Community paediatrics

Our child development team works with children under 5 years old who have more significant developmental/health needs.

Many of these children have complex health issues and may already see another doctor, for example an acute paediatricians or  paediatric neurologists etc.

Our role is to assess and review health and developmental. Our  speech and language therapists, physiotherapists and occupational therapists will do functional assessments and identify priorities for intervention.

These may include:

• home/nursery programmes of treatment, activities and strategies consultation
• training for parents and nursery staff
  providing equipment at home and at nursery.

Our team will also work closely with education and social care.

We see children and young people with:

• downs syndrome and other genetic disorders which cause disability
• physical disability including motor disorders such as cerebral palsy
• children with learning disabilities attending specialist schools who have associated complex medical problems such as epilepsy.

Cognitive assessments, including dyslexia

We don’t do cognitive assessments, educational support or advice for school age children. We don’t diagnose specific learning difficulties, or assess for dyslexia and dyspraxia.

For a diagnostic assessments for dyslexia, you’ll need to see an educational psychologist or specialist teacher.

Start a diagnostic assessment for dyslexia 

Autism spectrum disorder and ADHD

We diagnose children between the ages of 1 to 5 years of age with social communication difficulties which may indicate a possible autism spectrum disorder.

We also work jointly with child and adolescent mental health services (CAMHS) to provide ASD and ADHD assessments for school aged children.

Medication reviews

These are for children under the age of 11 with already confirmed ADHD and stabilised on medication. Children over 11 years of age and on medication for ADHD should be referred to CAMHS.

Sleep disorders

We offer assessment and review of children with sleep disorders associated with a neurodevelopmental disorder.

Co-ordination difficulties

We do assessments for children with co-ordination concerns that may indicate a developmental coordination disorder/dyspraxia. Our occupational therapists will do an initial functional assement.

Multi-disciplinary approach

We focus on excluding any neurological basis for your child’s difficulties. We also support a multi-disciplinary approach to diagnostic clarity with our OT colleagues.

This includes diagnoses such as:

• autistic spectrum disorder, attention deficit hyperactivity disorder
• statutory medicals for children living in special circumstances, for example, children looked after by the local authority and medical input to the adoption process.

Looked after children (children in care)

We also assess children who have recently come into the care of the local authority to make sure their health needs are met. We’ll ask parents or people with parental responsibility to provide consent for information about the child so that we can share information between us and the local authority.

Children in education

If your child has health or developmental needs that are impact on their education, the community paediatric team may need to share information about the child with the school and the education authority. We’ll ask you to give consent for this.

We may also assess your child if the education authority decide to initiate an education health and care plan (EHCP). This is usually a one-off appointment to complete a profile of the child’s health and developmental needs and how this may impact on their education.

We also give medical advice on the impact of health problems in educational settings.

We accept referrals for children/young people under the age of 19 years, except:

• children who’ve recently moved into Buckinghamshire county/or the UK
• those attending a special school within Buckinghamshire.

Due to the potential need for occupational therapy or speech and language support, we only accept referrals for children registered with a Buckinghamshire GP

You must provide supporting evidence and documentation. This includes:

• ASQ completed
• report from an education setting
• occupational therapy report or occupational therapy support from school setting for children with dyspraxia/ Co-ordination problems
• portage report if under portage
• hearing assessment if completed
• speech and language therapy assessment for children with primary social/communication/speech concerns
• reports confirming diagnosis and treatment to date if the child has been seen out of area previously or privately. For children already on medication, they should continue to receive private medication support, for children referred back to the NHS they’ll be seen in order of waiting times.

The following are NOT appropriate referrals as a primary presentation, unless there’s an undiagnosed or diagnosed neurodevelopmental condition

The following conditions should be referred to acute paediatrics or the appropriate speciality via doctor (GP):

• ENT/audiology
• acute medical conditions (excluding acute/chronic psychiatric)
• epilepsy
• failure to thrive
• growth problems
• physical abuse
• constipation
• daytime enuresis

Pathway of referral for children with feeding problems

Health visitor should refer to the child’s GP to assess and refer to a paediatric dietician or acute paediatrician.

For children with feeding problems due to disability

Refer to multi-disciplinary feeding team.