Specialist Neurodevelopmental Services

Specialist neurodevelopmental services
 

Neurodevelopmental disorders are a group of conditions that impact on brain functioning and neurological development. Attention deficit hyperactivity disorder (ADHD) and autism spectrum condition (ASC) are the most common neurodevelopmental disorders, and can result in difficulties in social, cognitive, and emotional functioning.

The onset of neurodevelopmental disorders usually takes place during early development, and are typically identified in toddlers, children, and adolescents.

Royal Free CAMHS specialist neurodevelopmental services assess children aged 6-17 for ADHD and ASC, which is assessed for in our complex neurodevelopmental clinic. Please see the below links for more information.

 

ADHD service

The ADHD service provides assessment and treatment for children and adolescents for whom there are concerns about attention deficit hyperactivity disorder (ADHD).  

 

What is ADHD?

The three core symptoms of ADHD are inattention, impulsivity, and hyperactivity.
Young people who have ADHD may have a short attention span, struggle to sit still for sustained periods of time, or may appear to act before they think.

For more information on ADHD, please see the following links:

 

What is our referral process?

We can accept ADHD assessment referrals for children and adolescents aged 6-18 who have a Camden or Barnet GP and live in either Camden or the following Barnet postcodes: NW2, NW11, N3. 

  • Referrals must be made in writing by a GP, paediatrician, teacher, psychiatrist, or another CAMHS professional. Referrals must include enough information regarding the following:
  • What symptoms of ADHD the young person displays
  • How long the symptoms have been present
  • Whether the young person exhibits these symptoms at school, at home, or in other settings
  • Important background information, such as family breakdown, social services involvement, moving from a different city or country, languages spoken at home, etc

All referrals are screened by our team before a patient is accepted into our assessment clinic.

 

What is the assessment process like?

Prior to a first appointment, parents, teachers and, if old enough, the child themselves, will be asked to complete some questionnaires. These are for us to learn about the young person ahead of meeting them in clinic and help to standardise the assessment process. Please note that all patients are required to complete these forms, even if a child already has been assessed and diagnosed by a clinician in the private health sector.

Once a patient's questionnaires are returned to Royal Free CAMHS, the forms will be screened. If an ADHD assessment is appropriate based on our screening, the patient will be added to our waiting list. To help gather more information for an assessment, we may also ask permission for a member of our team to complete an observation of the young person’s learning and behaviour at school. 

When the young person reaches the top of our waiting list, the family will be invited to an initial assessment. Please note, due to a backlog of referrals and assessments caused by COVID-19, our waiting times are longer than usual. 

When the assessment is complete the clinician will provide the family and the young person, if appropriate, with feedback. If an ADHD diagnosis is made, the young person’s GP will receive a report providing confirmation of the diagnosis and how this was made. With the family’s consent we can also send a copy to your child’s school. If the young person is found not to have ADHD, the rationale for this decision will be explained and alternative explanations for their difficulties will be provided.

 

What are the treatment options for ADHD following diagnosis?

Treatment of ADHD consists of a range of therapeutic options. The two interventions with most evidence for effectiveness are parenting programmes and medication. 

 

Parenting programmes

Parenting programmes are usually the first-line intervention. They can help parents learn to use more specific skills to help their child accept limits and boundaries, prevent difficult behaviour and deal with its consequences.

We currently run a termly ADHD Family Support Package (FSP) for parents/carers of young people diagnosed with ADHD in our service. If you wish to find out more about the FSP, please ask your child’s consultant for a flyer.

There may be other parenting programmes available depending on your area. Please speak to your child’s consultant for more information if you are interested.

 

Medication

Medication can be a useful adjunct to parent programmes but is not a ‘magic cure’ for ADHD. It simply creates a window through which other interventions at home and school can become more effective. Not all parents or young people decide to have ADHD medication and so we will always discuss the pros and cons of medication and their alternatives with you carefully. We will monitor your child’s height, weight, and blood pressure regularly if medication is prescribed.

 

Talking therapies

Other treatments provided by our service include ‘talking therapies’ such as cognitive behavioural therapy (CBT), family therapy or psychotherapy. Please discuss any concerns that may be appropriate for treatment with talking therapy with your child’s consultant.

 

Complex neurodevelopmental service

The clinic provides specialist assessments and treatment plans for children with possible neurodevelopmental or neuropsychiatric disorders. These include autistic spectrum condition (ASC), Tourette’s syndrome, obsessive compulsive disorder (OCD) and more complex presentations of attention deficit hyperactivity disorder (ADHD).

 

What is ASC?

Autism spectrum condition (ASC) is the medical term for autism. Every autistic person is different, and some features of ASC include social communication difficulties, restricted behaviours or interests, and sensory sensitivities.

For more information on autism, please see the following links:

It is common for people with ASC to have co-occurring conditions such as ADHD, anxiety, depression, OCD, eating disorders, sleep disturbance/disorders, and tic disorders, including Tourette’s.

 

What is our referral process?

We can accept complex neurodevelopmental assessment referrals for children and adolescents aged 6-18 who have a Camden or Barnet GP and live in either Camden or the following Barnet postcodes: NW2, NW11, N3.

Please note that for patients with a Camden GP, we only accept referrals to this clinic for complex presentations of ADHD. Referrals of Camden patients for ASC assessments only will not be accepted by Royal Free CAMHS.

Referrals must be made in writing by a GP, paediatrician, teacher, psychiatrist, or another CAMHS professional. Referrals must include enough information regarding the following:

  • What symptoms the young person displays
  • How long the symptoms have been present
  • Whether the young person exhibits these symptoms at school, at home, or in other settings
  • Important background information, such as family breakdown, social services involvement, moving from a different city or country, languages spoken at home, etc

All referrals are screened by our team before a patient is accepted into our assessment clinic.

 

What is the assessment process like?

Prior to a first appointment, parents, teachers and, if old enough, the child themselves, will be asked to complete some questionnaires. These are for us to learn about the young person ahead of meeting them in clinic and help to standardise the assessment process. Please note that all patients are required to complete these forms, even if a child already has been assessed and diagnosed by a clinician in the private health sector. Families will also be asked for permission to contact relevant agencies for further information before assessment.

Once a patient's questionnaires are returned to Royal Free CAMHS, the forms will be screened. If a complex neurodevelopmental assessment is appropriate based on our screening, the patient will be added to our waiting list.

When the young person reaches the top of our waiting list, the family will be invited to an initial assessment. Please note, due to a backlog of referrals and assessments caused by COVID-19, our waiting times are longer than usual. 

Assessments are conducted by a multi-disciplinary team consisting of a Child and Adolescent Psychiatrist, Clinical Psychologist, and Child and Adolescent Psychotherapist. There are usually other members of the team also present. 

When the assessment is complete you will receive a report providing a summary of our conclusions and how these were reached. We encourage families to share this report with the young person’s school so that appropriate accommodations can be made.

 

What happens following the assessment?

Follow-up assessment appointments are often required. These may include:

Observation of the child/young person in a different setting, e.g., school
Cognitive or neuropsychological assessment
Specialist diagnostic assessment e.g., Autism Diagnostic Observation Schedule (ADOS)

Following the assessment, some children/young people are followed up in the clinic. Others are seen within our wider CAMHS service for the recommended interventions, such as child psychotherapy or family therapy. Some children/young people are referred to local or other CAMHS services if more appropriate.