I am happy to accept a self-referral from parents who have concerns but it is often helpful for a child to be referred by the family’s General Practitioner or another specialist such as a Psychologist, Speech & Language therapist, Occupational Therapist or educational professional.
This is because Health Insurance companies often require a doctor referral and because background professional information about the child is often essential. It’s also important to make sure that I am the right person to see the child.
The child’s GP plays a key role in overall care and if needed, onward referral and continuing medical treatment. GP involvement at the outset often results in better after-care.
I see patients by appointment at 35 Great James Street on Tuesdays. I don’t ordinarily take phone calls out of office hours or do home or school visits.
Assessment & Diagnosis:
Developmental disorders, such as ADD/ADHD, Autistic Spectrum & Dyspraxia, are clusters of overlapping and inter related problems. The vast majority of children will have a mixed picture of strengths and difficulties and many will have two or three additional problems. Children rarely fit a ‘textbook’ diagnostic description so a detailed assessment is essential.
So, before the appointment I will usually ask for certain background information in the form of a school report or questionnaires for teachers and/or parents or carers, as well as reports from previous assessments (such as those from psychologists or therapists). Sometimes parents prefer not to involve the child’s school and I understand there can be difficult situations. However, it is important to say that without another independent opinion of the child (even if there are conflicting viewpoints!) it might be difficult to arrive at a firm diagnosis on the first appointment.
I will aim to give my expert opinion as a senior clinician as to the diagnosis and appropriate options for helping. My assessment is based on asking a large number of structured questions in a fairly straightforward conversational way. I usually see child and parents together so if they feel comfortable, the child can contribute and I can unobtrusively observe them at play or interaction over an extended time. Parents are understandably wary of talking about their child’s problem in front of him/her but I find that in general, children and young people can offer valuable insight and find the process helpful and positive. It may be helpful to explain to your child that I am a doctor who will try to find out why they are having difficulties and how we can together help make things go better. There will be no tests or needles involved!
I rarely ask for blood tests, EEGs or brain scans. In complex cases, sometimes I recommend another professional assessment to help with diagnosis such as a psychological or speech and language therapist assessment.
I will write a detailed report for you about my assessment with copies to the referring professional and your GP. If medicines are to be involved, then I will manage these myself initially until things are stable and then often jointly with your GP.
A first appointment is generally 90 minutes, but there can be flexibility depending on the overall picture and previous professional involvement. If I need to see you or your child again it will be for a shorter period.
I am unable to take phone calls but for some situations it might be possible to make a telephone appointment through my PA. Emails are easier to deal with (though please be sparing with emails).
In the first instance please contact me to discuss any concerns about your treatment. If you feel your concerns have not been dealt with then you should contact the Responsible Officer at St George’s University Hospitals NHS Foundation Trust.