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Children With Neurodisability Dr Lesley McDonald Community Paediatrician West Centre

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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

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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

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Child Development Centres West Centre (West) West Centre (West) Bridgeton (East) Bridgeton (East) Glenfarg (North) Glenfarg (North) Southbank (South) Southbank (South)

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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

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The team around the child Child and family Paediatrician specialist health visitor physiotherapy occupational therapy social work resource team clinical psychology admin staff

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Other CDC services CDC dieticiangeneticistorthoptist speech and language therapy community autism team neurologist

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CDC links CDC educational psychology home visiting teachers nurseriesGPhealth visitor RHSC paediatricians RHSC therapists PACT social work area teams CAMHSaudiology

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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)

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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

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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

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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

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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

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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

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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

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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

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Contact Numbers West 207 7100 West 207 7100 Bridgeton 531 6550 Bridgeton 531 6550 Glenfarg 531 6191 Glenfarg 531 6191 Southbank 201 0923 Southbank 201 0923