Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-27T16:22:58.629Z Has data issue: false hasContentIssue false

Training matters: neurodevelopmental disorders in psychiatric practice

Published online by Cambridge University Press:  29 August 2023

Mary Barrett*
Affiliation:
Consultant psychiatrist for adults with intellectual disability, working for Leicestershire Partnership NHS Trust, Leicester, UK. She also holds the roles of Higher Training Programme Director with Health Education East Midlands and Chair of the Intellectual Disability Specialty Advisory Committee, Royal College of Psychiatrists (RCPsych), London, UK. In the latter role she oversaw the development and implementation of the new RCPsych intellectual disability training curriculum in 2022.
Aastha Sharma
Affiliation:
Consultant child and adolescent psychiatrist working with Cambridgeshire and Peterborough NHS Foundation Trust's child and adolescent mental health community services in Cambridge, UK. Her clinical and research interests include neurodevelopmental disorders, eating disorders and systemic therapy.
Sundar Gnanavel
Affiliation:
Consultant child psychiatrist with Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, working with Sunderland and South Tyneside Children and Young People's Service, Sunderland, UK. His clinical and research interests include neurodevelopmental disorders, quality improvement pertaining to neurodevelopmental service pathways and medical education. He is also an honorary senior clinical lecturer at Newcastle University, Newcastle upon Tyne, UK.
Alje van Hoorn
Affiliation:
Consultant psychiatrist with Cornwall Partnership NHS Foundation Trust, Truro, and an honorary clinical lecturer at the University of Exeter Medical School, Exeter, UK. His research interest is in neurodevelopmental disorders and he is a member of the RCPsych's Neurodevelopmental Psychiatry Special Interest Group (NDPSIG).
*
Correspondence Dr Mary Barrett. Email: mary.barrett1@nhs.net

Summary

Traditionally, service provision for neurodevelopmental disorders such as attention-deficit hyperactivity disorder, intellectual disability and autism – where this has been available – has focused on the needs of children, but there is now increased understanding of neurodevelopmental disorders as lifelong conditions, often with an ongoing need for health and social care provision. Medical and allied professionals frequently report limited education in neurodevelopmental disorders both during their training and post-qualification. This article gives an overview of theoretical and practical considerations for training of psychiatrists and allied healthcare professionals in relation to neurodevelopmental disorders. Key UK policy drivers and capability frameworks pertaining to this training are discussed. The Royal College of Psychiatrists’ 2022 revised curricula for medical trainees in psychiatry are examined in relation to neurodevelopmental disorders and ongoing CPD requirements in this area for career psychiatrists are considered. A brief overview of multidisciplinary training in neurodevelopmental disorders and the role of the psychiatrist in this is discussed. An international perspective on training in this area is touched on and current challenges in low- and middle-income countries are outlined. Last, the future direction of training in neurodevelopmental disorders is considered.

Type
Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5). APA Publishing.Google Scholar
Berney, T, Brugha, T, Carpenter, P (2017) Royal College of Psychiatrists Interview Guide for the Diagnostic Assessment of Able Adults with Autism Spectrum Disorder (ASD) (Revised Edition). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/members/sigs/neurodevelopmental-psychiatry-special-interest-group-ndpsig/ndpsig-autism-diagnostic-interview-guide-2.pdf?sfvrsn=1dc6557_2).Google Scholar
Cassidy, S, Au-Yeung, S, Robertson, A, et al (2022) Autism and autistic traits in those who died by suicide in England. British Journal of Psychiatry, 221: 683–91.10.1192/bjp.2022.21CrossRefGoogle Scholar
Department of Health and Social Care (2018) The Government Response to the Learning Disabilities Mortality Review (LeDeR) Programme Second Annual Report. Department of Health and Social Care.Google Scholar
Department of Health and Social Care (2019) ‘Right to be Heard’: The Government's Response to the Consultation on Learning Disability and Autism Training for Health and Care Staff. Department of Health and Social Care.Google Scholar
Department of Health and Social Care (2022) Building the Right Support for People with a Learning Disability and Autistic People: Action Plan. HM Government.Google Scholar
General Medical Council (2018) Outcomes for Graduates 2018. GMC.Google Scholar
Ginsberg, Y, Quintero, J, Anand, A, et al (2014) Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Primary Care Companion for CNS Disorders, 16(3): PCC.13r01600.Google ScholarPubMed
Health Education England (2019a) Core Capabilities Framework for Supporting People with a Learning Disability. NHS England/NHS Improvement (https://www.skillsforhealth.org.uk/LDframework).Google Scholar
Health Education England (2019b) Core Capabilities Framework for Supporting Autistic People. HEE (https://www.skillsforhealth.org.uk/autism-framework).Google Scholar
Health Education England (2020) The Oliver McGowan Mandatory Training in Learning Disability and Autism. HEE (https://www.hee.nhs.uk/our-work/learning-disability/current-projects/oliver-mcgowan-mandatory-training-learning-disability-autism).Google Scholar
Hirvikoski, T, Mittendorfer-Rutz, E, Boman, M, et al (2016) Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208: 232–8.10.1192/bjp.bp.114.160192CrossRefGoogle ScholarPubMed
Kommu, JVS, Jacob, P (2020) Specialty training in child and adolescent psychiatry in India. European Child & Adolescent Psychiatry, 29: 8993.10.1007/s00787-019-01407-4CrossRefGoogle ScholarPubMed
Maudsley Learning (2021) The Autism Core Capabilities rEPosiTory (ACCEPT) Project: Gap Analysis. Maudsley Learning.Google Scholar
Mian, AI, Milavić, G, Skokauskas, N (2015) Child and adolescent psychiatry training: a global perspective. Child and Adolescent Psychiatric Clinics of North America, 24: 699714.Google ScholarPubMed
Morris-Rosendahl, DJ, Crocq, M-A (2020) Neurodevelopmental disorders – the history and future of a diagnostic concept. Dialogues in Clinical Neuroscience, 22: 6572.Google ScholarPubMed
National Development Team for Inclusion (2022) Evaluation of Oliver Magowan Mandatory Training Trial in Learning Disability and Autism. NDTi.Google Scholar
National Institute for Health and Care Excellence (2011) Autism Spectrum Disorder in Under 19s: Recognition, Referral and Diagnosis (Clinical Guideline CG128). NICE.Google Scholar
National Institute for Health and Care Excellence (2012) Autism Spectrum Disorder in Adults: Diagnosis and Management (Clinical Guideline CG142). NICE.Google Scholar
National Institute for Health and Care Excellence (2015) Challenging Behaviour and Learning Disabilities: Prevention and Interventions for People with Learning Disabilities whose Behaviour Challenges (NICE Guideline NG11). NICE.Google Scholar
National Institute for Health and Care Excellence (2018) Attention Deficit Hyperactivity Disorder: Diagnosis and Management (NICE Guideline NG87). NICE.Google Scholar
Neurodevelopmental Psychiatry Special Interest Group (2023) About us. RCPsych (https://www.rcpsych.ac.uk/members/special-interest-groups/neurodevelopmental-psychiatry/about-us).Google Scholar
Posner, J, Polanczyk, GV, Sonuga-Barke, E (2020) Attention-deficit hyperactivity disorder. Lancet, 395: 450–62.10.1016/S0140-6736(19)33004-1CrossRefGoogle ScholarPubMed
Robertson, B, Omigbodun, O, Gaddour, N (2010) Child and adolescent psychiatry in Africa: luxury or necessity? African Journal of Psychiatry, 13: 329–31.Google ScholarPubMed
Royal College of Occupational Therapists (2023) Becoming an Occupational Therapist. RCOT (https://www.rcot.co.uk/about-occupational-therapy/become-an-occupational-therapist/how-become-occupational-therapist).Google Scholar
Royal College of Psychiatrists (2017) Prescribing Anti-Epileptic Drugs for People with Epilepsy and Intellectual Disability (College Report CR206). RCPsych.Google Scholar
Royal College of Psychiatrists (2020) The Psychiatric Management of Autism in Adults (College Report CR228). RCPsych.Google Scholar
Royal College of Psychiatrists (2021) Attention Deficit Hyperactivity Disorder (ADHD) in Adults with Intellectual Disability (College Report CR230). RCPsych.Google Scholar
Royal College of Psychiatrists (2022b) General Psychiatry: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/general-psychiatry-curriculum-final-16-june-22.pdf?sfvrsn=b0983a16_4).Google Scholar
Royal College of Psychiatrists (2022c) Old Age Psychiatry: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/old-age-psychiatry-curriculum-final-16-june-22.pdf?sfvrsn=73f6e513_4).Google Scholar
Royal College of Psychiatrists (2022d) Child and Adolescent Psychiatry: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/child-and-adolescent-psychiatry-curriculum-final-16-june-22.pdf?sfvrsn=d7d78cc6_4).Google Scholar
Royal College of Psychiatrists (2022e) Forensic Psychiatry: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/forensic-psychiatry-curriculum-final-16-june-22.pdf?sfvrsn=f72e88e3_4).Google Scholar
Royal College of Psychiatrists (2022f) Psychiatry of Learning Disability: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/psychiatry-of-learning-disability-curriculum-final-16-june-22.pdf?sfvrsn=5d9c61ca_4).Google Scholar
Royal College of Psychiatrists (2022g) Medical Psychotherapy: Royal College of Psychiatrists Higher Specialty Curriculum (ST4 – ST6). RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/2022-curricula/medical-psychotherapy-curriculum-final-16-june-22.pdf?sfvrsn=db427153_4).Google Scholar
Royal College of Psychiatrists (2022h) Psychiatry Silver Guide: Guidance for Psychiatric Training in the UK. RCPsych (https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/silver-guide-version-final_15-june-22.pdf?sfvrsn=bf01078_4).Google Scholar
Royal College of Psychiatrists (2023) Dual Training: Training combinations with a recommended five years’ duration. RCPsych (https://www.rcpsych.ac.uk/training/curricula-and-guidance/dual-training).Google Scholar
Royal College of Speech and Language Therapists (2021) Curriculum Guidance for the Pre-Registration Education of Speech and Language Therapists (RCSLT Guidance). RCSLT (https://www.rcslt.org/wp-content/uploads/2020/08/RCSLT-Curriculum-Guidance-March2021.pdf).Google Scholar
Rydzewska, E, Hughes-McCormack, LA, Gillberg, C, et al (2018) Prevalence of long-term health conditions in adults with autism: observational study of a whole country population. BMJ Open, 8(8): e023945.Google ScholarPubMed
Sweetmore, V (2022) Mental health nursing and autism: I am a mental health nurse so why did it take me so long to realize I'm autistic? Journal of Psychiatric Mental Health Nursing. 29: 770–3.Google Scholar
Timimi, S, Taylor, E (2004) ADHD is best understood as a cultural construct. British Journal of Psychiatry, 184: 89.10.1192/bjp.184.1.8CrossRefGoogle ScholarPubMed
UK Foundation Programme (2021) Curriculum. UK FP (https://foundationprogramme.nhs.uk/curriculum/).Google Scholar
World Health Organization (2017) International Conference on Autism & Neurodevelopmental Disorders: Thimphu, Bhutan, 19–21 April 2017. WHO (https://apps.who.int/iris/bitstream/handle/10665/259504/sea-ment-185.pdf).Google Scholar
World Health Organization (2019) International Statistical Classification of Diseases and Related Health Problems 10th Revision (Version: 2019). WHO (https://icd.who.int/browse10/2019/en#/F90-F98).Google Scholar
World Health Organization (2019) ICD-11: International Classification of Diseases (11th revision). WHO (https://icd.who.int/).Google Scholar
Young, S, Asherson, P, Lloyd, T, et al (2021) Failure of healthcare provision for attention-deficit/hyperactivity disorder in the United Kingdom: a consensus statement. Front Psychiatry, 12: 649399.10.3389/fpsyt.2021.649399CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.