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Kids Doctor Checkup

MY PRACTICE

As a responsible Doctor, I make sure patients have time to get to know me and my professional background so they’ll feel comfortable with their care choice. Through a holistic approach I view each patient as a whole rather than a single symptom to be treated. I’m dedicated to building long-lasting relationships based on trust and medical integrity with every single patient.

ADHD ASSESSMENT & DIAGNOSIS (Identification)

Referral

When to suspect ADHD LINK

I am happy to see children / young people up to their 18th birthday.

If 18th birthday is coming up soon it may be advisable to see an adult specialist. 

As well as ADHD, if you are very concerned regarding a mental health problem such as depression or your child has expressed suicidal or self-harm thoughts, then it would be advisable to see a Psychiatrist. 

I only accepts referrals from the ADHD Foundation or via Ghosh Medical Group

 

By accepting an appointment to see me, you have agreed that the focus of the consultation will be to decide if ADHD is the cause or contributing factor to your child's difficulties.

Formal assessment for any conditions other than ADHD will require a separate appointment. 

 

I apply a child focused and holistic approach to a detailed neurodevelopmental assessment that will consider

  • family/schooling/lifestyle factors including negative / adverse early life experiences.

  • medical problems and conditions that can be confused with ADHD

  • co-existing conditions (co-morbid) such as autism, dyspraxia, dyslexia, sensory processing difficulties as well as learning/emotional/mental health difficulties that if not causing may be contributing to the child's difficulties.

 

Part of the assessment process involves evaluating how much of a role, if any, these other factors play and attempting to identify and exclude these.

This is vitally important because, although getting a timely diagnosis of ADHD is important, it is also crucial that a child or young person isn’t wrongly diagnosed with ADHD. 

As such, an ADHD assessment is not a simple or tick box exercise and should never be diagnosed on the basis of just a behavioural checklist even ones that claim to be validated. 

Assessment

  1. I follow NICE guidance as a minimum standard. My holistic assessment is supported by objective scientific evidence using QbTesting for all children. This is 'gold standard'.  Read further regarding QbTest LINK.

  2. The first appointment is 90 minutes and F2F. I do not offer video consultation for the first appointment.

  3. This will involve taking a detailed history, examination and informal observation. This will include talking to your child about their life, experiences and difficulties. This is an important part of my assessment and in my opinion best done F2F. This is why I do not offer online assessments. 

  4. I will also review the ADHD screening assessment completed by the ADHD Foundation or GMG  (they will have sent me all the reports including QbTest result) prior to your appointment) and the health-development questionnaire you completed pre-clinic, this will help to focus on areas of concern for you and your child.​

  5. As a large part of your child's day is spent in school, for my assessment, I will always require feedback from your child's teacher/s.

  6. Even if you feel the school do not share your concerns, their opinion is still an important part of my holistic approach. School feedback is one of many pieces of the jigsaw I will consider. The ADHD Foundation will have requested school feedback. If this has not been completed then please contact me and I will send the relevant forms to be completed by the school (teacher/SENCO).

  7. If school feedback isn’t readily available for the first appointment (has left school or summer holidays) it will still be helpful if you can bring any school reports, learning plans etc.

  8. Also, please bring any letters or reports from any therapists (e.g speech) or specialists your child has seen in the past. I like to have as much information as possible to get a full and holistic picture of your child's health and neurodevelopmental profile. 

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Diagnosis

  1. Depending on evidence gathered and complexity, I aim to give my opinion on diagnosis i.e., does your child have ADHD or not,  at the first appointment. 

  2. However, in some cases, if your child's difficulties are complex that cannot be covered during the appointment or if I need to request further information (school, other professionals) a 2nd or 3rd  appointment will be required. This will also apply if following the initial assessment, I feel your child may need additional assessments/tests to help me to diagnose or deal with your child’s condition. Examples include psychology, psychiatry, speech/language therapist and occupational therapist. 

  3. ​Once assessment is completed, with your consent, I will email a Summary Assessment and Diagnostic Report outlining my findings/opinion/recommendations for parent/child/teacher. I will send a copy to your GP. You should expect to receive this report, in most cases, within 14 working days. The cost of this summary clinical report is included in your appointment fee. I keep this report brief and to the point, to minimise overall cost to you. One or two queries regarding the report I am more than happy to discuss via email, otherwise may require a further appointment (F2F or Video). 

Support, Therapy, Treatment including Medication

  1. Through a holistic approach, I view each patient as a whole rather than a single symptom to be treated. 

  2. I will discuss support/therapy options at the first or second appointment. 

  3. Not all children with ADHD require medication. If medication is the right choice for your child then it is important to note that medication is more likely to be effective if part of a multi-modal psycho-educational approach with school and home-based ADHD specific support and behavioural strategies. I will discuss some of these strategies during the first few appointments but for more detailed practical support I would recommend discussion with the school SENCO and the ADHD Foundation.

  4. Further reading regarding ADHD Psychoeducation and Support / Training for Parents and Others: LINK1  LINK2  LINK3

  5. Further information regarding Medication Titration 

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OTHER NEURODEVELOPMENT ASSESSMENTS

1. For autism, I can certainly do an assessment/autism screen and advice on whether it is likely but for a formal diagnosis this usually requires a team approach using standardised autism diagnostic tools. A young person may have autism and ADHD together. For appointment and likely costs please contact me. 

2. For 'motor dyspraxia' (Developmental Coordination Disorder) I recommend an initial assessment by a Paediatric Occupational Therapist followed by a medical assessment by a Paediatrician. If the former is done then please contact me regarding likely costs.

3. For sensory processing difficulties ( I do not use the term disorder) you will need an assessment by a specialist paediatric occupational therapist.

4. General concerns regarding development and behaviour

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