What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

If you have ADHD then the front part of your brain (pre-frontal cortex) may work differently and you may find it hard to:

  • Remain focused and concentrate as you get easily distracted and forget things.
  • You may find you have more energy than others and find it hard to sit still as you are restless and constantly fidget.
  • You may be impulsive and do and say things before you’ve had chance to think about it.

It can be caused by:

  • Genetics (ADHD can run in the family)
  • Chemical imbalance in the brain (faster recycling of messengers: lack of chemical messengers (postman) to deliver the messages (letters)
  • Other risk factors (i.e. you were of a low birth weight)

ADHD can occur in people of any intellectual ability, from any culture or background, and presents in different ways. People with ADHD may also have additional problems, such as sleep and anxiety disorders.

Symptoms of ADHD tend to be first noticed at an early age, and may become more noticeable when a child/young person's circumstances change, such as when they start school. Most cases are diagnosed in children/young people between the ages of 6 and 12.

Some children/young people have significant problems in concentration and attention, but are not necessarily overactive or impulsive. These children/young people are sometimes described as having Attention Deficit Disorder (ADD) rather than ADHD. ADD can easily be missed because the child/young person is quiet and dreamy rather than disruptive.

If there are concerns that a child/young person has difficulties with concentration, hyperactivity and impulsiveness, then they can be referred into Community Paediatrics (as per the referral criteria) to see if assessment is required.

Neurodevelopmental Paediatricians are children’s Doctors who specialise in childhood development and are trained to carry out ADHD assessments.

Neurodevelopmental Specialist Nurses are qualified Nurses who are highly skilled in working with young people and their families. They are trained to carry out ADHD assessments and work alongside the Neurodevelopmental Paediatricians.

At the Consultation, a professional (Paediatrican or Specialist Nurse) will complete a detailed history with you, which will include gathering information about your child's health, from birth to the present day.  It will include asking questions about their early development, family and social history, education, and behaviour. This will help to identify your child’s strengths and difficulties and build a full picture of your child’s health and needs. 

We realise this may be a lot for you to remember and talk about. It may be helpful for you to think about the above points and make notes prior to the appointment. You will be able to discuss any concerns and ask any questions you may have. Please feel free to bring along another adult to the appointment with you if you wish to discuss concerns without your child present. This appointment will usually last between 60 and 90 minutes.

ADHD Secretaries are the first point of contact for families of children/yp who have been diagnosed with ADHD and for professionals requiring/sharing information regarding a child/yp with ADHD. 

You can contact them with any queries via: Telephone: 01270 278139 / 01270 278293     E-mail: tmc-tr.compaedsleighton@nhs.net

The symptoms of ADHD in children/young people and teenagers are well defined, and they are usually noticeable before the age of six. They occur in more than one situation, such as at home and at school.

The main signs of each behavioural problem are detailed below.

Inattentiveness
The main signs of inattentiveness are:

  • having a short attention span and being easily distracted
  • making careless mistakes – for example, in schoolwork
  • appearing forgetful or losing things
  • being unable to stick at tasks that are tedious or time-consuming
  • appearing to be unable to listen to or carry out instructions
  • constantly changing activity or task
  • having difficulty organising tasks

Hyperactivity and impulsiveness
The main signs of hyperactivity and impulsiveness are:

  • being unable to sit still, especially in calm or quiet surroundings
  • constantly fidgeting
  • being unable to concentrate on tasks
  • excessive physical movement
  • excessive talking
  • being unable to wait their turn
  • acting without thinking
  • interrupting conversations
  • little or no sense of danger

These symptoms can cause significant problems in a child/young person's life, such as underachievement at school, poor social interaction with other children/young people and adults, and problems with discipline.

If a child/young person is accepted onto the ADHD pathway, they will receive an appointment with a Consultant Community Paediatrician or Neurodevelopmental Specialist Nurse, where a detailed history from birth to present day will be obtained. The clinician will discuss the outcome of assessment, this may not take place on the same day if further information or discussion is required. 

If the information and evidence obtained as part of the assessment is not suggestive of ADHD, then it will be explained and the child/young person will be discharged. Referrals or discussion regarding alternative service or support may take place. The child/young person can be re-referred to Community Paediatrics if new supporting evidence becomes apparent. 

If a diagnosis of ADHD is confirmed following assessment, then the parents/carers will be signposted to the ADHD Specific presentation hosted on our website (link when available, paper copies can be provided if required) where you will receive information on the condition, strategies to help manage ADHD and the treatment options available. There will also be other links to useful websites and organisations. The parents/carers and child/young person do have the option of a one-to-one session with a Neurodevelopmental Specialist Nurse to discuss this more in depth if required and requested.

Following this if it is felt that treatment for the child/young person may be beneficial, then you will be offered an appointment with a Consultant Community Paediatrician to discuss and potentially commence a trial of medication. A physical examination of the child/young person will be carried out and the benefits and side effects to the medication will be discussed. A prescription will usually be given at this consultation, unless further medical investigations (such as an ECG) are required. 

You will be advised when the follow up appointment will be with a member of the team. 

If you do not want to trial treatment, then you will be discharged into the care of your GP. A re-referral can be made back at any point until the child/young person becomes 16 years of age.

Please note that it is the parents/carers responsibility to inform us if there are any changes in contact details to allow us to offer appointments. The Trust operates on a 'Was Not Brought' policy, which can result in discharge from the service if appointments are not attended.

We have put this brief video together, to act as a reminder of the information discussed at your session. We hope you find it helpful. If you have any questions, then please do not hesitate to contact us. 

 

If you are a parent of a child/young person with ADHD you have a very important role to play in helping your child/young person to gain control over their behaviour. But first of all you need to be reassured that ADHD is not your fault - you are not a ‘bad parent’. You can learn some specific ways of talking, playing and working with your child/young person who has been shown to improve children/young people's attention and behaviour. (Of course these techniques can also be very helpful for other carers and friends, not just parents).

There are now a number of programmes run by professionals to help parents. Most of these programmes focus on ‘behaviour management’. This involves learning how to plan and structure activities, and to praise and encourage children/young people for even very small amounts of progress.

  • Ensure that clear and appropriate rules for behaviour are explained and that you are consistent with your approach and management.
  • Ensure that your child/young person has structure and routine in their day.
  • Remember that it is important to build a positive relationship with your child/young person.
  • It is important to understand the condition and how it can impact on your child/young person’s life.
  • You may also find it useful to attend or join peer support groups

It is important for parents and schools to work closely together in deciding how best to help a child/young person with ADHD. If you are a parent or carer of a child/young person with ADHD you might find it useful to discuss some of the material in this booklet with your child/young person’s teacher.

Your child/young person’s school is required by law to identify pupils who have difficulties in learning or behaviour, and to find ways of helping them overcome those difficulties. Guidance given to all schools emphasises that children/young people with behavioural problems should be seen as having educational needs, rather than as naughty or ill. All schools have someone who is particularly responsible for making sure that children/young people with special educational needs receive appropriate help. This person is usually referred to as the Special Educational Needs Coordinator (SENCo).

General Support Resources (Community Paediatrics)