Children With Neurodisability Dr Lesley McDonald Community Paediatrician West Centre
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Children With Children With Neurodisability Neurodisability Dr Lesley McDonald Dr Lesley McDonald Community Paediatrician Community Paediatrician West Centre West Centre
Children With Neurodisability Dr Lesley McDonald Community Paediatrician West Centre
Children With Neurodisability Dr Lesley McDonald Community
Paediatrician West Centre
Slide 2
Community Child Health 0-19 years 0-19 years wide range of
developmental difficulties / disabilities wide range of
developmental difficulties / disabilities holistic approach
holistic approach partnership with parents partnership with parents
multidisciplinary working multidisciplinary working interagency
working interagency working communication communication
Slide 3
Settings Child development centres 0-5 years Child development
centres 0-5 years Mainstream school health Mainstream school health
MLD schools MLD schools Complex needs schools Complex needs schools
EBD schools EBD schools
Slide 4
Child Development Centres West Centre (West) West Centre (West)
Bridgeton (East) Bridgeton (East) Glenfarg (North) Glenfarg (North)
Southbank (South) Southbank (South)
Slide 5
Referrals ODER one door entry referral ODER one door entry
referral referrals from GP, HV, RHSC, nursery, educational
psychology referrals from GP, HV, RHSC, nursery, educational
psychology referral centres for specialist developmental assessment
referral centres for specialist developmental assessment links with
other agencies education, social work links with other agencies
education, social work
Slide 6
The team around the child Child and family Paediatrician
specialist health visitor physiotherapy occupational therapy social
work resource team clinical psychology admin staff
Slide 7
Other CDC services CDC dieticiangeneticistorthoptist speech and
language therapy community autism team neurologist
Slide 8
CDC links CDC educational psychology home visiting teachers
nurseriesGPhealth visitor RHSC paediatricians RHSC therapists PACT
social work area teams CAMHSaudiology
Slide 9
Children with additional needs ex preterm ex preterm autism
autism Downs syndrome Downs syndrome early developmental impairment
(global developmental delay) early developmental impairment (global
developmental delay)
Slide 10
Ex preterm infants EPICure study EPICure study infants
5. Growth short stature part of syndrome short stature part of
syndrome 0-2 years: check wt, ht, OFC frequently 0-2 years: check
wt, ht, OFC frequently >2 years: check annually >2 years:
check annually use both Downs and standard growth charts use both
Downs and standard growth charts red book should have Downs insert
red book should have Downs insert
Slide 24
6. Others atlantoaxial instability atlantoaxial instability no
screening procedure do not bar from sports at risk: GA, RTA refer
neck pain / pain behind ear neck pain / pain behind ear abnormal
head position abnormal head position deteriorating head position
deteriorating head position loss of bladder / bowel control loss of
bladder / bowel control
Slide 25
Early developmental impairment (EDI) formerly known as global
developmental delay formerly known as global developmental delay
unhelpful term, implies difficulties temporary and will catch up
unhelpful term, implies difficulties temporary and will catch up
EDI a more appropriate diagnostic term, proposed at international
consensus conference in 2008 EDI a more appropriate diagnostic
term, proposed at international consensus conference in 2008
Slide 26
EDI definition persistent significant limitations in two or
more developmental domains persistent significant limitations in
two or more developmental domains motor communication cognitive
skills social skills emotional regulation / behavioural skills self
care skills
Slide 27
onset before age 5 onset before age 5 not better explained by
another established developmental disorder not better explained by
another established developmental disorder reassess by school age
or before age 9 to review diagnosis reassess by school age or
before age 9 to review diagnosis
Slide 28
Assessment history history examination examination
developmental assessment developmental assessment investigations as
appropriate investigations as appropriate multidisciplinary working
multidisciplinary working follow up over time follow up over time
exciting advances in genetics and neuroimaging exciting advances in
genetics and neuroimaging
Slide 29
Summary wide range of disabilities which may be encountered in
general practice wide range of disabilities which may be
encountered in general practice awareness of services available
awareness of services available if in doubt, phone to discuss if in
doubt, phone to discuss