What is ADHD
- also known as Attention Deficit Hyperactivity Disorder.
This is a group of symptoms that are usually present from an early age. Most cases are recognised when children are 6 to 12 years old, but sometimes this is missed or attributed to being 'naughty'. It may be missed more often in girls as they often display more inattention rather than hyperactivity.
Symptoms may change with age, but can also continue into adulthood.
People with ADHD may have other difficulties with anxiety, poor sleep or social and communication difficulties.
1. Inattentiveness. This describes poor concentration, perhaps making easy mistakes in school work, being forgetful and often losing things, being easily distracted and daydreaming.
2. Hyperactivity. This is often seen in younger children and they may be fidgety, find it hard to sit still and prefer to always be on the move.
3. Impulsivity. This may be when the young person does not think before they act, for example shouting out the answer in class, interrupting people more than you might expect and doing 'silly' things before they think it through.
These features must be present at home and at school for an ADHD diagnosis.
Without treatment and support ADHD can cause significant problems for a child and their family. It may interfere with their ability to receive an education and they often don't reach their full potential.
We often see the impact on their self esteem. They are so often in trouble for their behaviour and often say they can't please anyone and so decide to stop trying.
They may take excessive risks and be injured through accidents.
There is evidence to support that untreated ADHD can increase the risk of coming to the attention of the criminal justice system, often due to shoplifting and petty theft, but also using illicit substances.
Increased risk of road traffic accidents is also a concern for young children as pedestrians and also as adult drivers.
How to get help.
Talk to your child's teacher to raise your concerns.
Share your concerns with the school SENCO (special educational needs coordinator)
Child ADHD screening tool here (parent to complete)
Assessment process
We are able to offer ADHD diagnosis through our clinic, for both children and adults. Follow up appointments are available for children. We hope to offer these for adults also in the coming months. We can also prescribe medication if appropriate and arrange a shared care agreement with your GP.
You will first be seen by one of our psychiatrists for an initial assessment. A thorough developmental history and interview is carried out.
For children / below age 18
An ADHD assessment requires a number of questionnaires to be completed by family as well as teachers from the school. Multiple information sources are collated to confirm the diagnosis, including Connor's questionnaires. ADHD tests (child)
Total cost for ADHD assessment £1300 (£500 initial assessment plus £800). A full report is provided with treatment recommendations.
If these tests show discrepancies or further issues, additional tests may be necessary, but this is not usually the case. We may suggest a Qb test, a computerised assessment for ADHD.
QB Check
QB Check is a computerised assessment lasting 30 minutes and is an additional diagnostic aid for ADHD. A number of shapes are presented on the screen and the patient responds as quickly and accurately as possible by pressing the spacebar on a computer keyboard. A camera located above the computer screen records their activity during the assessment. Their image is not recorded, only the movement is tracked.
The assessment is able to record movement, rating levels of hyperactivity, as well as readings which give an indication of the degree of inattention and impulsivity. It has been shown to be a very accurate assessment for ADHD when used in addition to the clinical interview and can also be used to assess response to treatment.
This test cannot be used alone for a diagnosis.
Cost of Qb check plus written report £275. Pay for Qb test
If a diagnosis of ADHD is made, a full explanation will be given and advice regarding further management, including the use of medication.
Further appointments are available if a diagnosis is confirmed, to discuss treatment options, including medication.
Additional fees will apply to subsequent appointments - £200 follow up appointment - usually required 3-4 times per year, if your GP has agreed shared care.
How is ADHD managed
First steps are to make sure appropriate educational support is in place.
Teaching assistant time can help keep a young person on track in lessons and this may be something that school can provide.
Sometimes this may only be provided after diagnosis has been made.
ADHD can be relatively easy to treat once the diagnosis is made.
1. Medication
There are two main types of medication used.
Stimulant medication such as methylphenidate, it has other names like Ritalin, Equasym and Concerta that you may have heard of.
Non stimulant medication called atomoxetine.
Medication can improve concentration and reduce impulsivity. It works very quickly.
Some families decided to only use medication during the school week and have medication breaks at the weekend and holidays. This can work very well.
2. Therapy
Different therapies can be useful in supporting ADHD.
Psychoeducation is helpful to teach you and your child about ADHD and what it means.
Organisational skills can be taught.
Social skills training may be useful, to help you child manage different social situations.
Further useful information can be found here - Parent and carer leaflet - ADHD
Adult
There are three parts to an adult ADHD assessment.
The first part of the assessment is carried out by one of our psychiatrists who will take a detailed developmental and psychiatric history.
The second assessment is a structured interview with the patient and ideally, a relative or friend that knew the patient in childhood. This is called a DIVA assessment. (£800) Pay for DIVA test (adults)
Part three - At the same appointment we also carry out a computerised assessment for ADHD, called a Qb Check. This can also be delivered remotely. Pay for Qb test
A full written report will be provided for all patients detailing all of the results.
We are able to offer ongoing care and treatment for adults. We now have adult psychiatrist within the team.
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