Guide Little Minds
Let me be your Guide for transformation
With 20 years of experience managing thousands of children, and passionate about managing problems in children, from pre-school through to teenagers and young adults. These include problems with anxiety, depression, self-esteem, conduct, developmental, and learning problems. I have gathered around me a multidisciplinary team of educators, therapists and practice staff to respond to any problem no matter how large or small. We have developed a digital platform to confidently and easily collect information, from parents and teachers vital for an accurate assessment. We pride ourselves, in providing a responsive support service, to our parents, teachers, and therapists closely connected to your child’s health and schooling.
We also offer our patients, an alternative consultation location, away from our Hillcrest Hospital rooms, at 8 Village Road, 2 away from Delcairns centre in Kloof, for those who do not wish to enter a hospital COVID. Please go to our websites for further information at drflett.com, and schoolingassessment.com.
We will guide you through the assessment process each step of the way. We can be contacted on 031 1000 474 and emailed at [email protected].
Dr John Flett, Specialist Paediatrician MBChB, MRCP(UK), FCP(SA)
Do you feel like a parent with “butterfly wings” flapping against a tornado?
Your emotions of helplessness, worry, and guilt, combined with a child without friends, low grades, mood disturbances, behaviour and learning problems, can seem overwhelming.
They are leaving you to feel that your child is the only one experiencing difficulties.
As a paediatrician with 20 years of experience and a specialised interest in developmental neurology, I have dedicated the past twenty years solving these problems.
I have developed a unique treatment and management method to manage children and guide families along the road to unlock their true potential.
****Listen to what our families say****
The assessment process provides a broad overview of your child’s problems so that an accurate diagnosis and a detailed treatment plan can be made.
It also provides an opportunity for a complete health evaluation to check current health and exclude other medical problems that may be causing low concentration and poor school performance.
The assessment is a collection of multiple pieces of information about your child, so that “ a complete picture“can be visualised. Information is gathered, from everyone involved in your child’s daily life, including both parents, family members, teachers and therapists that your child sees.
There is a false perception that a detailed assessment requires lots of medical tests, such as brain MRI, EEG’s and blood tests. Tests are only done if your child’s health requires them.
The assessment process is information collection and not blood collection.
Both parents’ attendance is strongly encouraged to provide different points of view and information about your child. And further insights about your own schooling and medical history.
Early online submission of the parent and teacher assessment questionnaires, along with any therapist reports, well before the consultation, will allow us more time to discuss more in-depth issues. New patient registration forms can also be completed online. Other additional reports and samples of schoolwork or homework can be brought to the consultation to demonstrate your child’s problems further.
The first assessment takes well over an hour; this includes an interview chatting with your child, and a comprehensive neurological and physical examination. Your child will also be given a simple written task to complete depending on their age. Please bring along your child’s favourite pens and pencils.
A medical report is generated after the appointment, and we strongly advise you to consent to us sending a copy to the teacher and therapists that your child has seen. This builds trust and better communication between everyone involved in your child’s education and care.
Please arrive 15 min early for your appointment so we can plot the weight and height.
The National Institute for health and care excellence guidelines ( NICE ) 2020, states that a diagnosis of ADHD should only be made by a specialist paediatrician, or specialist psychiatrist or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD. This diagnosis should be based upon a full clinical and psychosocial assessment, a full developmental and psychiatric history, and reports of the child’s mental state. For a diagnosis of ADHD, hyperactivity-impulsivity and/or inattention symptoms should meet the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5TM) for ADHD; and the International Statistical Classification of Diseases.
We are your first point of contact because we are able to see the big picture and suggest the appropriate actions to be taken. Often, expensive, unnecessary testing is performed when parents and children are referred to as inexperienced therapists and non-specialists. Making the right decisions early will save time and expense and avoid travelling in the “wrong direction“. We were turning left instead of right changes the long term trajectory and outcome for your child.
Try not to see the school as the problem but rather the solution. The teacher sees your child for up to 6 hours a day and knows your child’s needs best.
Even bright kids with good grades underachieve and have low self-esteem and social difficulties.
Please complete the following forms. (Please use the Google Chrome browser)
Parent new assessment form for children under the age of 16 years.
Adult and adolescent form for those over the age of 16 years.
Please ensure the teacher completes the Teacher first assessment form.
So you’ve been asked by the school to get a paediatric assessment, and you may have some concerns of your own about problems at school, or home, and not sure how to go about getting help for your child. This can seem overwhelming, making you feel that your child is the only one experiencing difficulties. This is most certainly not the case!- in fact, 1 in 5 children are identified as having problems in the first few years at school. These may appear as teachers disruptive, have difficulty understanding the teacher’s instructions, or experience fears and anxieties to such a level that it makes learning difficult. After all! If your child’s potential was determined at birth, there would be little need for school.
New research shows parents spend an incredible 37 hours a week worrying about their children. .An assessment provides understanding and peace of mind that the problems can be addressed.
Your child’s self-esteem.
When kids learn or think differently, new tasks and skills might not come as easily. Self-esteem is tied to how kids value themselves and how capable they feel. If your child has specific learning challenges, they may have more negative feelings and thoughts.
Your ability to help:
You’re not sure what will help and worry if you can’t “fix” the issue, you won’t be able to find any way to help and support your child.
An assessment can be the first step you can take to help your child with, learning, emotional or behavioural problems.
Ways to manage it:
Remember: You don’t have to have all the answers and fix it alone. Raising a child who learns or thinks differently can feel lonely. Fortunately, there are people you can turn to for help, like your child’s teacher and paediatrician.
Children with ADHD and learning difficulties need to be assessed as early as possible to give the appropriate help.
Research shows that there will be a 200 to 300 per cent increase in failure rates without early help, and 50% will have to repeat a grade by high school. 35% do not matriculate, and only 5 % will complete college.
ADHD with progressive learning problems:
A recent study showed 80% of children, two years behind in reading, writing, spelling and maths.
Even the most intelligent children, with superior intelligence, can show “chronic and severe” underachievement causing low self-esteem.
The three main characteristics of ADHD are inattention, impulsivity and hyperactivity. These can interfere with academic and schooling success. Having unmanaged ADHD and concentration problems is like attending school in body but not in mind. This is the same as missing 2 to 3 days of school a week. Over the year, this will translate into a large educational gap in education and appear a learning problem.
Up to 50 % of children with ADHD also have an associated learning disability, especially spelling, reading, writing and maths. Therefore, just imagine the resulting consequence of the combination of missing 40 % of school and a 50 % increased risk of learning problems. This combination can hugely reduce your child’s chance of success, without early identification and treatment of problems.
- Just got the report card! And I am totally shocked by the poor grades.
- School grades up to now have been good, and report cards have not indicated any problems.
- Able to complete homework but struggling to complete longer independent tasks at school.
- I was called in for a meeting with the teacher for the first time ever to discuss my child’s behaviour and concentration.
- Organisation and getting reading for school in the mornings is a struggle.
- She was always making us late.
- Has become so emotional and there is increased conflict with siblings.
- I dread the afternoons and homework.
- I don’t see the problems at home that the teacher sees at school.
- Last year’s teacher didn’t mention there was a problem.
- Has become withdrawn and wants to constantly stay in their room.
- She is recently showing school avoidance.
- Homework is a battleground.
- Perhaps this school is not the right one for my child.
- Overly sensitive to clothing, sensitive to sounds and smells
- Simple, quick one-step tasks are completed efficiently and accurately, but complex tasks are not.
- The teacher says she is a bright child, but she is not reaching her true potential because of her concentration.
- He is taking too long to finish his classwork, even after an extra time allowance. Gets distracted from the task at hand.
- She fidgets a lot with her stationery, cannot sit still and wants to get up from her seat and move around.
- Gets easily frustrated with himself.
- Teacher says that the concentration is interfering with learning.
- He finds being focused, organised and completing tasks more challenging. It exhausts him.
- She constantly wriggles on her chair and gets distracted by her belongings. The teacher has to remove everything from the table to limit distractions.
- Need to sit on his own in front of the class next to the teacher to get any work done.
- Often out of his seat or collecting things under the table that he has dropped.
- Enormous effort to get everything down on paper and this effort leaves her anxious and exhausted at the end of every day.
- Concentration is erratic, and therefore so is the quality and accuracy of work. This can cause a feeling of being overwhelmed.
- Impact of poor concentration. Looks exhausted and complains of tiredness in the afternoons at home.
- Tasks are rushed due to daydreaming and reduced time to complete tasks—careless errors.
- With increased demands of the second and third term, the increased workload, poor attention to detail, and the inability to concentrate for extended periods lead to decompensation and falling behind the class.
- Work is completed but is too untidy, and work presentation is below average.
- Disrespectful and argumentative.
- Other learners complain they cannot concentrate because he is distracting them. The teacher constantly has to stop teaching to discipline him. The other children’s learning is negatively impacted by his behaviour.
- Emotionally immature and lacks independence. Work incomplete. Dreamy and distracted.
- Has difficulty handling transitions.
- Battles to sit upright in his seat, and poor coordination with sports.
- Struggles with gross motor coordination are observed during sport and PE.
- Fine motor ability is weak, and handwriting is untidy, compared to his same-sex peers.
- It looks like her “reflexes are not coordinated ”—struggles to dress.
- Gross and fine motor coordination is affecting his writing and sport.
- The fine motor ability affects her writing, which prevents her from putting her thoughts down onto paper.
- At times he does go off into a world of his own. His weak fine and gross motor ability limit his school performance.
- The other girls in the class often ask her to settle down.
- becoming anxious. I want to manage the focus before her self-esteem is eroded. I know she is capable; however, the erratic focus is holding her back, which is so sad considering her true potential. We want to make learning easier her.
- Needs extra attention to maths and languages as he is falling behind.
- As the work has become more detailed and conceptual, she finds it more difficult to hold information in her head, manipulate and generate output.
- It’s overwhelming when there are so many elements and steps to remember when tasks become more complex.
- His slower work pace is also a big concern, having to remember instructions and keeping up with the majority of the class is a worry.
- She is aware that she is weaker in some areas and slower in completing certain tasks in the class.
- He is aware that he is weaker in maths. He lacks confidence.
- Her writing is a little large.
- Battles to write stories.
- Informal spelling is poor and learned spellings are good.
- The teacher has suggested having an occupational therapy assessment.
- Letter and number reversals.
- Suggested a move to learners support class or another school to address learning barriers. Despite additional speech and language and OT therapy, there remain difficulties keeping up with, the mainstream class.
- Sentence structure, spelling and grammar are weak. This reduces self-esteem causing anxiety and reluctance to put work down on paper, for fear of getting work wrong.
- Completes work but takes a long time.
- Takes a lot longer to master concepts that have been taught.
- He gets frustrated and sad if he can’t do what other children can do. It does affect his confidence.
- She is having problems with first, second and third additional languages. It’s difficult to keep up-to-date with these subjects, but she is up-to-date with all other classwork.
- Able to read fluently, but struggles to put her thoughts onto paper. Vocabulary, spelling and sentence construction are below average.
- He struggles to remember new concepts taught, and also methods of working things out. He often reads the instructions incorrectly, eg, doubling numbers instead of having them. He loves arts, drawing and colouring in.
- Comprehensions are difficult.
- Lack of vocabulary and imagination seems to hamper his creative writing. He struggles to understand how to write using paragraphs. Sentence construction is basic.
- Does not enjoy maths.
- Expresses herself well, verbally, but cannot put these ideas on paper.
- Constant tummy ache and always wants to go to the sick room.
- Constantly wants to go to the bathroom during class time.
- Battles to connect with his peers socially and keep friends.
- Has become a loner and is alone in the library at the break.
- She is a bright girl and has the potential to succeed given enough time.
- Needs to find his own confidence.
- Always anxious despite getting reassurance.
- Starting to bite nails.
- He gets distraught when the other children have finished work and are allowed to do something fun and he still has to complete his work.
- Becomes more stressed when doing longer tasks, and is desperate to finish as she knows how to do them, but there isn’t enough time. She rushes and makes careless mistakes.
- Needs additional assistance to be organised, and remember routines. Needs to double-check other children and see that she is doing the right things required to work independently.
- He is bright and able to understand concepts, but cannot complete tasks. This is starting to impact self-esteem. The early year enthusiasm, excitement and love for his classroom is beginning to wane.
"Ferrari brain with bicycle brakes"
Dr Flett's MOTOR VEHICLE framework.
TREATMENT ONLY after ALL support WHEELS
are in place.
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Dr John Flett
My medical journey started almost 30 years ago as a General Practitioner in a Small Town, Waterfall, not far from the Hospital I now work in; Hillcrest Private Hospital. During this time as a GP dealing with young families and their precious new off-spring, a “Paediatric call” was heard loudly. Along the way I travelled with my family to the U.K, to specialise in Paediatrics, gaining the British Paediatric Specialist qualification, MRCP(UK) Paediatrics within two years. I was fortunate enough to work in centres of excellence like Great Ormond Street children’s Hospital and The Hammersmith Mother and Child Hospital, gaining top-level experience and learning from leading experts in children’s care and development. On returning to South Africa, my journey continued in the Department of Paediatrics, at the University of the Witwatersrand, Johannesburg. In 1998 I gained my South African Paediatric Specialist Qualification, FCP(SA) Paediatrics. After spending time as a consultant at the Johannesburg General Hospital, the yearning to return to Durban grew stronger, and in 2000 I returned to Durban to enter `private practice.
I enjoy all aspects of Paediatrics and child health care. I get a real buzz interacting with parents and their children, solving problems no matter how small they appear. I manage babies’ care as small as 500g and 25 weeks at birth and on the other end “children” of over 90 kg and 25 years old.
I have a strong passion for managing all aspects of schooling related problems These include child and adolescent: anxiety, depression, self-esteem, conduct problems, developmental problems, learning problems, and the complete range of ADHD associated challenges