Background: As the coronavirus 2019 pandemic continues, healthcare services need to adapt to continue providing optimal and safe services for patients. We detail our adaptive framework as a large Developmental and Behavioral Pediatrics service in a tertiary academic institution in Singapore. Methods: The multidisciplinary team at our unit implemented various adaptations and workflow processes during this evolving pandemic in providing continued clinical care tailored to the challenges specific to our patient population. Services were continued via teleconsultation mode during the 'Circuit Breaker' (enhanced movement restriction) period. Specific workflow processes, IT infrastructure, and staff training were put in place to support smooth running of this service. Segregation of services into two teams based at two separate sites and implementation of stringent infection control measures surrounding the clinic visit by providers, patients and their families were incorporated to ensure safety. Measures were also taken to ensure providers' mental wellbeing. Results: The clinical service was continued for the majority of our patients with a lowest reduction in patient consultations to half of baseline during the 'Circuit Breaker' period. We received positive feedback from families for teleconsultation services provided. Conclusion: We have been able to continue services in our DBP clinics due to our dynamic reassessment of workflow processes and their prompt implementation in conjunction with the hospital and national public health response to the pandemic. Given that this pandemic is likely to be long drawn, our unit remains ready to constantly adjust these workflows and make

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BackgroundThe corpus callosum plays a pivotal role in the inter-hemispheric transfer and integration of information. Agenesis of the corpus callosum is a frequently recognised anomaly that may present with a wide spectrum of clinical features.ObjectivesTo characterise the demographic profile, clinical phenotypes, describe the associated malformations and to evaluate long-term outcomes including neurodevelopment in children with anomalies of the corpus callosum.MethodsA retrospective case-note review of children with documented agenesis/dysgenesis of the corpus callosum attending the Child Development Centre (neurodisability service) at St. Luke's Hospital, Bradford, UK, between 1990 and 2008 was performed.ResultsForty-six children (32 boys) with a median age of 7 years (range: 2 months–17.5 years), the majority being of South Asian origin and born of consanguineous marriages, were identified. More than two-thirds of the patients were identified in the neonatal period (before 4 weeks of age) and the overwhelming majority (96%) in infancy. Four-fifths of patients had other associated malformations of the central nervous system (CNS). Non-central nervous system malformations were seen in 85%. More than a third of children suffered from epilepsy, the majority requiring monotherapy to control their seizures. Global developmental delay was seen in 93%. Associated chromosomal anomalies, syndromes and metabolic disorders were identified only in a minority. A small number of children also presented with behavioural and neuropsychiatric problems including autistic spectrum disorder.ConclusionThe neurodevelopmental outcome in children with callosal abnormalities to a great extent depends on the presence and the severity of associated CNS malformations. Future studies are needed to justify the role of fetal MRIs to help diagnose these anomalies and formulate an appropriate multidisciplinary management plan.

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