G491 Establishing and evaluating a multidisciplinary sleep clinic for children with neurodevelopmental difficulties in an inner-city population

Abstract

Aims Sleep difficulties impact physical and mental health, cognitive performance, behaviour, and family wellbeing, and are common in children with neurodevelopmental problems. Surveys identified a high rate of burdensome sleep problems in our inner-city Community Paediatric population. We describe establishing a community–based sleep service our clinical model of assessment and intervention early outcomes. Methods Children aged under 18 years with neurodevelopmental difficulties and significant sleep problems are referred by Community Paediatricians and CAMHs. Assessment and intervention are delivered by an integrated Paediatric and Psychology team. The mainstay of intervention is psychoeducational workshops and telephone follow up with a lesser role for medical investigation and prescription. Sleep problem severity is recorded at assessment and conclusion of intervention using parent ratings; Composite Sleep Disturbance (CSD) and dissatisfaction scores (range 0–12 and 1–5; higher scores indicating more significant problem) Classifying problem as large/moderate = significant; or small/none = not significant Scoring degree of related parental anxiety and burden Results Since April 2017 the service has accepted 200 referrals; 137 children have been assessed clinically. Satisfaction with assessment is high; 87% very likely to recommend (12% likely); 77% felt needs very well met (22% well met). Severity scores at assessment indicate significant problems and burden/anxiety related to sleep Table 1: Outcomes for 137 sleep clinic patients after initial assessment. Conclusion We have demonstrated high demand for a sleep service in the Community Paediatric population and that it is very well received. Early outcome measures suggest this service is effective and does not lead to high rates of referral, investigation or prescription.