Our holistic paediatric assessment covers a wide range of factors, including genetic, antenatal, post-natal, medical issues, developmental profile, trauma and sensory attachment patterns. If there has been exposure to alcohol and/or drugs in utero, our team will assess this and may conduct a clinical psychology assessment of some areas of neurodevelopment, including cognitive/learning abilities, executive functioning and adaptive behaviour. This combined assessment will offer a formulation that considers developmental trauma and may also lead to a diagnosis of FASD (foetal alcohol spectrum disorder) and/or PSE (prenatal substance exposure), and always draws this together in the context of the child's early life experiences.
We provide parents, carers, schools, professionals, and - when appropriate - children with a full report, recommendations and a feedback session. This is to share and fully make sense of the outcome of the assessment and any FASD/trauma/sensory-attachment formulation or diagnosis. We spend time ensuring all those involved understand and can take forward the bespoke recommendations and that they can be integrated into daily life.
Depending on the age and developmental abilities of children, we aim to include them at all stages of the assessment. When appropriate we offer a separate direct child-focused feedback session and/or a child-friendly letter/mini report explaining the assessment.
At present all the families we work with are funded via the Adoption Support Fund or local authority. We do not accept private referrals.
This assessment can usually be completed in a two hour face-face session with all three of the team present: Paediatrician, Clinical Psychologist and Occupational Therapist. This assessment will include taking a medical history with parents/carers, a direct OT/Psychology assessment of the child, and a paediatric medical exam and facial photographs (if clinically indicated) of the child.
The direct OT/Psychology part of the session may take place with the child in a separate nearby room, if they are comfortable with this, and may include a formal cognitive assessment and/or sensory motor assessment. The medical examination and any facial photographs will always take place with the parent/carer present.
Whether a sensory assessment or cognitive assessment or a combination of the two is required will be decided by the team once the referral is accepted, depending on the profile and needs of the child. The format of the assessment will vary with the needs of the child and is adapted to use either formal assessments, or more informal/play based assessments, depending on the age/presentation of the child and the referral questions.
A one-hour formulation/feedback meeting will then be offered about a month later on MS Teams. With the family's permission, we aim to include the referring social worker and the school for part of this appointment. This allows for a joined-up understanding of the outcome and recommendations.
A full report will then be sent out detailing the assessment, the formulation and full recommendations going forward. The recommendations may involve further assessments or interventions, but will always also include suggestions that family and school can implement and integrate directly into the child's life. These may include detailed and personal programs, sensory diets or developing a My ACE Space regulation profile. We are passionate about ensuring recommendations are achievable and meaningful.
In some cases we can offer one-to-one direct/online sessions with child/family/school to further develop the practical therapeutic strategies recommended, to ensure they that can be transferred into everyday life.
We are currently developing a plan for how we can offer a slightly longer intervention package of support to help the key people in a child's life to embed (and if required adjust) our recommendations.