Developmental paediatrics

Currently the Community Paediatrics, ASD and ADHD services are receiving an extremely high volume of calls. We understand the frustration this is causing to families trying to contact us and are working on a solution to remedy this. If you need to contact the service please email [email protected]. We are aiming to respond to all emails within two working days of receipt.

We work with many other professionals in assessing and managing developmental difficulties. The people we work with include therapists (speech, occupational and physiotherapy), educational psychology, educational professionals, child mental health service (CAMHS) and charities. This multi-team approach aims to support not only the children we see but also the families.

Conditions we assess and manage 

We assess and manage conditions like: 

• Developmental delay
• Contribute to ADHD and ASD assessments
• Sleep difficulties in children who have diagnosed neurodevelopmental disorders
• Developmental Co-ordination Disorder

We assess and manage children with complex neurodisability, working alongside other specialist doctors and teams, for conditions like:

• Cerebral palsy
• Genetic and chromosomal problems such as down syndrome
• Other conditions such as neurofibromatosis

Often the children we see can have a complex mix of physical and developmental problems (including learning difficulties) and we are a part of a wider team involved in their care.

Conditions we don’t manage 

We don’t manage physical or mental health conditions such as:

• Tics
• Medically manage behaviour problems
• Assess for dyslexia, dyscalculia or sensory processing difficulties
• Constipation, bedwetting, weight difficulties
• Depression, anxiety, self-harm

If you are concerned about your child’s mental health you should talk to your
GP, school nurse or health visitor who may suggest a referral to CAMHS.

Contact us

The Developmental Paediatrics team can be contacted using the below details:

Call 0151 282 4930 and select the relevant option:

• Option 2 for Community Paediatrics
• Option 3 for ND Assessment Team
• Option 4 for ND Treatment Team

Prescriptions 

Please be aware many of the medications that we use are “controlled medications” legislated for under the misuse of drugs act 1971.

The medications we use should not be increased/stopped unless discussed with your prescribing clinician or one of the clinical team. They should not be used for other people. We do retain the right to refuse to prescribe medication if there is a reasonable concern that the medications are being used inappropriately.

We require three weeks’ notice to provide a repeat prescription due to the checks needed. We do not provide emergency prescriptions.

Repeat Prescription Form 

To make a request for a repeat prescription, please fill out the repeat prescription form.

Information for families

What happens at the clinic appointment?

New patient appointments last around 60 minutes. Follow-up appointments will last around 30 minutes.

At an initial appointment we aim take a developmental history from the child’s parent or carer. This includes any problems during pregnancy, birth, and the period soon after birth. We ask about current concerns when these started and how they affect daily life. We also need to know about other health problems, medications, medical problems in the family and any other concerns. This often includes a social history.

We also examine the child for assessment of underlying medical problems that could be associated with their difficulties.

We may need further information from other people involved with your child, such as from school or nursery. We might request reports or send questionnaires for this extra information. We may ask to see the child in the nursery/school setting.

Sometimes we may need to organise medical tests such as blood tests or scans. These are usually to look for a cause for the difficulties your child has presented with. We assess each case as to whether further tests are needed.

You may be signposted to services that can support you or your child with the concerns you have.

After the clinic we will write a letter summarising the appointment. You will receive a copy of this. With your agreement we may copy this to other professionals involved with your child such as school. If there is any information you do not wish others to know, please alert the doctor/nurse about it.

We have clinics in Alder Hey and community sites. Please carefully check the appointment letter and find out where your clinic is held. If you go to the wrong site, your appointment will have to be cancelled.

Time of arrival: Parking could be difficult. Before seeing your child, we need to check his/her height, weight and sometimes, blood pressure. Please arrive at least 15 minutes before the clinic.

What to bring to the appointment

If possible, please bring your child’s health record (the ‘Red Book’), especially if your child is under five years of age. Please also bring reports from other professionals and the latest school report, if you have them.

Here are the therapy departments in Alder Hey Children’s NHS Foundation Trust who may be involved in your child’s care:

• Community Physiotherapy
• Occupational Therapy
• Community Speech and Language Therapy (Liverpool)

Resources for parents, including medication information

SEN and Disability Local Offer

More information about the Local Offer for Children, young people and families can be found at:

• Liverpool
• Sefton
• Knowsley

Medical information

Further information regarding ADHD medication can be found on links below:

• Methylphenidate-for-attention-deficit-hyperactivity-disorder-ADHD.pdf (medicinesforchildren.org.uk)
• Atomexetine-for-ADHD.pdf (medicinesforchildren.org.uk)
• Guanfacine-for-ADHD.pdf (medicinesforchildren.org.uk)
• Melatonin-for-sleep-disorders.pdf (medicinesforchildren.org.uk)

Other organisations

• Addvanced Solutions
• The Sleep Charity
• Disability charity Scope UK
• The Tuberous Sclerosis Association
• Nerve Tumours UK
• ADHD Foundation

Developmental delay

Children develop in the same way but at different rates. Sometimes children need to be assessed for possible underlying medical conditions if they have had delay gaining certain skills by a certain age for e.g. delay in walking by 18 months of age.

Some children are slow to develop skills in one area only such as gross motor (sitting, walking, and jumping) while others are slow to develop skills in more than one area such as gross motor and speech and language. This may indicate ‘global developmental delay’.

Our doctor will take a history from the parent/carer and examine their child. This will help to assess if any investigations are needed. Some children catch up in their development while others will need support. Some children may need investigation for medical conditions and the doctor may suggest blood tests (such as genetic testing) and sometimes brain scans. Occasionally, other tests such as hip X-rays may be needed.

Find out more about Global Developmental Delay by reading our information leaflet.

Sensory impairment

The team works closely with the Ophthalmology team and specialist teachers of visual impairment to support children with vision impairment. 

More information can be found on the below links:

• Scope
• Downs syndrome association 

Information for professionals

Referrals

Referral criteria

We accept referrals from health or educations professionals. We do not accept self-referrals. We accept referrals for children up to 16 years of age.

If a child is under 6 years of age, please refer to Developmental Paediatrics.

Referral process

Please find below the link to our Developmental Paediatrics online referral platform. This is the quickest and most effective method of referral for Developmental Paediatrics, making the referring and tracking progress of referrals easier. Please also find guides below for using the online platform. If you are experiencing any significant problems with the online referral platform, please revert to using the paper referral form below as normal.

The paper referral forms can still be used in the event of a system error on the online referral platform. If you are experiencing any significant errors please use the below link to access the paper form. This referral form can be submitted electronically by saving it into a PDF format and emailing it over to our Booking & Scheduling team [email protected]. Further guidance is attached to the form itself.

Download referral form (65kB)

ADHD and ASD referrals

If a child is over 6 years of age, then a referral may be submitted to relevant pathway. Please go to our ADHD service page and ASD service page with links embedded.

If you have concerns related to ADHD and also another condition, you will need to submit two separate referrals.

Sleep

Sleep pathway pilot

This pathway is a pilot for those children who are either known to Developmental Paediatricians, or fulfil the requirement for a Developmental Paediatrician referral (i.e. underlying neurodevelopmental disorder/problems) in the absence of any contributory medical causes that need intervention.

Those referred to sleep pathway will be expected to complete a sleep diary for 14 days and undergo comprehensive behavioural management provided by The Sleep Charity.

Referral criteria

• Confirmed NHS Neurodevelopmental diagnosis
• Neuro disability
• Only children under the Developmental Paediatrics catchment area (including Liverpool, Knowsley and Sefton)
• Aged 5 to 16 years (No new referral will be accepted once they have passed their 16th birthday)

Exclusion criteria

• Any sleep disorders other than sleep latency and insomnia are not suitable for this pathway and will not be accepted.
• Children and families unwilling to engage/consent in sleep intervention will not be accepted into the pathway.
• Any other medical causes that are felt to be impacting on sleep.
• Children younger than 5 years of age. Local offers i.e. children centres should be explored

Useful links