How we work

Our approach

Families arriving with a child who has cerebral palsy, autism, a brain injury or a genetic epilepsy are rarely short of offers. What they are short of is a way to put those offers in order. This is the order we use.

One specialist. The whole picture.

Our approach to complex paediatric neurology is integrated rather than merely multidisciplinary. The difference is not cosmetic. In a multidisciplinary model a child is seen by several professionals who each report separately, and the family is left holding a set of documents that do not quite agree with one another. In an integrated model one paediatric neurologist brings the history, the examination, the imaging, the EEG, the genetic findings and the developmental assessment together into a single coherent picture — and into one plan that can actually be acted on.

This matters most in exactly the situations this site is about: drug-resistant epilepsy, cerebral palsy, autism with a neurological question behind it, developmental delay where the cause has not been established, high-risk infant follow-up, and the assessment of whether an emerging treatment genuinely fits a particular child. In each of these the answer depends on reading several strands against each other, which is difficult to do when nobody holds all of them at once.

A name for the problem comes first

Before any treatment decision, the question is whether we actually know what we are treating. A precise diagnosis occasionally unlocks a licensed medicine, frequently changes which ordinary medicines are right, and always makes the prognosis something better than guesswork. It is almost always the right place to start. Getting a precise diagnosis →

Established care is completed first, not skipped

The interventions that guidelines recommend and trials support are the ones most likely to change a child’s day: early intervention, goal-directed training, physiotherapy, communication, tone management, vision. If those are not fully in place, adding a newer treatment on top rarely makes sense — the time and attention given to it are time and attention not given to the therapy that would have worked. Conventional care →

Nothing is tried blind on a child

The distinction matters. Trying something of unknown outcome on a child and waiting to see what happens is not what we do. The method has four parts, and a treatment that falls outside all four is not something we propose.

1. Established care, applied in full. Everything the guidelines recommend and the trials support, delivered completely rather than partially. This is the foundation and most of what changes a child’s day comes from here.
2. Precision medicine. The diagnosis is pursued to the molecular level where that is possible, and treatment is chosen on the basis of what is actually found — which medicines suit this gene and which are harmful in it, whether a licensed disease-modifying treatment exists, what needs monitoring.
3. Close reading of the current literature. Where each method has reached, in which condition and at which phase of injury, changes from year to year. Keeping up with that is part of the clinical work, not an academic extra.
4. Individualised, safe, innovative treatment. Where established options are exhausted or insufficient, an innovative approach may be considered — but only one with a defensible rationale for this particular child, a known safety profile, defined monitoring and a point at which it is reviewed. Chosen for the child, not offered as a package.

Families who ask about cells, light, magnetic stimulation or cannabinoids are not being naive, and the question is not dismissed. What is explained in each case is precisely how far the evidence has reached, whether it applies to this child and this phase, and what would have to be true for it to be a reasonable step. Research-stage treatments →

Innovative treatments are given alongside intensive rehabilitation, not instead of it

This is the part most often left out when these treatments are described. Across the methods on this site, the clearest results come from combination rather than from the intervention on its own: magnetic stimulation paired with intensive upper-limb therapy outperforms either alone, and cell therapies have been studied with a rehabilitation programme running alongside them. The reasoning is the same in each case. These interventions act on the capacity to change; what determines whether that capacity turns into function is what the child then practises. A treatment delivered without an intensive rehabilitation programme attached is being given in conditions under which it is least likely to show an effect.

Side effects that arise during treatment are managed, not waited out

Every active treatment produces unwanted effects in some children, and the newer ones are no exception. What matters clinically is not whether they occur but whether someone is watching for them, recognises them early and adjusts. That means a named clinician following the child throughout, a defined monitoring plan with the relevant tests at the relevant intervals, and clear rules for reducing the dose, pausing or stopping. A treatment delivered as a single procedure with no follow-up arranged is the arrangement under which an avoidable problem becomes an unavoidable one.

There is no one treatment for one patient

Children arrive with different causes, different severities, different ages and different priorities, and the same label covers very different situations. A plan built for one child will rarely transfer intact to another. In practice a programme is assembled from several elements — rehabilitation, medication, equipment, management of tone, nutrition, sleep and vision, and where appropriate an investigational treatment — weighted according to what is limiting this particular child. It is then reviewed and changed as the child changes. A centre offering the same protocol to every child who arrives is not individualising treatment; it is applying a product.

The decision stays with the family and their own doctor

Nothing on this site is a recommendation to start or stop a treatment. It is written to make a conversation with the doctor who looks after your child a better conversation — with sharper questions and a clearer sense of what a good answer sounds like. How to judge a therapy →