CLINICAL SERVICES 

General Information

All assessments include a full written report.

Appointments can be arranged in the International and Private Patients wing at Great Ormond Street Hospital, or at home or in school if appropriate. See Practicalities.

What are cognitive and neuropsychological assessments?

Cognitive assessments are standardised psychometric tests, sometimes referred to as 'IQ' tests that provide the most accurate and reliable measure of individual abilities. They consist of a mixture of screen-based, manual and paper/pencil tasks.

  • evaluate key aspects of intellectual ability including reasoning with words, non-verbal and visual-spatial problem-solving, working memory and processing speed
  • results allow us to:
    • understand where a child's overall abilities are, in comparison to other children of the same age
    • highlight uneven profiles, i.e. a gap between abilities in different areas, that can affect learning
    • make clear educational recommendations to promote development and achievement, and consequently self-esteem 
  • assessments are presented in a relaxed and reassuring manner and effort is praised; most children enjoy doing them

 

Additional assessments of academic attainments or acquired skills, e.g. reading, spelling and maths, are also carried out where appropriate. This is particularly important if there is concern that a child has selective difficulty in any of these areas, or is generally under-performing at school. Results from these assessments may support a diagnosis of a specific learning disorder affecting literacy ('dyslexia') or numerical abilities ('dyscalculia'), with associated recommendations for educational support and exam allowances.

Neuropsychological assessments include the assessments of intellectual ability and attainment described above, plus additional tests to measure specific functions such as memory or attention. These assessments may be used where there are questions or concerns about particular aspects of a child's cognitive functioning, or where they are having difficulties at school that cannot be explained by their general abilities.

What is child and adolescent neurodevelopment?

Neurodevelopment refers to the way in which the brain develops through childhood and produces the range of abilities and behaviours that we typically expect at different ages. Brain development processes are complex and in some children they may follow an ‘atypical’ pattern leading to difficulties in one or more areas, such as learning, social behaviour or emotion regulation. These difficulties may emerge in the early years or not become apparent until later childhood or adolescence.

Clinical psychologists specialising in child and adolescent neurodevelopment have expertise in the cognitive, social, behavioural and emotional characteristics associated with typical and atypical neurodevelopment; and in understanding how best to support these common areas of difficulty.

Depending on their nature and severity, difficulties may influence academic progress and ability to cope with school, peer relationships, family functioning, mood and self-esteem.

Sometimes a neurodevelopmental disorder may be indicated and a diagnostic package can be offered. However, it is not unusual to find a mixed picture of features that does not meet diagnostic criteria for a disorder but still affects quality of life. In these situations, identifying the profile of strengths and difficulties and providing clear explanations and recommendations for family, school and other agencies can make a valuable difference to long-term outcomes.

 

Assessments

  1. Initial Assessment

A detailed 90-minute consultation process to:

  • discuss your concerns or questions
  • gather information in key areas
  • complete screening questionnaires as appropriate
  • provide advice on next steps 

It is common for parents to request an initial assessment when they have some concerns but are not sure what kind of help they need. 

If an initial assessment leads to further direct assessment of the same child, e.g. a cognitive or neurodevelopmental assessment, the fee for the subsequent assessment is reduced by £250 to reflect the information already collected.

 

  1. Cognitive Assessment

  • an initial assessment interview to discuss concerns and gather information
  • reviewing information from school if appropriate
  • direct cognitive assessment with the child or young person to evaluate intellectual ability
  • assessment of reading, spelling and numeracy if indicated
  • 30-minute feedback session to discuss the results and recommendations

 

  1. Neuropsychological Assessment

  • an initial assessment interview to discuss concerns and gather information
  • reviewing information from school if appropriate
  • direct cognitive assessment with the child or young person to evaluate intellectual ability
  • assessment of reading, spelling and numeracy if indicated
  • additional assessment of other areas of neuropsychological functioning as indicated, e.g. memory, attention or executive function
  • 45-minute feedback session to discuss results and recommendations

It may be necessary to split the assessment over two sessions to ensure that fatigue does not affect performance

 

  1. Neurodevelopmental Assessment

  • extended interview with parents to include full developmental history
  • standardised questionnaire measures to evaluate behaviour
  • school liaison or observation, if appropriate
  • direct cognitive assessment of the child or young person
  • additional neuropsychological assessment if indicated
  • additional standardised assessment of social communication and interaction using the ADOS-R and ADI-R; if indicated
  • 60-minute feedback session scheduled to discuss results and recommendations

Where necessary for formal diagnosis, and agreed with parents, administration and interpretation of these assessments is carried out in collaboration with an appropriately qualified clinical colleague, in accordance with the current NICE (National Institute for Health and Clinical Excellence) guidelines.

 

 5.  Early Years Developmental Assessment

A broad-based evaluation of language, motor and cognitive development in pre-school children including:

  • initial assessment interview to discuss concerns and gather information
  • direct observation and play-based developmental assessment session with the child
  • completion of parent-report questionnaire measures
  • information gathering from other sources if appropriate, e.g. nursery
  • 30-minute feedback session to discuss results and recommendations 

 

Support and Interventions

Following any of the assessments listed above, it may be appropriate to offer intervention work with the child or young person, or their parents, school or other agency, to support and manage the difficulties identified.

  • initial assessment interview to discuss concerns and gather information
  • direct observation and play-based developmental assessment session with the child
  • completion of parent-report questionnaire measures
  • information gathering from other sources if appropriate, e.g. nursery
  • 30-minute feedback session to discuss results and recommendations

The initial plan is usually for anything from 2-8 sessions. It is common for homework tasks to be set between sessions.