I think my child may have ADHD

What is Attention Deficit Hyperactive Disorder?

Attention Deficit Hyperactive Disorder (ADHD) is a neurodevelopmental disorder that includes a persistent pattern of inattention, hyperactivity, and impulsivity that is more extreme than is typically observed in children at a similar age of development. This may include:

• Hyperactivity: Difficulties in sitting still, fidgety, agitated and always on the go.
• Inattention: Difficulties in concentrating, being disorganised, being forgetful and often struggling to finish tasks.
• Impulsivity: Speaking out and acting without thinking, interrupting others while talking and difficulty waiting for own turn to talk.

Symptoms of ADHD will be present across multiple environments and settings, such as home and school. 

How does ADHD affect children and young people?

Children and young people with ADHD may struggle to regulate their emotions, they may overreact and struggle to calm themselves. Although these symptoms can also be found in children without ADHD, they are often more severe and persistent in those with ADHD and can have a significant impact on a child’s day to day activity. 

What to do if you are worried a child or young person may have ADHD

If you are concerned that a child or young person has ADHD, you should speak to their teacher or school nurse to make them aware of your concerns and to explore ways to support your child in school and help them focus. The introduction of behaviour and/or learning support may help your child to focus.

We also ask that parents and carers complete local courses aimed at supporting parents of children with additional difficulties/needs. Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach you ways of helping yourself and your child.

We encourage you to try these strategies over a period of at least 10 weeks to determine whether your child’s behaviour has responded to the strategies offered. Your child’s progress should be monitored and recorded throughout this time, making note of any change. If after this time you have not seen a change in their behaviour, then it may be possible to refer for an ADHD assessment with a healthcare professional providing they meet the criteria outlined below. 

Please note, before completing a referral you must be able to demonstrate techniques used to support the child to date, including teaching support at school and parent/carer attendance at a local parent training and education programme. Please click here to find a local parent/carer course. 

Referral criteria

Referrals can be made by parents/guardians, staff working in educational settings and health professionals.

To refer a child into the Worcestershire Community Paediatric Service for an ADHD assessment, the child must meet the below criteria:

• The child is aged between 5 1/2 - 18 years old
• Showing core symptoms of inattention, hyperactivity or impulsivity for at least 6 months
• The symptoms are persistent at home and in school
• The symptoms are impacting the child’s ability to carry out day-to-day tasks*
• You have evidence/information from those close to the child from a home and school setting
• You an evidence/demonstrate techniques used to support the child to date at home and at school
• Parents/ carers have completed a parenting course/ behaviour training
• You can provide the child's latest end of year school report by email to: Community Paediatrics Team — whcnhs.access.commpaeds@nhs.net
• For children not attending school, you have alternative information from a second setting including evidence of inattention, hyperactivity and or impulsivity difficulties that have not responded to strategies in that setting and home over the last 6 months 

*Where a child has ADHD-like symptoms but can perform day-to-day tasks, they do not meet the criteria for a diagnosis in accordance with clinical guidelines. There are many other conditions that can present with these symptoms. Please speak to your GP or paediatric team for advice.

Please note, as part of the referral process, you are required to provide evidence/information from those close to the child from a home and school setting, this includes the child’s last school report. 

Home Educated Children

For children not attending school, alternative information will be required from a second setting, such as a tutor, an educational setting or any other setting which is different to their home environment or an extra-curricular activity that they attend. The type of information required includes evidence of inattention, hyperactivity and or impulsivity difficulties that have not responded to strategies.

If there is not a second setting that the child attends, please complete part 1 of the referral form with as much information as possible and state that there is no second setting. 

Supporting information

• If your child is home schooled, please contact the Educational Team for advice.
• Referrals will NOT be accepted without supporting evidence of the strategies tried and the outcomes, most recent school report and evidence of the primary carer attending a parenting course.
• Children and young people who have already been diagnosed with ADHD can be referred directly to the ADHD team.

What does an ADHD assessment involve?

1. A medical assessment at one of our paediatric clinics
2. Collection of information about the child in different settings (such as home, school and extracurricular classes)
3. Validated ADHD symptom questionnaires
4. If necessary, an objective assessment measure such as the QB test

(A QB test is a computer based test that combines attention and impulse control measurements with activity recordings)

If you have any questions about this process, please contact the Community Paediatric Team.

How our clinicians make a diagnosis of ADHD

ADHD diagnosis follows the DSM-5 or ICD 11 criteria, including documentation on levels of functional impairment. Diagnosis, management, and treatment of ADHD in Worcestershire adheres to the National Institute of clinical excellence 2018 guidelines.

Further information on guidance on making a diagnosis of ADHD can be obtained from the National Institute for Health and Care Excellence.

Private Diagnosis

If a child has an existing private diagnosis, we require a full copy of the assessment to be provided, as well as the parent and school to complete our ADHD referral form, so we have the most up to date information.

The NHS are not obligated to accept private diagnoses however we are more likely to if the provider has followed the NICE Guidelines.