Synopsis:
The approach and attitude towards Functional Neurological Disorders (FND) has changed over the last decade and anecdotally at least, we seem to be seeing more cases in our day-to-day practice. Patients with functional symptoms present to many disciplines and functional symptoms can co-exist with organic pathology. There is now evidence to show earlier diagnosis and treatment can lead to more positive outcomes.
In today’s Grand Round we will explore some of this ‘new’ thinking to help clinicians discuss functional disorders earlier with families. We will also discuss a new initiative for earlier intervention once the diagnosis of FND has been made.
This project involves the development of Physiotherapy and Clinical Psychology advanced scope of practice competency frameworks. The Victorian Paediatric Rehabilitation Service (VPRS) is developing a statewide assessment and triage service for children and adolescents with a diagnosis of Functional Neurological Disorder (FND) who require specialist rehabilitation. The clinic aims to ensure patients receive timely intervention and coordinated care, bridging the gap between diagnosis and treatment, early rehabilitation and a transition to community-based therapy. The latter of which will be achieved through developing links with community-based healthcare providers. Education packages are being developed to increase competency in working with paediatric FND patients for professionals working in community-based services and regional VPRS sites.
Speakers:
Dr Neil Wimalasundera trained in the UK as a neurodisability paediatrician and was clinical lead for the Wolfson Neurodisability Service at Great Ormond Street Hospital before moving to Australia. He started at the Royal Children’s Hospital in 2017 and he is the Director for the Victorian Paediatric Rehabilitation Service. His specialist interests include the management of complex movement disorders, cerebral palsy and acquired brain injury.
Dr Kelly Thompson is a Senior Clinical Psychologist who combines tertiary mental health experience with expertise working within specialised medical settings. She is currently working with the Victorian Paediatric Rehabilitation Service at Monash Children’s Hospital. Kelly is the recipient of an advanced practice grant dedicated to developing and facilitating an assessment and triage clinic for children and adolescents with a diagnosis of Functional Neurological Disorder.
Amanda Apple is a senior physiotherapist in rehabilitation at the Royal Children’s Hospital where she has worked since 2006. Amanda works primarily in the area of Functional Neurological Disorder (FND) and at present is part of the team setting up a Statewide Triage Clinic for Children and Adolescents with FND which aims to deliver timely formulation, education and intervention to this patient group. She also has interest in persistent pain and fatigue as well as upskilling and support for regional and rural clinicians so that young people can access services close to where they live.