Child Development Centre

The ASD co-ordinator service provides support to families who have a child/young person diagnosed with ASD.  The goal of this service is to assist families to access relevant community support agencies and to help ensure that any recommendations in the child’s assessment plan are actioned.

Referrals to the ASD Co-ordinator service can be internal or external.  The child does not have to be a client of the Child Development Centre to access this service.  They may, therefore, have been diagnosed by a recognised professional within the community or district health board (DHB), or may have transferred into the Waikato from another region.

Entry criteria

• Child/young person is aged 0-19 years, and
• Has been newly diagnosed with ASD only, or ASD with a Global Developmental Delay (GDD), and
• Has not been diagnosed with a co-existing intellectual (ID), physical (PD) or sensory (SD) disability – see note below

In conjunction with the family, the ASD coordinator develops a service plan outlining the agreed actions to be taken and planned follow up dates.  Depending on the needs of the family, provision of support can be made for up to two years.

Note: Where a child has been diagnosed with ASD and an ID, PD or SD, a referral should be made to Disability Support Link (rather than the ASD co-ordinator), who will provide relevant co-ordination services. 

Referrals to Baby Clinic come from the Waikato Hospital Newborn Intensive Care Unit (NICU).

All children discharged from the Waikato Hospital Newborn Intensive Care Unit (NICU), weighing less that 1250grams, are eligible for followup.  This consists of telephone contact with the family of all babies discharged from Waikato NICU prior to age one (corrected for prematurity).

• Infants residing in the Waikato region are invited for a developmental screening appointment when the child is one (age corrected for prematurity). 
• All children and parents are invited to attend a full developmental assessment at age two (corrected for prematurity). 
• The final part of this routine follow-up involves telephone contact for all families when the child is between 4 and 5 years to ascertain if any further developmental services are required to support the child.

Baby Clinic involves psychologist, and either  a speech language therapist (SLT) or physiotherapist.  A paediatrician monitors growth and any medical concerns. 

Referrals for children who are not current Child Development Centre clients are via the Child Development Centre Pathway Clinic to determine eligibility to service.  The Feeding Assessment Tool will need to be completed as part of Pathway Clinic assessment. 

Children who are current Child Development Centre clients may be referred directly to the Feeding Clinic.  The Feeding Assessment Tool will need to be completed and attached to the referral (excluding Paediatric referrals).

The Waikids Feeding Clinic is a multidisciplinary assessment and intervention clinic. The aim is to provide a multi-faceted assessment of complex feeding issues, for children with disability, who are not feeding at a level consistent with their developmental level. This assessment is used to inform a treatment plan to be implemented by the child’s key worker.

• The assessment team consists of a psychologist, speech language therapist and an occupational therapist, all trained in the Sensory Oral (SOS model) approach to feeding intervention .
• The child’s paediatrician and Waikids paediatric dietician will be consulted as needed. 
• Assessment involves observation and/or videotape of the child feeding, as well as an interview with the parents and key worker. 
• The assessments take two hours, with one hour follow ups offered at 3 months and 6 months to monitor progress.

Entry criteria

• Child has disability/developmental disorder (meets Child Development Centre entry criteria).
• Child is not feeding at the level expected for their level of development.
• Family have consented to assessment and are willing to take part in the intervention/management plan.
• Primary paediatrician has been consulted and medical/ organic issues ruled out as primary causal factor.
• Child’s lead clinician/therapist is able to attend  the appointment and implement the intervention with the family.

Note: Queries regarding aspiration are to be referred to SLT before coming to Feeding Clinic.

Referrals to ID Clinic are internal to Child Development Centre or by specialist referral (e.g. paediatrician at Children’s Clinic).

The Intellectual Disability Clinic (ID Clinic) provides an assessment to establish whether a child or young person has an Intellectual Disability (ID). Intellectual Disability is a life long condition, which affects learning, understanding and problem solving. It is one of the most common causes of ongoing developmental delays and learning difficulties.

When a child is diagnosed with an ID, it means that they have a lot of difficulty in the two following areas:

• Cognitive skills (thinking, understanding and problem solving) well below what would be expected for his/her age.
• Adaptive functioning (the skills a person needs to live independently), such as communication, self-care, safety and getting along in social situations and school activities.

There are two main reasons to assess for ID:

• To help understand the child and to help family, friends and teaching staff have realistic expectations of them.
• To establish eligibility to health funded disability services.

Assessments

• ID assessments are carried out by one or two psychologists who gather information about the child’s development, academic progress and daily living skills, and carry out cognitive (thinking, understanding and problem solving) testing with the child.
• The appointment takes around 3 – 4 hours. Where possible, feedback is given on the day of assessment.

Entry criteria

• Child or young person is at least  7 years of age and has had more than one year of stable schooling and
• Child or young person has significant learning difficulties across all curriculum areas AND there are significant delays in adaptive living skills across two or more settings (home, school, community) and
• The child’s parents understand the reason for the assessment (see above) and are seeking greater understanding of the child’s intellectual level and/or access to health-funded disability services.

Note: Access to Education funded services is not determined on the basis of a diagnosis of intellectual disability but on the Education service’s own functional in depth assessment of current skills and rate of learning. Some educators and families think formal diagnosis will improve their access to education resources. This is not the case and ID assessments are not completed to contribute to applications for education resources or services.  

An IDA is an interdisciplinary diagnostic assessment. The goal of IDAs is to facilitate understanding of diagnostic issues and refer on for intervention, needs assessment and advocacy services.

Referrals to IDA are internal to Child Development Centre only. 

• Assessments are carried out by a team consisting of a psychologist, speech language therapist and an occupational therapist. 
• A physiotherapist can also be involved, if required. Interviews with parents and others will also take place.
• In some cases an observation of the child at preschool or school is necessary. 
• The assessments for younger children (1-6 years) typically take a morning (9am to noon). Older children may take two mornings or more.

Orthopaedic Clinic provides regular and ongoing orthopaedic assessment and management for children and young people with complex orthopaedic conditions related to their developmental disability.

Referrals to this clinic are accepted from paediatricians or therapists. 

This clinic is run by a paediatric orthopaedic surgeon and a Child Development Centre physiotherapist once-twice monthly.

A paediatric clinic is a medical review.  The goal of the paediatric clinic is to assess if there are any underlying medical conditions contributing to the developmental problem.

• A new paediatric appointment will take approximately one hour, and may be undertaken by a consultant paediatrician, paediatric fellow or experienced paediatric registrar. 
• Review appointments are half an hour.

Paediatric Neurology Clinic is a specialist outreach clinic for children with complex neurological condition’s requiring a neurologists opinion.  It also provides regular and ongoing physical assessments for children and young people with neuromuscular conditions (e.g. muscular dystrophy).

Referrals are accepted from paediatricians. 

This clinic is provided by visiting paediatric neurologists.  The children with neuromuscular conditions are also assessed by a Child Development Centre physiotherapist.   This clinic occurs 3-4 times per year. 

Developmental paediatricians provide assessment and diagnosis, including medical investigations and ongoing care for children and young people with developmental disabilities. 

Pathway clinic is a multidisciplinary assessment.  The goal of Pathway Clinic is to provide a timely, brief developmental assessment to enable informed decisions about referral pathway within Child Development Centre and/or out into the community.

Referrals to Pathway can be internal or external.

There are two types of Pathway Clinic:

1. Preschool
2. School-age (for children 5-8 years). 

• The Pathway Clinic is run by senior staff, who interview caregivers, undertake a developmental screen and, depending on their findings, refer on to further services within Child Development Centre and/or to early intervention and other community services.
• A Pathway Clinic appointment takes about 45 minutes for preschoolers and about 1.5 hours for school age children.

Physiotherapists at Child Development Centre provide assessment and management of children with developmental disabilities which impact on their motor function, and related conditions.  They work with the child's family, wider community and other health professionals to establish goals, develop treatment programmes and provide education, resources and equipment. Conditions seen may include:

• Cerebral Palsy
• Muscular Dystrophy
• Erb’s palsy
• Torticollis
• Gross motor delay
• Premature infants 

Psychologists provide assessment, diagnosis and intervention to children and young people who have significant learning and/or behavioural difficulties that are associated with a developmental disability. 

Psychologists focus on the psychological issues (social, emotional, cognitive and behavioural) that impact on children and their family/whānau.  

SCA is a psychology-led clinic.  The goal of the SCA clinic is to establish whether or not a child or young person has or may have an Autistic Spectrum Disorder (ASD). 

Referrals for an SCA can be internal or external.

• The assessment team currently consists of two senior or consultant psychologists, one to interview the caregiver, the other to work with the child. An SCA appointment takes 2 to 3 hours. 
• If a diagnosis of ASD is confirmed, then appropriate referrals within Child Development Centre and the community can be made.  If the outcome of the assessment is unclear then a plan for further assessment or intervention within Child Development Centre is developed. 

Social work within the Child Development Centre is provided to assist children with a diagnosed disability to develop to their full potential offering the ability to experience enriched lives free from dysfunction within an empowered family setting.

Referrals are from Child Development Centre clinicians.

• The social worker will work with children/families where a disability has been diagnosed, they will remain a client of the Child Development Centre, and do not currently have appropriate social service support agencies working with them.   
• The social worker will complete a psycho social assessment to determine a picture and understanding of the child/family as unique individuals who will respond in their own way to the diaognosis and the changes and adjustments it brings to their lives. 
• A plan with goals and outcomes will be agreed to with the child/family, focusing on meeting the child/families needs and developing future potential. 
• The social worker will be involved with the child/family until the goals are perceived to be met, if required. The social worker will review the progress after a three months period before discharging the child/family from the Child Development Centre social work case load. 

Soiling Clinic provides assessment and treatment for children with chronic constipation and/or faecal soiling. The goals of soiling clinic are to investigate underlying medical causes for the problem, to educate children and parents about how the problem has developed and why it continues, and to provide medical and behavioural treatment.

Referrals to soiling clinic can be internal or from a health professional such as GP, public health nurse or paediatrician.  

• Soiling clinic is run by a paediatrician or paediatric registrar and a senior psychologist.
• First appointments usually take around 45 minutes, and review appointments 15 to 30 minutes.

Entry criteria

• Child is over 4 years of age
• GP or paediatrician has already trialled appropriate medication (see kidshealth.org.nz for advice)
• The soiling is developmentally inappropriate and not due to a surgically correctable problem.

Speech Language Therapy at Child Development Centre provides assessment, management and advice for:

• children aged 0 – 16 years with feeding or swallowing difficulties
• children 0 – 2 years with communication difficulties as a result of an identified disability or a delay in 2 or more areas.

Referrals to speech language therapy can be internal or external.

The sessions may be clinic, community or home based depending on the child’s needs.

Splinting Clinic provides upper limb assessment and splinting management for children and young people with developmental disabilities affecting their upper limb.  The aim of Splinting Clinic is to maintain or improve range of movement and function in the upper limb.

Referrals are accepted from the child’s primary therapist or paediatrician.

This weekly clinic is run by a Child Development Centre physiotherapist and a Child Development Centre occupational therapist. 

Positive Parenting is an evidence based approach to parenting which aims to promote children’s development and manage children’s behaviour in a constructive and non-hurtful way. 

This programme is for parents of children up to 12 years old who are clients of Child Development Centre.

It is based on good communication and positive attention to help children develop. Children who grow up with positive parenting are more likely to develop their skills and feel good about themselves. They are less likely to develop behaviour problems. Stepping Stones Triple P recognises 7 key aspects to positive parenting.

1. Ensuring a safe and interesting environment
2. Creating a positive learning environment
3. Using assertive discipline
4. Adapting to having a child with a disability
5. Having realistic expectations
6. Being part of the community
7. Taking care of yourself as a parent

The Visiting Neurodevelopmental Therapy service is a trans-disciplinary service that provides home and community-based assessment and intervention for preschool children with complex developmental difficulties/disabilities and their families.

• The therapists support children and their family/whanau with everyday activities such as mobility, play, selfcare, early communication and social participation, as well as equipment and home modification needs. 
• They work closely with other agencies involved with the child.
• A visiting neurodevelopmental therapist may be a physiotherapist or occupational therapist.

Autism Spectrum Disorder (ASD) coordinator service