LAUSR

Aim To determine the incidence of previously unrecognised chromosomal, neurodevelopmental (e.g. autism spectrum and attention deficit, learning disability) and other conditions in young people with behaviours reported as challenging referred for assessment in the paediatric disability clinic. Method This was a retrospective observational study. The hospital’s electronic clinic calendar was systematically searched to identify all young people referred because of challenging behaviours by the local Youth Offending Team and by Education, where medical advice was required for Education, Health and Care planning, September 2015–August 2017. Data were extracted from individual electronic medical records (table 1). Result 21 males and 2 females aged between 13 and 18 years were referred by the Youth Offending Team. 16 males and 5 females aged between 4 and 15 years were referred by Education. All underwent Single Nucleotide Polymorphism (SNP) array testing along with blood and other investigations tailored to the individual. Abstract G420(P) Table 1 Condition identified Youth Offending Team Referrals (n=23) Education Referrals (n=21) Learning Disability (LD) confirmed 1 5 Red flags for LD awaiting outcome of further assessment 5 5 Autism spectrum disorder (ASD) confirmed 0 1 Red flags for ASD awaiting outcome of further assessment 7 2 Red flags for Attention Deficit Hyperactivity Disorder awaiting outcome of further assessment 0 5 Chromosomal condition confirmed 3 0 Awaiting SNP microarray result 1 2 New-onset Epilepsy confirmed 1 0 Acquired Brain Injury confirmed 1 0 New safeguarding referral 2 0 Additional diagnosis confirmed, already known neurodevelopmental diagnosis 4 (1 in 5) 3 (1 in 7) Total number of new needs identified 24 21 Conclusion This small study suggests that young people who present with behaviours that challenge may benefit from paediatric assessment that includes screening for red flags of neurodevelopmental, chromosomal and other conditions and for safeguarding concerns. Behaviours that challenge should prompt paediatric assessment undertaken with the same diligence as for physical symptoms and signs, even in those with already identified neurodevelopmental conditions.