Understanding ADHD For Professionals
ADHD means: Attention Deficit and Hyperactivity Disorder
It is a Neurodevelopmental Disorder. This means:
- That those who have ADHD have a brain that works differently to those who don’t have ADHD.
- ADHD is usually spotted in childhood, and individuals will experience it throughout their teenage and adult years too.
- Having ADHD means children and young people learn and behave differently compared to others.
- For example, those with ADHD have a hard time concentrating, have lots of energy and may behave without thinking about the consequences.
Everyone experiences these difficulties sometimes, although people with ADHD experience them more frequently, and more intensely. Despite struggling with some things people with ADHD are also capable of things others find tricky! ADHD cannot be prevented or cured. But it is considered to be highly treatable; spotting it early, having a good treatment plan to identify strategies to support the child’s or young person’s difficulties.
ADHD AND EMOTIONS
Individuals with ADHD may experience difficulties in regulating their emotions. So, they may need support to recognise and monitor how they think, feel and behave.
Like everyone else, those with ADHD have emotions, however what varies is that they often feel these emotions more intensely and they may last longer, interfering with everyday life.
Those with ADHD have troubles with their emotions because they struggle with mental skills known as ‘executive functions’. These
functions include the ability to put things into perspective, think flexibly and exert control over impulses.
Having ADHD and trouble with Emotion Management can look like:
- May find it difficult to be motivated when they find something boring
- May avoid interactions with others
- Likely to give up quickly
- Excessive Worry
- Find it challenging to calm down after being in a state of anger or distress
- Easily overwhelmed with feelings of discouragement, frustration or anger over seemingly minor annoyances
DIAGNOSIS IN CHILDREN AND
YOUNG PEOPLE
The diagnosis of ADHD depends on a strict set of criteria as set out by the DSM-5 (Diagnostic and statistical manual of mental disorders).
When to make a referral to CAMHS:
- The child (if over 12) or parent/carer (under 12) has consented to a referral
- Symptoms must be displayed continuously for 6 months
- Symptoms must start before the age of 12
- Symptoms must be present across at least two different settings (e.g., home and school)
- Symptoms must have a significant impact on the child’s functioning on a social and or academic level
- Symptoms must have a significant impact on the child’s functioning on a social and or academic level
- Symptoms must not be due to a difficult developmental phase or better accounted for by another condition
It is also beneficial to know children can present with the issues listed and not have ADHD. Factors such as genetics, early trauma and life experiences can also influence children’s behaviours and present very similarly to ADHD.
A diagnosis is very rarely given before a child is 7 years of age as it is thought they may have a degree of immaturity in their general development which may improve if younger than 7 years old.
DIAGNOSIS AND ASSESSMENT
The diagnosis of ADHD requires a detailed assessment made by specialists who utilise a variety of methods. There is not one single test for ADHD.
An ADHD assessment can include:
- Gathering a detailed report of the child’s development history from parents/carers and medical records with consent
- Conducting interviews and obtaining reports from those that work closely with the child, including parents and teachers
- Use of standardised questionnaires for home and school
- Carrying out an observation of the child in school and/or in clinic to see what their symptoms are like in different settings.
This variety of different clinicians, all trained within their own field, are united in the process to provide the best support for both child and family. An ADHD assessment is usually only considered in children over 6 years old, due to the developmental stage of children below this age having common features of ADHD.
TREATMENT
HIGHLY TREATABLE
ADHD cannot be cured since it is caused by genetics and brain differences. However, it is considered to be highly treatable.
MULTI-MODAL
A multimodal treatment approach (more than one approach) is considered to be the most effective approach to manage symptoms of ADHD in children; one single intervention would not be considered best practice or lead to optimal outcomes.
The treatment of ADHD is set out by the National Institute for Health and Care Excellence (NICE) guidelines.
- PSYCHOEDUCATION
- BEHAVIOUR MANAGEMENT INTERVENTIONS
- PSYCHOTHERAPIES
- MEDICAL TREATMENT
What Treatment Is Available?
Psycho-education and parent training programmes focused upon behavioural approaches are considered in the first instance.
Many psychological therapies are effective in treating additional problems which commonly co-occur with ADHD, such as anxiety.
Medical treatment is not considered for school age children presenting with mild symptoms.
Medication is only considered for those over 6 if:
- Their ADHD symptoms are severe enough to significantly impair functioning across more than one setting, despite environmental modifications
- Parents have been educated on ADHD
- A baseline assessment has been completed
Websites, Resources & Books
ADDIS – national attention deficit disorder information and support service
ADHD information for parents and carers
Parent and Carers Resource Pack
ADHD Foundation – leading charity for Neurodiversity
Help Your Child With ADHD | Parents Guide to Support | YoungMinds
What Should I tell the family?
If you have any concerns the child may be displaying signs and symptoms associated with ADHD within your professional capacity it is important that you discuss this with the parent/carer and child (if age appropriate) first and give rationale as to why you think it may be ADHD.
You can signpost the family or offer referral for assessment (RFA) if felt appropriate.
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