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Prader-Willi syndrome: guidance for children and transition into adulthood
M Guftar Shaikh1,2, Timothy G Barrett3,4, Nicola Bridges5
1Department of Paediatric Endocrinology, Royal Hospital for Children, Glasgow, UK.
Insights
Prader-Willi syndrome (PWS) is a rare genetic disorder affecting development. This consensus statement provides guidance for clinicians on managing PWS in children and adolescents, covering diagnosis, assessment, and care transition.
Area of Science:
- Genetics
- Neurodevelopmental Disorders
- Pediatrics
Background:
- Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder affecting approximately 1 in 10,000-30,000 births.
- Key features include neonatal hypotonia, feeding issues, followed by hyperphagia and obesity risk.
- Associated conditions include developmental delay, learning disability, endocrinopathies, scoliosis, respiratory issues, behavioral challenges, and mental health concerns.
Purpose of the Study:
- To provide a consensus statement and reference document for clinicians managing children and adolescents (up to 18 years) with PWS.
- To outline best practices for diagnosis, clinical assessment, and management across bio-psycho-social domains.
- To guide the transition of care from pediatric to adult services.
Main Methods:
- Development of guidance based on peer-reviewed scientific reports.
- Incorporation of expertise from experienced clinicians in the UK and Ireland.
- Consideration of the full spectrum of PWS management in the pediatric setting.
Main Results:
- The consensus statement addresses the multi-disciplinary approach required for PWS management.
- It covers diagnosis, clinical assessment, and management strategies for children and adolescents.
- Guidance extends to the transition period and ongoing care into adulthood.
Conclusions:
- Effective management of PWS necessitates a comprehensive, multi-disciplinary approach.
- This consensus statement offers essential guidance for healthcare professionals caring for pediatric PWS patients.
- The document supports optimal patient outcomes through informed clinical practice and care transition.
Abstract:
Prader-Willi syndrome (PWS) is a rare orphan disease and complex genetic neurodevelopmental disorder, with a birth incidence of approximately 1 in 10,000-30,000. Management of people with PWS requires a multi-disciplinary approach, ideally through a multi-disciplinary team (MDT) clinic with community support. Hypotonia, poor feeding and faltering growth are characteristic features in the neonatal period, followed by hyperphagia and risk of rapid weight gain later in childhood. Children and adolescents (CA) with PWS usually display developmental delay and mild learning disability and can develop endocrinopathies, scoliosis, respiratory difficulties (both central and obstructive sleep apnoea), challenging behaviours, skin picking, and mental health issues, especially into adulthood. This consensus statement is intended to be a reference document for clinicians managing children and adolescents (up to 18 years of age) with PWS. It considers the bio-psycho-social domains of diagnosis, clinical assessment, and management in the paediatric setting as well as during and after transition to adult services. The guidance has been developed from information gathered from peer-reviewed scientific reports and from the expertise of a range of experienced clinicians in the United Kingdom and Ireland involved in the care of patients with PWS.
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