Child Neurology started off as Developmental Paediatrics in our department. Over the past decade, there had been growing interest in the field of Developmental Paediatrics and Child Neurology. The programme had evolved to include Neuro-rehabilitation as part of the division over the past five years. In 1998, the division of Neuro-developmental Paediatrics overtook the tasks of assessment, management, re-assessment, habilitation and rehabilitation of children with the spectrum of developmental, behavioural or neurological disorders.

Activity & Service
The programme is unique in that it consists of comprehensive neurological, developmental and behavioural assessment of children and their families. The commonest disorders referred to the programme are speech and language disorders, autistic spectrum disorders, epilepsy, cerebral palsy, learning disabilities, specific learning disorders, brain tumours, hydrocephalus, spina bifida, neuromuscular disorders, attention deficit hyperactivity disorders, hearing disorders, visual impairment, behavioural problems, and neurocutaneous disorders.

We encourage active participation of parents and caretakers in our programmes. Parental involvement and support are essential for comprehensive care of these children, not only at home but also in the centre. We realize the parents of handicapped child often have enormous psychosocial stress. We provide respite care service to release their stress.

Combined comprehensive multi-disciplinary clinics had been set up to provide holistic care for children with various neurological or developmental disabilities. There were joint consultative clinics provided by the orthopaedic surgeons, paediatric surgeons, paediatric neurosurgeons, paediatric ENT surgeons, paediatric ophthalmologists, paediatric dental surgeons, paediatric gastro-enterologists, paediatric respirologists and paediatric psychiatrists.

Specialized programmes had been conducted, eg conductive education for children with cerebral palsy; gait analysis laboratory and spasticity clinic with various treatment modalities, such as intramuscular botulinum toxin injection, or selective dorsal rhizotomy; oro-motor rehabilitation clinic; drooling assessment clinic; feeding clinic; neurogenic bladder clinic; very low birth weight follow-up clinic; dysmorphic baby clinic; neurocutaneous clinic; and comprehensive epilepsy clinics for pre-surgical evaluation of intractable epileptics.

This programme had evolved into a very solid and comprehensive one for both undergraduate and postgraduate teaching and serves as a breeding ground for trans-disciplinary team work for children with disabilities.

Professionals of various disciplines including clinical psychologist, physiotherapist, occupational and speech therapists, nurses, optometrist and audiologist, and social worker work together to provide a comprehensive service of assessment and inter-disciplinary management.

Acute neurology and neurophysiology diagnosis are integral components of the service. The team provides acute neurological consultation in Queen Mary Hospital, Grantham Hospital and Tsan Yuk Hospital.

Strength & Development
We strive to provide a spectrum of mixed primary assessment, secondary treatment, and tertiary (inter-disciplinary management) care within the same setting tailored for children with disabilities. We also provide in-patient, day-patient, and out-patient neurodevelopmental professionals training.

The Child Neurology team is innovative, academic as well as inter-disciplinary. Multi-disciplinary clinics and specialized neuro-habilitative programmes were organized. Innovative programmes and new treatments are started in the context of on-going research.

Educational Programmes

Research/ Grant & Awards
The Neuroscience Research Centre (NRC) established in the University of Hong Kong linked the basic neuroscientists and clinical neuroscientists together. We had been the chief clinical coordinator and actively participated in helping the Neuroscience Research Centre to bid for Neuroscience as the Area of Excellence (2001) in the University of Hong Kong with other departments like Anatomy, Physiology, Medicine, and Psychiatry.

We have started an Autism Research Programme and we are the first centre to be trained to use ADI-R for setting the gold standard for diagnosis of Autism for research collaboration in 2000. Our collaborator is Prof Catherine Lord, University of Chicago (Clinical & Research use of Autism Diagnostic Interview- Revised (ADI-R).

Active research projects
Innovative Research Projects of Integration of Traditional Chinese Medicine with Neurohabilitation- Herbal Medicine research in Attention Deficit and Hyperactivity Disorder; Tongue Acupuncture in Child Neurology (1997- 2000).
i. Trial of Traditional Chinese Medicine (Tongue Acupuncture) in Integrative Rehabilitation of Children with Encephalopathy (Cerebral Palsy/ Autism) (funded by RGC, HKU).
ii. Rett Syndrome- molecular genetic, cardiac and MRS study (supported by our department).
iii. Hair mineral analysis of children with neuro-developmental disorders.
iv. Use of Traditional Chinese Medicine (Tongue Acupuncture, TAC & Traditional Acupuncture) in improving functional ability of Motor Neuron Disease (MND), Spinal Muscular Atrophy (SMA) and Duchenne Muscular Dystrophy (DMD).
v. Double Blind randomized placebo control trial of using Tongue Acupuncture in cortical blindness using Functional brain mapping.
vi. Functional polymorphism of the transporter gene MDR1 in epilepsy-gene frequency and relation with multi-drug resistance: A pharmaco-genetic study in Chinese epileptics (funded by CRCG, HKU).
vii. ADHD.
viii. Neurofibromatosis.
ix. Quality of Life.
x. Genetic study in ADHD, Autism, Epilepsy, Marfan Syndrome.

Collaboration
Our team conducts multidisciplinary and interdisciplinary assessments for children with developmental, neurological or behavioural problems. Our team collaborated with other specialties for clinical service and research e.g. neonatology, neurosurgery, ENT surgery, orthopaedic surgery and radiology from Hong Kong West Cluster hospitals: Queen Mary Hospital, Grantham Hospital and Tsan Yuk Hospital to launch for several innovative Neuro- rehabilitation projects:

All through these years, we have made regular exchange programmes with overseas centres. We provide neuro-developmental training to doctors and nurses from different parts of the world.

Paediatricians and Fellows from Beijing and Shanghai had been attached to our Rehabilitation Programme and these fellows started the first Children's Rehabilitation Programme in Shanghai Fudan University (2001) and Beijing Medical University (2002), which modeled after our programme. These were the pioneer Children's Rehabilitation Centres in China.

Regional & International Collaboration in clinical service and research