This service sees children where there are concerns regarding possible neurodevelopmental conditions such as Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). We provide direct access to multi-professional assessment and are able to offer understanding, advice and specialist intervention support as appropriate. Formal diagnostic assessment is also provided where clinically appropriate and beneficial for the child/family.
We see children and young people in our multi-disciplinary clinics but may also offer home, school or community based appointments where appropriate.
Who is the Neurodevelopmental Service for?
All under 6s will need to be seen by our Community Paediatricians first before referrals are sent to the Pre-Six Neurodevelopmental Pathway. This is to ensure a thorough medical assessment is completed and available to NDS staff when they meet with you.
Once accepted by the Neurodevelopmental Service (NDS), children in the Pre-Six service will receive an initial home visit to discuss their concerns. At this point an information pack is provided and referrals to other services can be made if appropriate (e.g. portage/Speech and Language Therapy). The child will also receive a nursery observation and may be seen by a speech and language therapist. If it is still unclear as to what the underlying difficulties are, then the team may initiate further assessment which could be in the form of an Autism Diagnostic Observation Schedule (ADOS) or a Multi-disciplinary Assessment (MDA).
Children in the Pre-Six Pathway can also be offered Psychology led toileting and behaviour workshops if appropriate.
Referrals will be managed by psychology and nursing staff with advice and medical oversight from paediatricians as required.
There will be a comprehensive assessment of the neurodevelopmental difficulties being experienced which could include specific ADHD, ADD, and ASD concerns.
Once assessment is complete the Clinician will evaluate the evidence, reach some conclusions and formulate a plan (called a formulation). This step is essential to giving planned and effective support to you and your child.
If appropriate, prescribing and medicines reviews will be undertaken in conjunction with a named Consultant Paediatrician.
Young people over 12 yrs old who are referred to NDS will be triaged jointly with our colleagues in CAMHS. This is to ensure that cases are seen by the most appropriate team, without the need for a second referral and the delay this can cause.
What to expect at your appointment
A first appointment will include a developmental history along with discussions with the child/young person and their parents/carers around the concerns. This will also provide an opportunity for clinic based observations of the child/young person. An initial action plan is agreed at the end and a copy of this, along with a summary of the appointment is sent out to the family and referrer afterwards.
After the first appointment
For children where a diagnostic assessment is felt appropriate, screening questionnaires will be sent out following the initial appointment.
Some children may also require a school observation to help inform assessment and this will be agreed with the family and completed afterwards.
Support offered can include advice, signposting to other services, consultation to school, or more formal interventions from Specialist Nursing, Psychology, Speech and Language or Occupational Therapy, in relation to the neurodevelopmental difficulties being experienced.
If appropriate, medication can also be considered following a further joint assessment appointment with a Specialist Nurse and Community Paediatrician.
- Pre-Six Neurodevelopmental Service – All children referred into this service need to have been seen by a Community Paediatrician. Referral is via NCHC’s Single Point of Referral
- Post-Six Neurodevelopmental Service – All children need to be referred in using the single point of referral (SPOR) referral form. All children must have an accompanying supporting assessment report ideally from an Educational Psychologist, Specialist Learning Support Teacher (SLST) or Specialist Behaviour Support Teacher (based at one of the Short Stay School’s for Norfolk, SSSfN). Reports from professionals with appropriate equivalent experience and knowledge (e.g. specially trained SENCOs, Speech and Language Therapists, Clinical Psychologists) will be accepted, but must contain the following:
- Detailed observations of behaviours which are suggestive of underlying neurodevelopmental difficulties, to include examples of the child’s social communication, interaction and behaviour during structured and unstructured times
- Details of the child’s expressive language and comprehension ability
- Details of the child’s overall level of cognitive functioning and potential in comparison to their peers.
For more information please contact:
Norwich Community Hospital
Norwich NR2 3TU
Telephone: 01603 508 931