Worcestershire Children's Attention Deficit Hyperactive Disorder (ADHD) service

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.

Before referring your child for an ADHD assessment, we ask that parents/carers of children displaying hyperactivity, impulsivity and/or inattentiveness are able to demonstrate:

• The consistent application of strategies and techniques designed to support children displaying ADHD-like behaviours for 10 weeks or longer
• You have engaged with your child's school or education setting to explore the support available to them, and this support has been in for 1 school term or longer

If you can evidence these activities, please continue with your referral. 

You could join us for an online session designed to improve the understanding and management of a child displaying ADHD-like behaviours. Our workshops offer strategies on how best to support your child in and outside of school, and ensure you know how and where to access support locally. 

Following your attendance, we ask that you apply these strategies over a period of at least 10 weeks to determine whether your child's behaviour has changed. Your child's progress should be monitored and recorded throughout this time, keeping a note of any improvement or decline in their behaviour. If you're finding the strategies are not having the intended impact, then it may be possible to refer for an ADHD assessment.

Referral criteria

Parents/carers and professionals will need to work in partnership to complete the same referral form so that we understand how the child/young person presents at home and at school. If no problems are being seen in school, we will still need the school view.

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 access education and social opportunities to their full potential.
• You have evidence/information from those close to the child from a home and school setting.
• You can evidence/demonstrate techniques used to support the child to date at home and at school.
• It is highly recommended that, parents/carers complete a course/training to support their understanding of inattention and hyperactivity symptoms and how best to support their child.
• 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.

Referrals may be rejected if there is no indication of any detailed strategies that have been put in place and the outcomes.

*Where a child has ADHD-like symptoms but can access education and social opportunities to their full potential, 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.

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.
• 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. This is so we have the most up to date information on the child.

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