1.  Dr Gauri Bhusari, Associate Specialist  Dr Kaushik Banerjee, Consultant Community Paediatrician Comorbid Emotional Difficulties in children with Neurodisabilities – The unmet Need

2. Background Mental Health Needs for Children are in spotlight Between the ages of 5 and 16 years, 1 in 10 children has a clinically diagnosed mental health disorder ref Green H, McGinnity A, Meltzer, H et al. (2005) Mental health of children and young people in Great Britain 2004. London: Palgrave.

3. Chief Medical Officer's annual report 2012: Our Children Deserve Better: Prevention Pays

4. Background In our clinical practice more and more children are presenting with likely Emotional and Mood Disorders Community Paediatricians have limited experience in assessment of these problems

5. Aims To determine the prevalence of emotional difficulties in children attending community paediatric clinics which would help to quantify levels of unmet needs To highlight gaps in service provision and present findings to commissioners

6. Care for children and young people with depression Recognition in tiers 2–4 If a child or young person aged 11 years or older is referred to CAMHS without a diagnosis of depression, routinely screen with a self-report questionnaire for depression (the MFQ is the best) as part of general assessment.

7. Why MFQ- S Mood and Feelings Questionnaire(MFQ), developed by Adrian Angold and Elizabeth J. Costello in 1987. The MFQ- S is free to download. Well validated, simple to use tool for screening in community settings Journal of Abnormal Child Psychology, Vol. 34, No. 3, June 2006, pp. 379–391 ( C 2006) The Short Mood and Feelings Questionnaire (SMFQ):A Unidimensional Item Response Theory and Categorical Data Factor Analysis of Self-Report Ratings froma Community Sample of 7-through 11-Year-Old Children Carla Sharp,1,4 Ian M. Goodyer,2 and Tim J. Croudace3

8. Methods Children aged 8 years or over attending new or Follow-up clinic appointments to be screened using MFQ – short version (child self-report) MFQ –S questionnaire  Depression in children and young people Depression in children and young people NICE Quality Standards, QS48 - Issued: September 2013

10. Age Range

11. MFQ-Scores One child had a score of 23

12. 25/50 had scores of 8 and above 6/50 had scores between 8-10 19/50 had scores above 10

14. Co-morbidities Dyspraxia 3 Cerebral palsy 2 Tics 2 Visual impairment 1 Chromosome abnormality 1 School Refusal 1

15. Conclusions  Emotional difficulties frequently co-exist in children with neurodisabilities  Using a validated tool helped to measure prevalence within our clinic population  There is high prevalence of co-morbid emotional difficulties within children seen in our clinics

16. Conclusions  Most of the children affected have significant levels of difficulties  High numbers of relatively young children were identified  Helps to quantify the severity providing supportive evidence when making referrals to CAMHS  Documentation of Voice of Child

17. Plan  Present to commissioners as evidence of the unmet need  Further surveys involving both children and carers

18. Thank You