What is a Child Development Centre?
Child Development Centres (CDCs), which are part of the NHS, provide treatment for children whose development may be delayed. Mark Leach (Development Manager, Disabled Children and Young people) and Dr Meng Tan (Lead Paediatrician) both work at Newham’s CDC in East London. They speak to Isabelle Rameau about what happens there…
“A child will usually be referred to the CDC because people are concerned about his or her development,” explains Mark Leach. “This referral might be made by the child’s GP, a Special Educational Needs Co-ordinator, a health visitor, or a social care provider.”
Newham’s CDC has a multidisciplinary team consisting of a number of professionals in specific areas, including paediatricians, speech and language therapists, occupational therapists, physiotherapists, advisory teachers and educational psychologists. There are also care co-ordinators who work with families to provide early support, for instance, arranging short breaks. In addition to the assessment team and the therapy services attached, there is an information exchange which provides information and support to families around disabled children’s services, such as how to claim for a Disability Living Allowance. Information sheets are also available for parents.
Once a child has been referred, the CDC’s specialist health visitor will visit the family to discuss what will happen in the multidisciplinary assessment which takes place at the centre, and answer any question.
Dr Tan is part of the team which carries out the assessment. “Usually there will be more than one professional present. It will be led by the paediatrician, but there may also be a physiotherapist, occupational therapist or speech therapist, depending on the nature of the child’s problems. Quite often, a teacher from the support services may be there too, especially for younger children.”
The team will take a detailed history for the child and carry out an objective assessment of their development. One of the difficulties for children who are in the care system is that they sometimes arrive at the CDC with missing information in their medical history, because of being moved from one borough or foster carer to another. This can compound problems for children with developmental delay.
At the same time, the professionals in the assessment team will also observe the child and interact with them. The paediatrician will carryout a physical examination, including weighing and measuring the child and checking that they are physically all right. That is particularly important if there are neurological problems, such as cerebral palsy.
“At the end, we talk to the parents about what we found, what our concerns are, and whether those match the parents’,” says Dr Tan. “We will detail what we think would be best for the child, and set out a management plan for them.” This is also an opportunity to give advice to parents about what equipment they can use, or if they are concerned about whether what they are doing is correct, like feeding the child. When they leave, parents are given a brief handwritten report, with a full report following up later on, compiled from the notes taken by each specialist during the assessment.
It is up to parents to decide how they want to follow up the assessment – although key workers or specialist health visitors will contact families if they feel that immediate action is needed. Dr Tan has found that, sometimes, families need time to take in the information. “We acknowledge that it can be difficult for parents when there is a large group of relative strangers there, so we offer them the opportunity to come back to talk to someone on a one-to-one basis if they wish to.”
Dr Tan understands how anxious parents can be to have as much information as possible. “We do see many children who have various patterns of developmental delay but no ‘label’ can be placed on that in terms of the cause of the delay. With that uncertainty, parents often ask ‘if my child is delayed, will he or she catch up?’, and that is very difficult to answer.”
Treatment will usually involve the multidisciplinary team a speech therapist, occupational therapist and physiotherapist will work together within the treatment plan, depending on the child’s needs. This will carry on as long as the therapists feel that the child is benefiting from it. In parallel, the child will attend review appointments at the CDC to reassess the situation – sort of ‘checkpoints’ to see how the child is developing, and make any required changes to the treatment plan.
As well as working for Newham’s CDC, Dr Tan is also a medical adviser for a local authority, giving advice to prospective adopters when matched with a child. He feels strongly about providing as much information as possible to families, while not offering them false hope. “We can’t give them any kind of absolute guarantee. They need to remember that the child comes with their own ‘package’ of factors that will affect their development – such as their genetic mix and past experiences. But on the positive side, some of that can be modified by how the child is brought up in their new family and the environment they are in – families also have their part to play in helping their child develop – and all of that is just as important.”
Isabelle Rameau
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Originally published in the Be My Parent newspaper in September 2009.
This article is published with the kind permission of the people involved. You may download it for your own reference but if you wish to use it for any other purpose, please contact Be My Parent for authorisation: Be My Parent, BAAF, Saffron House, 6-10 Kirby Street, London EC1N 8TS. Telephone: 020 7421 2666.
Last updated: 10 March 10
