Investigations at Cheyne Child development service

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Overview

After your child’s assessment at Cheyne Child Development Centre, the doctor may recommend further investigations. It is also very common for no investigations to be needed, so do not be worried if none are arranged.

If investigations are recommended, the doctor will discuss which tests to do and explain the benefits and possible risks. They will ask for your consent before any tests go ahead.

Most tests are requested electronically, so you may not be given any paper forms.

Below are examples of investigations that may be arranged. We do not always request all of these tests. The decision about whether to do investigations, and which ones are appropriate, is based on your child’s individual needs. This means investigations can vary from child to child.

Blood tests

Blood tests can help identify possible medical factors that may affect a child’s health, growth or development, such as:

  • Nutritional deficiencies: checking levels of vitamins and minerals (such as vitamin D or iron)
  • Metabolic conditions: checking how the body processes nutrients, which can affect development
  • Genetic conditions: some blood tests can look for genetic changes linked to developmental differences (for example, Down syndrome)

Before you attend

  • You do not need to book an appointment. You can attend Children’s Outpatients at Chelsea and Westminster Hospital for blood tests, as long as you arrive before 3pm.
  • Most blood test requests are electronic, so you will not usually need to bring any forms unless your doctor has specifically asked you to.
  • Blood test requests remain on our computer system for 3 months. If it has been longer than 3 months since the request was made, you may need a new request.
  • It can help to know the name of the doctor who requested the tests so the phlebotomist can confirm they are doing all the requested tests.
  • Explain what will happen using words and pictures your child can understand.
  • Try not to focus on the most unpleasant parts of the test in advance if this will increase your child’s anxiety.
  • If your child asks whether it will hurt, it is usually best to be honest. You might describe it as a “strong pinch”.
  • Bring any toys, comfort items or visual supports that help your child stay calm.
  • Dress your child in clothing with short sleeves, or sleeves that can easily be rolled up above the elbow.
  • Acknowledge your child’s feelings, but try to avoid long discussions if this makes them more worried.
  • Reassure your child that the staff are there to help.

Where to go for blood tests

  • Blood tests are carried out in Children’s Outpatients at Chelsea and Westminster Hospital.
  • Children’s Outpatients is on the 1st floor, near lift bank D.

This video shows Children’s Outpatients at Chelsea and Westminster Hospital.

What happens on the day

  • Report to reception and let them know you are attending for blood tests.
  • Take a seat in the waiting area. The waiting room can be busy. People who are not having blood taken may be asked to wait elsewhere.
  • Explain what is happening in simple, direct language your child can understand.
  • Where possible, offer choices to help your child feel more in control (for example where to sit, the colour of a plaster or a small reward afterwards).
  • When it is your turn, your child’s name will be called.
  • The phlebotomist will check the electronic request, confirm details and prepare to take the blood sample.
  • Things that can help during the blood test include:
    • Guided imagination: encourage your child to imagine a favourite place or activity, including what they might see, hear and smell.
    • Distraction: use a favourite toy, book, game or conversation topic, ideally before your child becomes upset.
    • Music: play your child’s favourite music or sing a silly song.
  • All our phlebotomists are trained and skilled in taking blood from children. Please discuss any concerns with the phlebotomist.
  • Play therapists may be available to help distract children if needed.
  • If your doctor has given you a specific form for a genetic test, bring it with you and give it to the phlebotomist. Most blood tests do not require paper forms.
  • After the sample is taken, you will be asked to press firmly on a pad to stop bleeding. This helps prevent bruising.
  • The phlebotomist will label the tubes and send them to the laboratory for testing.
  • Once bleeding has stopped, a dressing will be applied and you will be able to leave.
  • If your child has been asked to provide a urine sample as part of the tests, please remember to hand it in.
  • Praise your child afterwards, including specific behaviours they managed well.
  • Results will be returned to the clinician who requested the tests.

MRI scan

Overview

MRI scanner at Chelsea and Westminster Hospital
MRI scanner at Chelsea and Westminster Hospital

An MRI (magnetic resonance imaging) scan uses a magnetic field (not X-rays) to take pictures of the body. The MRI scanner is a hollow machine with a short tunnel through the middle. Your child lies on a bed that slides into the tunnel.

An MRI scan usually lasts between 20 and 40 minutes. There is no radiation involved.

Some children can have the scan without medication if they can lie still. Others may need a general anaesthetic if they are not able to keep still. If your child needs a general anaesthetic, you will be contacted in advance and offered a pre-assessment appointment where the process will be explained.

A parent or carer can usually stay with their child during the scan if it is safe to do so and after completing a safety questionnaire. Please do not bring other children or siblings to the scan appointment, as they cannot enter the scan room.

If your child needs to do anything specific to prepare for the scan, we will send details with the appointment letter.

In most cases, your child can:

  • eat and drink as normal
  • continue to take any prescribed medication

Before entering the scan room

  • You will be asked to complete an MRI safety checklist for you and your child.
  • The radiographer will explain the scan and answer any questions.
  • You and your child will need to empty pockets and remove all loose metal objects (such as watches, keys and coins), as well as any bank cards or travel cards with magnetic strips, as the scanner may stop these from working.

What does the scan involve?

This video shows a person going into and out of an MRI scanner.

  • Your child will need to lie on the scanner bed and keep very still. Movement can make the pictures blurry and the scan may need to be repeated.
  • Once your child is positioned correctly, the bed will move into the scanner so the area being scanned is in the centre of the machine.
  • The radiographer will speak to your child during the scan to explain what is happening.
  • Your child will be given a buzzer to press if they need to attract staff attention during the scan.
  • The scanner makes a loud knocking or banging sound when it is working. Headphones are provided to reduce the noise.
  • The scan is painless. Sometimes the bed vibrates slightly due to the noise, which is normal.

Are there any risks?

MRI scans are generally very safe and have no lasting effects. The scanner does not touch your child during the scan.

MRI is not suitable for people with certain metal implants (such as some pacemakers) because the scanner uses a strong magnetic field. This is why a thorough safety check is completed before the scan.

What happens afterwards?

In most cases, your child can go home straight after the scan. They can eat and drink as normal and return to their usual activities.

EEG (electroencephalogram)

An EEG is a test that measures the electrical activity of the brain. It can be helpful for:

  • Assessing possible seizure activity: if a child has seizures or unusual episodes, an EEG can help identify abnormal electrical patterns in the brain.

What to expect

  • Preparation: depending on the type of EEG, there may be specific preparation steps. You will be told about these in advance.
  • Comfort: reassure your child that the test is safe. Bringing a favourite toy or blanket can help them feel more comfortable.
  • Results: the clinician who requested the test will discuss the results with you and explain what they mean for your child’s care.
  • Support: investigations can feel overwhelming. Please ask your clinician if you have questions about the test or the process.

If you have any questions or would like more information, your clinician will be able to support you.