What is ADHD?
‘ADHD (attention deficit hyperactivity disorder) is a condition where the brain works differently to most people. Symptoms of ADHD usually start before the age of 12. They involve a person’s ability to pay attention to things (being inattentive), having high energy levels (being hyperactive) and their ability to control their impulses (being impulsive). ADHD is thought to be recognised less often in girls than boys. This may be because girls with ADHD more commonly have inattentive symptoms and these can be harder to recognise.’ – NHS UK ADHD Children and Teenagers
‘There are three traits of ADHD including Hyperactivity, Inattention and Impulsivity. A child does not have to have all three traits to receive a diagnosis. It’s important to note that children in the early years, due to typical stages of child development, will demonstrate similar traits to that of ADHD however, If a child has ADHD the traits will be observed to a greater extent than their peers. You may find that the child demonstrates the traits more frequently and to a greater degree than other children their age.’ – ADHD Foundation
Signs that a child or adult may have ADHD
A child or young person may show signs of being inattentive, such as:
- being easily distracted
- finding it hard to listen to what people are saying or to follow instructions
- forgetting everyday tasks, like brushing their teeth or putting on socks.
They may show signs of being hyperactive and impulsive, including:
- having high energy levels
- fidgeting or tapping their hands and feet
- talking noisily
- feeling restless, or getting up and moving around when they’re supposed to sit still
- finding it hard to wait their turn, or interrupting conversations
- Understanding different behaviours – NHS UK ADHD children and teenagers.
Understanding behaviour related to ADHD
Referrals and assessment
All ADHD assessment referrals for East Kent Children, previously managed by EKHUFT, are to continue to be sent to NELFT as per existing process.
North and west Kent:
There are no specific blood tests to prove a diagnosis of ADHD. Commonly used questionnaires and forms help to build a picture of the child’s presentation. Commonly requested information includes: SNAP questionnaire for teacher and parent, school reports and in some cases a QB test may be requested.
There are three different types of ADHD and not every child with ADHD presents with all the symptoms of hyperactivity, impulsivity and inattention.
To warrant a diagnosis of ADHD, people aged younger than 17 must display at least six of the nine inattentive and/or hyperactive impulsive symptoms and they must be present before they are 12 years old.
The following are different presentations of ADHD. Symptoms can change over time, as can presentations:
- combined presentation
- predominantly inattentive presentation
- predominantly hyperactive-impulsive presentation.
Difficulties are usually noticed by both parents and educational staff.
Before the ADHD assessment, substantial information from the educational establishment and from home, in the form of standardised questionnaires and forms, will be requested. After this you will meet with a nurse via video.
The assessment includes a nurse video call with parent/carer covering topics such as:
- the child’s overall behavioural problems and support/advice and signposting provided
- the child’s medical history
- the child’s development, including medical problems and medications.
After the video call with a nurse, an initial appointment will be offered with a consultant paediatrician or specialist community paediatrician.
If concerns continue around the possibility of the child having ADHD, further information will be requested and a detailed assessment, by a consultant paediatrician or specialist community paediatrician, will be carried out.
Medway:
Our Medway team sits under the Indigo Pathway and includes Paediatricians, Specialist Nurses and Occupational Therapists who specialise in assessing and supporting children with ADHD. We work closely with our therapy colleagues, emotional wellbeing team and school nursing.
What we do
Assessment
Your child will usually begin with either an observation appointment or a QbTest. This is a computer-based assessment that helps us understand some of the core symptoms associated with ADHD.
During this appointment, your child will be seen on their own by a member of the ADHD team while parents or carers wait in the waiting area.
After the QbTest, you and your child will be invited to an appointment with either a paediatrician or a specialist ADHD nurse who is trained to assess and diagnose ADHD.
What happens during the assessment?
The assessment may include:
- A discussion about your child's development and family history using the information provided on the Family Development History form.
- A private discussion with a clinician if there is any information you would prefer to share separately.
- Height, weight and blood pressure checks.
- Information gathering from other professionals involved in your child's care.
- A review of reports and assessments from other services, such as:
- speech and language therapy
- occupational therapy
- paediatrics
- educational psychology.
If you have copies of any relevant reports, please bring them to your appointment.
What happens next?
In some cases, we may be able to reach a decision during the assessment. However, additional information is sometimes needed before a diagnosis can be confirmed.
Possible outcomes include:
- Your child meets the criteria for an ADHD diagnosis.
- Your child does not meet the criteria for an ADHD diagnosis.
- More information is needed before a diagnosis can be confirmed or ruled out.
If we need further information, we will explain this to you during the appointment and discuss the next steps.
What support is available following any assessment?
Following your appointment, you will be sent a full report of your child’s assessment with a diagnosis if appropriate. The report will include recommendations and strategies that nursery or school and home can use to support your child.
School can use this report to update relevant paperwork with your child’s needs and relevant diagnosis.
We act as an advocate and provide advice and support to families meeting their children’s needs. We are able to signpost to and refer to specialist services as necessary, source relevant information and liaise with agencies supporting the family. Sometimes, follow up appointments are not necessary.
Medication
Paediatricians and some of our specially trained ADHD nurses are able to assess for, diagnose and prescribe medications for ADHD. There are very clear NICE guidelines around the use of medication and monitoring of medication. Some young people may not be able to take medication due to other health issues and our staff will advise and discuss support options with you and your child.
When reviewing medication, we may ask for updated information in relation to how young people are coping with their medication. If there have been changes this informs our treatment plans. Medication Assessment Packs are used when starting medication or following changes to dosage, to monitor the effect of medication on symptoms and side effects.
Referral
The Indigo Pathway provides assessment for children aged two years and six months to under 11 years where there are concerns that they may be neurodivergent.
Assessments are available for:
- Autism (opens in new tab)(from two years and six months to under 11 years)
- ADHD (from six years to under 11 years)
Where a child needs support or intervention, please consider discussing with or referring to:
- Health Visiting
- School Nursing
- Therapy Services.
The pathway does not accept referrals for:
- children registered with a GP outside Medway
- children aged 11 years and over
- children where the only concern relates to mental health
- children who are not yet attending school and have not been referred to Speech and Language Therapy
- self-referrals from parents or carers.
Who can make a referral?
Referrals must be made by a professional working with the child and family.
We cannot accept referrals directly from parents or carers. If your child attends a school or nursery, staff can usually make the referral on your behalf. Referrals can also be made by a health professional, such as your GP.
Important information
Before referring for an autism or ADHD assessment, please check that the child has not already been referred through the NHS Right to Choose pathway. Children should not be on more than one waiting list for the same assessment.
Before submitting a referral
Please complete the relevant forms below and send them to medch.childrenscommunity@nhs.net(opens in new tab), together with the reference code from the Indigo referral form(opens in new tab).
ADHD assessment referral
Please submit:
- ADHD screening pack education (completed by the school or education setting)
- ADHD screening pack for home Medway (completed by the parent or carer)
- Family developmental history Medway (completed by the parent or carer).
Please note that referrals cannot be reviewed until all required documents have been received.