comprises a consultant paediatrician, specialist registrar in training, clinical psychologist, specialist speech and language therapist and occupational therapist.
The composition of the team may vary depending on the questions being asked.
You can contact the Neurodevelopmental Assessment Service on 020 7405 9200 ext 1143.