Pioneering services for children with learning, developmental, motor and behavioural challenges

Paediatric Services

How can our paediatrician help you? A summary of services:

There are several different Paediatric appointment and assessment options offered at Starjumpz.

General Consultation: 

This is a 60-minute appointment with an experienced Consultant Paediatrician with or without the child to seek advice. This can cover general paediatric concerns e.g. Sleep issues, constipation, ear ache, physical check up or an initial discussion about more complex issues. The appointment consists of some history taking and then examination of the child if appropriate. Specific advice is then given. Prior to the appointment it is anticipated that you would provide basic background information by completing a General Referral form. After the consultation a letter outlining the advice and recommendations given is produced.

Initial assessment: 

This is a 90-minute appointment with the child with the aim of giving reassurance to parents or making further recommendations and signposting to additional assessments. This would be a suitable appointment type to discuss behaviour concerns, concerns about possible Autism Spectrum Disorder, ADHD and/or dyspraxia etc. Prior to this appointment type it is anticipated that you fill out a comprehensive background information form and provide any previous medical or therapy reports for re your child. This information is carefully considered by our Consultant who will also take a more detailed history and then usually observe your child in a structured and unstructured way. Usually this type of appointment would be with the child present. Alternatively, you can book this type of appointment as a parent only appointment if you wish to have more discussion time with the Consultant Paediatrician than the General Consult and you wish for a more in depth analysis to be made.

A summary report is generated as a result of the assessment.

Rest of assessment: 

This is a 90-minute appointment to follow on from an initial assessment with the aim of making a diagnosis when appropriate or providing more detail about a child’s individual strengths and weaknesses. Prior to the appointment additional information and questionnaires are sought from parents and school. This information is carefully considered alongside the findings from the initial assessment and the clinical outcome of the assessments tasks completed during the appointment. These include an ADOS assessment, receptive language assessment and assessment of fine and gross motor skills and physical examination and the option to proceed to a QB check when clinically appropriate.

The ADOS-2 is a semi-structured, standardised assessment of communication, social interaction, play, and restricted and repetitive behaviours. It presents various activities that elicit behaviours directly related to a diagnosis of Autism Spectrum Disorder. By observing and coding these behaviours, you can obtain information that informs diagnosis, treatment planning, and educational placement.

A Comparison Score allows you to compare a child’s overall level of autism spectrum-related symptoms to that of children diagnosed with ASD who are the same age and have similar language skills.  This score also makes it easier to monitor an individual’s symptoms over time.

The Qb check is a continuous performance test, which measures sustained attention and selective attention. The test also records head movements using a webcam – more head movements than normal may indicate hyperactivity. It generates data, which is then compared with age- and gender-adjusted norms and presented in a report.

Following this assessment, a detailed comprehensive diagnostic report including recommendations would be produced.

Where there has been a delay of more than six months between initial assessment and rest of assessment or in cases where the child did not attend the consult there would be an additional fee of £100 to reflect the fact that a slightly longer appointment would be required to update.

Full paediatric assessment: 

This is a three-hour appointment which combines an initial assessment and rest of assessment appointments into one visit. This includes an ADOS assessment, receptive language assessment and assessment of fine and gross motor skills, physical examination and QB check when clinically appropriate.

Prior to this appointment you will be asked to complete a number of background information forms and questionnaires and to send in copies of any relevant medial or therapy reports. Background information and possibly rating scales will also be requested from your child’s school.

Postadoption assessments: 

At Starjumpz we are able to offer multi-disciplinary specialist assessments of children who have been adopted and are presenting with concerns about their learning and behaviour. The paediatric element of these assessments total 3 1/2 hours and can be split into a part one and part two. Comprehensive background information, (including screening questionnaires and rating scales) is required including the child’s permanence record from social services. The appointment will include an ADOS and QB check where clinically appropriate.

Children are usually seen by our Paediatrician, a speech and language therapist and Occupational therapist and a comprehensive assessment of their needs is made. If a diagnosis such as Foetal Alcohol Spectrum Disorder, Autism Spectrum Disorder, ADHD etc. is clinically appropriate this will also be made.

Following the appointment, a detailed multi-disciplinary report is produced which will include recommendations.

Post diagnosis follow-up appointments: 

This is a 90-minute appointment to discuss the diagnostic report, management techniques and where clinically appropriate medication options. This may result in a prescription being written and the need for ongoing follow-up and support. Following this assessment, a summary report and letter to the GP is produced. This appointment includes the cost of writing a private prescription but not the pharmacy costs. Many GPs will then agree to a shared care arrangement whereby our Paediatrician takes the specialist responsibility for supervising and monitoring the ADHD treatment but directs the GP as to what needs to be prescribed.

Children who are prescribed ADHD medications require further follow up at 3 months and then at 6 monthly intervals. At least once a year ADHD rating scales should be completed by parents and school.

 

Developmental Assessment: 

For babies and children between the ages of 3 months and 6 years we can offer a developmental assessment. This will take up to 2 hours and we will gather background information from you and your child’s nursery/school (if applicable) prior to the appointment. The assessment tool used is the Griffiths III. Griffiths III provides an overall measure of a child’s development, as well as an individual profile of strengths and needs across five areas:

Foundations of Learning – assesses critical aspects of learning during the early childhood years.
Language and Communication – measures overall language development, including expressive language, receptive language and use of language to communicate socially with others.
Eye and Hand Coordination – considers fine motor skills, manual dexterity and visual perception skills.
Personal–Social–Emotional – measures constructs relating to the child’s developing sense of self and growing independence, interactions with others, plus many aspects of emotional development.
Gross Motor – assesses postural control, balance and gross body coordination, among other abilities.

A full report is produced which will contain recommendations aimed at maximising your child’s development. This assessment can be repeated at 6 monthly intervals to map progress.

Follow-up appointment:

This is a 45 minute to 60-minute appointment for follow-up. Following the appointment, a summary report is written. Support by phone and email is given between appointments to those children on medication.

Stand-alone Qb check for ADHD: 

The Qb check is a new assessment which helps to screen children for ADHD.  A general referral form is completed and the Qb check carried out by a clinical assistant. A paediatric opinion is given on the findings and a Qb report and recommendation produced.