Everyone knows about children with ADHD and what they are like – and that is a big part of the problem. The image of badly behaving boys bouncing all over the place, ruining the class for everyone else is not an easy one to work against.
ADHD symptoms are usually noticed by parents while their children are still pre-school but to get a child diagnosed as having ADHD they must show the behaviour in a variety of settings so as to prove that it isn’t just an antipathy to school or poor parental discipline causing the problems.
As well as the well known hyperactivity and impulsiveness of the traditional image of ADHD in children, there is also inattentive behaviour, which is the type of AD(H)D that is often either missed – or just dismissed as stupidity or laziness.
The signs to look for are having a shorter attention span than others, making silly mistakes and forgetting things, or just being unable to organise themselves. You might well say that all kids are like that – and you’re right!
The difference is that for a child with ADHD it is even more so – and they really can’t change their behaviour. They often appear to be incapable of listening or carrying out instructions. They tend to keep changing from one task to another, and they certainly can’t stick to doing anything that takes much time or that they think is boring.
An inability to sit still and constant fidgeting, along with being a constant chatterbox and always interrupting can make children with ADHD pretty unpopular, both with their teachers and with their fellow children.
It can seem to others as if they are just being selfish as they are unable to wait their turn and often act without thinking. They are also often prone to accidents and show little awareness of danger or risk. As a consequence, children with ADHD seldom achieve anything like their potential and are frequently in trouble.
Perhaps as a result, children with ADHD can often also be very anxious or even depressed and sleep is a frequent issue. It is also very common for children with ADHD to have other learning or neurodevelopmental issues such as dyslexia, dyspraxia or even epilepsy.
A comorbidity with autism is also very common. One common problem being that the ADHD is missed due to the autistic behaviour masking it. If you have a child with an autistic spectrum disorder it is often a huge benefit to have them checked out for ADHD as the improvement in their ability to concentrate and engage when suitable medication is given can be quite spectacular.
Our ADHD service for children and adolescents
Psychiatry-UK offers a specialist diagnostic ADHD service for children and adolescents which fully complies with NICE guidance for the assessment and treatment of ADHD.
One issue that we are well aware of is that there may be varying agreements in place for shared care in different regions in the UK and this can cause major issues if you are unlucky in the postcode lottery but we will work with you to try to sort out any issues with local services and your GPs if your child has a diagnosis of ADHD from us.
The process and costs
The assessment of a child for ADHD is always going to involve input from the child’s school and can take some time to complete.
The first stage is to fill in our children’s ADHD referral form and to pay the initial consultation fee of £700 (If booking online please choose ADHD/ADD in Children from the list of treatments on the booking form). We will then send out rating scales to you and to your child’s school for them to complete before we see you. Once these have all been returned we will contact you to arrange the consultation.
The consultation will last up to 90 minutes. It will initially be with the child and you, the parent or or guardian, and then with the child alone. This is then be followed by another brief chat with you to give you feedback on the consultation and the outcome of the ADHD assessment.
It is at this point that the psychiatrist will discuss options for medication with you. The psychiatrist will then write to you and your GP, setting out the diagnosis and the treatment plan that you have agreed.
If you have decided to try medication, the next stage is to go through titration which is the process of working out the right medication and the correct dosage. You will have to provide us with a weekly report on how your child is doing on the medication with measurements of their weight, blood pressure and pulse. If you want you can get your own blood pressure monitor, or we can lend you one.
The fee for the titration is £125 and, if you use one of our monitors, we ask you for a £50 deposit. We will also charge you £25 for each prescription that we send out and you will also have to pay the pharmacy for the medication which can cost anything from £70 to £150, depending on which drug works best for your child.
Titration can take between a month and three months. When we all agree that your child is on the correct medication, we have another online consultation, but only for half an hour, and the psychiatrist will then write to your GP to ask them to take over prescribing.
Some GPs are still a bit wary of prescribing stimulants to children and in some areas of the UK there are local guidelines that do not allow them to work with any psychiatrists except those from their local service. We are happy to help in challenging such restrictive and unfair practices when we come across them.
Follow up appointments
After titration, the period in which the psychiatrist works out the correct medication and the correct dose for your child, there will also have to be follow up appointments. Initially they will every three, then, after six months, these will change to every six months.
Communication with the GP
The Psychiatrist will write to your GP with a report of the assessment and treatment. Once the child or young person is stabilised on stimulant medication, then the GP will be asked to continue the prescribing.
With some other medications such as Guanfacine, this will be requested too however it may not be possible for this to be prescribed by the GP.