Cognitive and Electrophysiological Correlates of Working Memory Impairments in Neurofibromatosis Type 1.

Neurofibromatosis 1 (NF1) is a single gene disorder associated with working Memory (WM) impairments. The aim of this study was to investigate P300 event-related potential (ERP) associated with WM in NF1. Sixteen adolescents with NF1 were compared with controls on measures of WM and EEG was recorded during a WM nback task. The NF1 group showed poorer performance on measures of WM as compared to the control group. No group differences were observed in P300 amplitude at Pz, but P300 latency was shorter in the NF1 group. Topographic analyses of P300 amplitude showed group differences indicating neural processing differences in the NF1 group relative to controls, which possibly contribute to the cognitive deficits seen in this population.

Debate: What if it's not just a phase?

In order to support children and young people who are exploring their gender, we need to develop a shared understanding of gender identities and enhance the evidence base relating to long-term outcomes. All professionals working with children and young people should be trained in gender diversity. Health-care systems must be adapted to enable us to record gender identity; outcome measures should be developed that accommodate different gender identities. In doing so, we will develop clearer information about the number of children and young people who are exploring their gender and the way that gender identities develop throughout childhood. We will also start to demystify gender and work to enhance understanding and acceptance of diversity.

A retrospective audit of referrals of 16-17 year olds with reference to substance abuse.

BACKGROUND: Emerge is an innovative Child and Adolescent Mental Health Service that provides support for 16-17 year olds. The team provide a community based multi-disciplinary, open access model, texting young people and travelling to locations convenient to them. There is an enhanced duty system providing a rapid flexible response within working hours. AIMS: To examine the referral data as part of the ongoing annual audit cycle and to establish prevalence of alcohol, cigarettes and substance use among young people referred to the service. METHOD: Data from the case notes was analysed using Statistical Package for Social Science. Demographic details, referrer profession, reason for referral, other services involved and substance use were examined. RESULTS: There were 437 patients referred to Emerge between 1/4/2010 and 31/3/2011, and 387 patients were accepted while 50 were signposted on. Cases were not accepted if they fell outside the age and geographical area, or were not in need of a mental health service. Overall, 24% of young people were reported to consume alcohol, 19% used cannabis and 9% reported using cigarettes. In all categories there were areas where documentation was not complete, and we suggest that these figures are an underestimate. CONCLUSION: This data has been fed back to the team, a full morning of teaching regarding drugs and alcohol has been delivered. Emerge often works with young people who are marginalised and may be harder to reach, consequently early sessions require neutral and supportive questions, thus if young people do not return after the first appointment, histories may be incomplete. The team will be reflecting on the lessons learned and considering ways to optimise their work.

Parental perceptions of a manchester service for autistic spectrum disorders.

Background. User feedback is now an integral part of both clinical governance and service development, and it also provides a key route to engaging parents and children. Autistic spectrum disorders (ASDs) can impact on all members of a family, and close working between parents and professionals is essential. Aim. To explore parental satisfaction rates and identify areas in need of improvement. Method. A postal survey was completed by parents whose children had been diagnosed with an ASD in the past 18 months in a Manchester Child and Adolescent Mental Health Service. The National Autism Plan for Children was used as a gold standard. Results. Parents were particularly satisfied with the way team members dealt with them and their children during appointments. However, the standard of written information provided about the condition, diagnosis, and support available could be improved. The findings show the benefits of receiving a diagnosis in the recommended timeframe. Discussion. We discuss ways of effectively using scarce resources.

Understanding the mental health needs of secondary school children in Manchester.

Background In a time of limited resources and the need for cohesive services, understanding levels of need and prevalence is key. Manchester has a diverse range of cultures and socio-economic groups; national data is valuable but not always representative of local need.Aim To assess the prevalence of mental health needs in secondary school pupils in Manchester.Method Parents and teachers in three secondary schools were invited to complete the Strengths and Difficulties Questionnaire (SDQ) and a tool examining unmet needs.Results Initially, 560 pupils were chosen. Having excluded families that opted out, 503 questionnaires were distributed. Teachers returned 200 questionnaires and parents returned 127. Higher than average levels of need were identified with teachers reporting that 18% of pupils scored abnormally on the SDQ. Parent rates were also higher than the national average at 13.4%.Discussion Parents and teachers wanted children to be seen at home and at school, the need for consultation and outreach from mental health into schools is emphasised.

Mental health needs of young offenders in custody and in the community.

BACKGROUND: Research has revealed high levels of mental health needs in young offenders but many studies have been small, focusing on specific populations. AIMS: To evaluate the mental health and psychosocial needs of a nationally representative sample of juvenile offenders in England and Wales, including female offenders and those from Black and minority ethnic groups. METHOD: A cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, was conducted in six geographically representative areas across England and Wales. Each young person was interviewed to obtain demographic information, mental health and social needs, and psychometric data. RESULTS: Young offenders were found to have high levels of needs in a number of different areas including mental health (31%), education/work (36%) and social relationships (48%). Young offenders in the community had significantly more needs than those in secure care and needs were often unmet. One in five young offenders was also identified as having a learning disability (IQ<70). CONCLUSIONS: Needs for young offenders were high but often unmet. This emphasises the importance of structured needs assessment within custody and community settings in conjunction with a care programme approach that improves continuity of care.