Areas of expertise
Autism Spectrum Disorder
I have extensive experience as a consultant paediatrician assessing children and adolescents with autism spectrum disorder (ASD). I’m the Autism Lead for my area in the NHS trust where I work. Speech difficulties, imagination difficulties, socialisation issues, and repetitive behaviours are the most common symptoms I see in children with autism. Examples of these repetitive behaviours would be lining up their toys, walking on tiptoes, or flapping hands. Experiencing and observing these behaviours can be confusing and alarming for the child and their family, so it’s important to reach out for support as soon as possible to get the help your child needs.
As autism is a complex condition, I take a multidisciplinary approach to my assessment and diagnosis process. Alongside talking with you to build up a history and carrying out the assessment with your child, I’ll get feedback from any schools or education settings to understand how they socialise and play with other children. This is extremely important for me to understand your child better.
I will rule out any other physical conditions that may be mimicking autism, those that share the same symptoms and presentation. Then, once you and your child are comfortable, I will conduct the assessments and decide on the best therapeutic approach with you, depending on the presenting diagnosis. The benefit of this approach is that the treatment plan is tailored and created for you and your family. The amount of follow-up support remains in your hands. I can also liaise with your GP or other health professionals so that care is continued in the community.
ADHD / ADD
I have been assessing, diagnosing, and treating attention deficit hyperactivity disorder (ADHD) in children for the past nine years. Many people are familiar with ADHD and what it looks like in young boys, but they are less familiar with attention deficit disorder (ADD), which tends to be more common in quieter children and girls.Those with ADD don't have the hyperactivity element, but they are inattentive and struggle to stay focused. They might daydream a lot and find it difficult to be in the here and now. By discussing your child's history with you, gathering feedback from school as well as assessing your child, I can help you determine if this is ADHD or ADD, and if so, what we can do about it.
I assess ADHD and ADD in children over the age of five, and I follow the National Institute for Health and Care Excellence (NICE) guidelines when treating children with ADHD. After an ADHD diagnosis, I believe it's essential to help your child adjust to their new diagnosis by providing ongoing help and support. Seeing the improvements children can experience once they have received the correct diagnosis and treatment is extremely rewarding. The first step of treatment is always psychoeducation (psychological education), providing you with information about the condition and symptoms to better understand how ADHD affects your child. I will also integrate parenting tips and strategies into the treatment plan, developed with your input and feedback.
I will also discuss medication options if your child’s symptoms are severe and impact their school performance, home life, and well-being. If your child is prescribed medication, I will follow up regularly to ensure they are not experiencing any side effects that could negatively affect their health, such as a reduced appetite. I will prescribe some initial behaviour change steps, and I can refer you to a child psychologist to help you implement other behavioural management strategies if needed.
Sleep Disorder and other Neurodevelopmental Disorders
Many children experience sleeping problems, which could look like difficulty falling or staying asleep, being unable to stay awake during the day, sleepwalking, or experiencing nightmares. Understandably, when a child doesn’t sleep well, it impacts their behaviour at home and in school. It may also mean that you end up suffering from poor sleep, fatigue, and higher stress levels.
During the first consultation, I will take a detailed history from your child’s birth until the present day to figure out what problems your child is facing. We will also discuss your current sleep routine and what a typical day looks like for your child. Then I will take some physical measures and run a neurological examination to determine whether it is a neurological or a developmental issue. I will look for any distinct syndromic facial features characteristic of some neurodevelopmental disorders or syndromes. Some conditions I may be able to diagnose on the day (e.g. dyspraxia), and others may need further investigation with scans or genetic tests. I can organise these for you in your local community. On occasion, sleep problems can occur temporarily without being caused by anything serious. If this is the case, you’ll leave the appointment feeling reassured that your child is developing well and there is nothing to worry about.
My first approach is sleep hygiene measures when treating sleep problems or disorders. If these measures don’t work, we will introduce medications to help your child sleep. The diagnosis and treatment of these conditions can be complex, which is why the detailed assessment and approach to treatment are so important. The benefit of this step-by-step approach is that we can try one thing at a time to see what works, meaning that your child and your family end up with the least amount of change and disruption to your lives.
My approach to treatment
As a mother, I can empathise with the struggles of being a parent because I have been there and through it myself. As a paediatrician, I want to assure you that seeking mental health treatment is important in supporting your child’s healthy development. Feeling nervous and apprehensive is completely normal, and I will do everything I can to help you feel comfortable and at ease when we meet. My goal is to provide a supportive and non-judgmental environment for the whole family.
I understand the worries that parents face when it comes to their child’s health, especially the uncertainty of it all. Are they growing ok? Is their behaviour normal? Have I done something wrong? Naturally, seeing the doctor about these worries can feel overwhelming for parents and the child. Perhaps you are wondering how your child will behave at the appointment, or maybe you say to yourself, what if they don’t believe me? However, I want to reassure you that I will listen to your thoughts and needs without rushing you.
I take a person-centred, holistic, and collaborative approach that recognises each child's unique needs, preferences, and values of the family system. During the first consultation, It’s normal for children to initially feel shy, upset, confused, or angry on arrival. I believe gently easing into the assessment is the best approach for parents and children, and I find it helpful to let children settle down before we start. You can bring notes on your observations to the first consultation if you think it will help me better understand the situation, and we will go through them together. Most children won't answer my questions initially, so I will let them play and explore the room whilst you and I are talking. The child or children can come and play with me at their own pace. Once everyone is settled in and calm, the assessment will start. After a physical review, I will play a series of games with your child, which will help me come to a diagnostic conclusion.
Personalised treatment plans
I will work with you to develop a treatment plan that meets your child’s specific needs and goals and will encourage you to take an active role in decision-making. Treatment plans are always tailored around the unique symptoms and circumstances affecting your child, and the family systems that work for one family may not work for another. I will create a step-by-step process for you to follow, which may include medication if necessary. We will start with tackling one issue at a time to avoid feelings of overwhelm and to give the treatment the best chance of success. Change is difficult for everyone, so slow and steady is the best approach.
I also integrate lifestyle interventions into treatment plans and can advise on weight management and sleeping problems. If your child needs extra support, I will either communicate with their GP or refer them to other specialised professionals, such as child psychologists or dietitians.
I understand the fear many parents have about prescribing children medication. In my practice, I aim to use as few medications as possible with children and follow the National Institute for Health and Care Excellence (NICE) guidelines. My philosophy is the lower the dose and the fewer the medications, the better. However, we know that sometimes that approach does not work, and children may need the help of medication. The length of time a child takes medications will vary depending on the agreed treatment plan.
I don't prescribe medication to children with ADHD under five, as the NICE guidelines do not advise this. I can prescribe medication to children with sleep issues from the age of two if sleep hygiene approaches have failed and they are not experiencing any improvements. I will also collaborate with other professionals and specialists working with the child to ensure all medication dosages are accurate and follow-up is arranged to track this.
My main aim is to keep all children in school so that they can access the educational curriculum. It is vital that children are happy and healthy and have a good quality of life. If medications are needed, then I believe they should be used in moderation.
Education & Training
I’m a Consultant Paediatrician with 20 years of experience registered with the Royal College of Paediatrics and Child Health (RCPCH). I currently work as a Consultant Community Pediatrician at Lancashire Teaching Hospitals NHS Trust. I am the designated doctor for safeguarding children in Lancashire, and a medical advisor for the adoption panel in Lancashire, Blackpool, and Cumbria. I am also the Autism Lead in the Chorley South Ribble region and have been instrumental in setting up and running the autism pathway. I’m trained in the Autism Diagnostic Observation Schedule and assess all forms of neurodevelopmental disorders, syndromes, neurodisability, motor difficulties, sleep disorders, and other conditions.
I’m passionate about sharing my clinical knowledge and training medical students. Alongside my clinical community work, I assess and sign off new doctors, and I am an examiner for undergraduate Objective Structured Clinical Examinations (OSCEs) at Manchester University. This academic experience keeps me updated with the latest research, treatments, and standards within my field. I am constantly learning and evolving, which I enjoy, and the practice and care for my patients are continually improving as a result.
Regarding my education, I completed my postgraduate diploma in Neurodisability from the University of Sheffield in 2016. I hold a diploma in Child Health (DCH) diploma and a Bachelor’s degree in Medicine (MBBS). I am a member of the Royal College of Paediatrics and Child Health (MRCPCH).
During my downtime outside of work. I enjoy gardening at the weekend and fixing things around the house. I love painting and DIY activities quite a lot. I enjoy getting things fixed and organising around the house. I love to learn - I'm always learning.
I enjoy travelling to historic places and love seeing old paintings and ancient ruins. I love anthropology and learning about different people's cultures, habitats, and how they lived.