Community Paediatrician Service

Eligibility criteria

Children and young people (under 19 years) with long-term conditions, who are registered with a GP in the Mid Essex area - excluding Halstead, Earls Colne, Wickford and Tiptree.

Exclusions

• Behavioural problems not related to neurodevelopmental conditions, such as ADHD and ASD.
• Dyslexia.
• Mental health issues which require input from CAMHS.
• Acute paediatric problems.

Service details

We assess and treat children with additional needs who have difficulties or problems in the following areas:

• Development
• Social and communication skills – autistic spectrum disorder.
• Attention and behavioural difficulties – ADHD core symptoms.
• Cerebral palsy and long-term neurological conditions.
• Coordination.
• Hearing.
• Gait.

We also see vulnerable children, such as those on the children in need and child protection plan.

Our team includes consultant paediatricians, specialty doctors and specialist registrars who are doctors in training.

Service delivery

We run clinics at various times, Monday to Friday, 8.30am-5pm, at these locations:

• Chelmsford: Stapleford House, Parkside, Springfield Green and Moulsham Clinic.
• Maldon: St Peter's Hospital.
• Braintree: Carousel Children's Centre.
• Burnham Clinic.
• South Woodham Ferrers Clinic.
• Witham Health Centre.

See map below for details of these venues.

Attendance is by appointment only.

Referral process

Your child must be referred by a healthcare professional, such as a:

• GP
• health visitor
• hospital
• local authority
• child and adolescent mental health services
• local acute trust

ADHD information for parents

Attention deficit hyperactivity disorder (ADHD) is a Neurobiological Disorder with symptoms that include inattentiveness, hyperactivity and impulsiveness.

Many people with ADHD also have additional problems such as Oppositional Defiant Disorder and sensory processing difficulties.

 Children with ADHD may also have generalised or specific learning difficulties

Common symptoms of ADHD include:

• a short attention span
• restlessness
• being easily distracted
• constant fidgeting

ADHD is the most common behavioural disorder in the UK. It is estimated that the condition affects 3–9% of school-aged children and young people. Worldwide, around 2% of adults may be affected by ADHD.

Symptoms of ADHD tend to start at an early age, and they may become more noticeable when a child's circumstances change, such as starting school. ADHD is normally diagnosed between the ages of three to seven, although in some cases it may not be until much later. It is more commonly diagnosed in boys. 

ADHD can be a lifelong condition, and many children continue to have symptoms as a teenager and adult. It is estimated that nearly two-thirds of children with ADHD still have some symptoms at the age of 25.

Autism Assessment Pathway

Following an assessment with a Community Paediatrician, your child may be referred on for an Autism Spectrum Disorder (ASD) diagnostic assessment.

This is a specialist assessment carried out by a multidisciplinary team including a paediatrician, an Occupational Therapist (OT) and a Speech and Language Therapist (SLT). Your child may be seen jointly by a paediatrician, OT and SLT or your child may be seen by the SLT and OT first and then a follow-up appointment will be carried out with the paediatrician to feedback the assessment findings.

The assessment involves one member of the team, usually the paediatrician, talking with you and finding out about:

• your concerns, and those of your child if appropriate
• how your child has been getting on at home, in nursery or school, or in care
• your child’s past and present health, and that of the family
• your child’s behaviour and development

The other members of the team, usually the speech and language therapist and occupational therapist will talk with and observe your child. They will also carry out other specific assessments like ADOS (Autism Diagnostic Observation Schedule) that will help to provide more information, such as an assessment of how your child uses language and/or how they interact and communication with others.

When the members of the team have completed their assessment they use all the information from the assessment, the information you have given them and any information from your child’s school/preschool or other professionals who work with your child to help them come to a decision about whether your child may have an Autism Spectrum Disorder (ASD).

If your child is diagnosed with autism spectrum disorder

You will be told at the assessment if your child meets the criteria for a diagnosis of ASD. The team will explain more about autism spectrum disorder and how it might affect your child.

You will also be given information about the support you and your child can get in your local area. For example, you may be given contact details for support groups that can give you the opportunity to meet other families with experience of ASD, and advice about other services that are available.

They team will share information from the assessment with your child’s GP, and if you agree, with other professions such as your child’s school or other professionals if appropriate, to help them offer you the support you need.

A member of the team should talk to you (and your child, if appropriate) about all of this, soon after the assessment, and give you a written report explaining the findings of the assessment.

If the diagnosis is uncertain

Sometimes there can be uncertainties when diagnosing autism spectrum disorder and it may not be possible to be clear about what is the diagnosis. If this happens the team will talk to you about will happen next. This may be that they will see your child again after an agreed period of time or they may refer your child to another team that can help.

If your child does not have autism spectrum disorder

A member of the team will explain why your child doesn’t have ASD and may offer to refer you to other specialists, for example, Emotional Wellbeing and mental health services, also known as EWMHS) if they think they may be able to help.

Please note: The demand for this clinical assessment is very high so at present, the average time for this assessment to be completed is 18 months to 2 years. We are working to reduce this waiting time and understand that this period of waiting can be a difficult time. It is important to know that you can access support while you are waiting for an appointment and that a diagnosis is not required to access this support