ADHD (Children and Adolescents)

At Berkeley Psychiatrists, professionals assist parents and children in managing ADHD symptoms effectively. This includes personalised assessments, accurate diagnoses, and evidence-based treatments tailored to each child's needs. Options for both online and face-to-face appointments are available.

Key Features:

• Meet with Experienced Psychiatrists: Speak to a Child and Adolescent Psychiatrist with extensive experience.
• Structured Clinical Assessments: Based on the latest DSM-V criteria specifically for childhood ADHD.
• Comprehensive Initial Assessment: Initial interviews last 90 to 120 minutes.
• Detailed Reports: Receive a full report detailing the diagnosis and treatment plan.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition marked by hyperactivity, inattentiveness, and impulsivity. Children with ADHD may struggle in these areas individually or in combination.

There are three main types of ADHD in children:

• Inattentive: Symptoms of inattention are predominant.
• Hyperactive/Impulsive: Symptoms of hyperactivity and impulsivity are predominant.
• Combination: Both inattentive and hyperactive/impulsive symptoms are present.

It's common for children to occasionally be inattentive, forgetful, or fidgety. These behaviours do not automatically mean they have ADHD. However, it's worth considering a more detailed assessment if these signs are frequent and visible across different settings such as school, home, and during playtime. ADHD symptoms generally appear before the age of 12 and can be diagnosed in children as young as five. If you observe persistent behavioural issues, seeking a professional evaluation is advisable.

Children with ADHD typically exhibit traits that are consistently present rather than appearing sporadically. These traits often become more apparent during certain activities like schoolwork or playtime. Consistent symptoms are a key indicator for considering an ADHD assessment.

Inattentiveness

Common signs of inattentiveness include:

• Short attention span and easy distraction
• Making careless mistakes, such as in schoolwork
• Appearing forgetful or frequently losing things
• Difficulty sticking to tasks that are tedious or time-consuming
• Seeming unable to listen or follow instructions
• Constantly switching between activities or tasks
• Struggling to organise tasks effectively

Impulsiveness and Hyperactivity

Common signs of impulsiveness and hyperactivity include:

• Inability to sit still, especially in calm environments
• Persistent fidgeting
• Difficulty concentrating on tasks
• Excessive physical activity
• Excessive talking
• Trouble waiting for their turn
• Acting without thinking
• Interrupting conversations
• Having little awareness of danger

Parents or educators observing these symptoms may want to seek a professional assessment. This can provide clearer insight and support for effectively managing the child's symptoms.

A Children’s ADHD assessment involves a structured clinical evaluation using the latest Conners 4 diagnostic assessment tool or similar validated assessment tools and questionnaires. The Conners includes three components completed by Parents and the Child, providing the Consultant Psychiatrist with a well-rounded view of the child's ADHD symptoms and their impact over time. Other such tools have different, but similar configurations.

During the assessment, the child and family meet with a Child and Adolescent Consultant Psychiatrist. The doctor conducts a thorough review of the child's current symptoms, their progression over time, their medical and developmental history, and family background.

After gathering this detailed information, the psychiatrist formulates a differential diagnosis. This comprehensive review helps in developing an individualised treatment plan. This tailored plan aims to provide optimal care and symptom management for the child. This approach ensures the child's needs are addressed, promoting their well-being and development.

Children with ADHD often receive a comprehensive, tailored treatment plan. This plan can include various elements, ensuring a balanced approach to managing their condition.

Components of a treatment plan might include:

• Specific ADHD medication: this can help in managing symptoms effectively.
• Focused psychological and behavioural coaching: this helps the child understand and manage their behaviour.
• Specialist educational tutoring and mentoring: these services support academic performance and learning strategies.
• Parent support and training: provides parents with tools to support their child's needs.

Each child's treatment is based on their unique needs and the family's preferences. By conducting a holistic assessment that considers the child's personal experiences with ADHD, professionals can gain a clear understanding of the condition. This approach allows for the recommendation of treatment options that are both effective and practical.

Parents play a crucial role in the management plan. They receive guidance on understanding ADHD, which helps them better support their children. This can include instructions on medication administration and the application of behavioural techniques.

Symptoms and Diagnosis

ADHD in children manifests mainly through hyperactivity, inattentiveness, and impulsivity. These symptoms can be grouped into three categories: inattentive, hyperactive/impulsive and these two categories combined. Children with inattentive ADHD often struggle with staying focused, make careless mistakes, and forgetfulness. Hyperactive/impulsive children display excessive fidgeting, constant motion, excessive talking, and difficulty waiting their turn. Those who have ‘combined ADHD’ display symptoms of both inattention and hyperactivity/impulsivity.

Assessment Process

The assessment begins with a detailed analysis of the child's presenting symptoms. The clinician evaluates how these symptoms have developed, considering the child's medical history, developmental history, and family history. The assessment involves a combination of direct interviews and standardised questionnaires.

Key components of the assessment:

• Initial interview: Lasting 90-120 minutes
• Diagnostic tools: Conners 4 or similar assessment tools
• Reports: Detailed reports outlining diagnosis and treatment plans

Treatment and Management

Once the assessment is complete, the psychiatrist formulates a diagnosis and proposes a treatment plan. Treatment usually combines medication, therapy, and support strategies. Medications commonly used include stimulants like methylphenidate and non-stimulants like atomoxetine. Therapy options may include cognitive behavioural therapy (CBT) and behavioural coaching.

Medication

Medication for ADHD in children helps manage symptoms such as inattention, hyperactivity, and impulsivity. Stimulants are often the first line of treatment, followed by non-stimulants if necessary. The choice of medication depends on individual needs and responses.

Behavioural Therapy

Behavioural therapy focuses on modifying negative behaviours and developing positive skills. CBT helps children understand the connection between thoughts, feelings, and behaviours. Therapy sessions aim to improve organisational skills, time management, and social interactions.

Benefits of Behavioural Therapy:

• Improved focus and attention
• Enhanced organisational skills
• Better social skills and relationships

Support for Families

ADHD affects the child and the family. Support systems are crucial for managing daily challenges. Parents may need guidance on handling behaviours and supporting their child's development. Clinicians often recommend parent training programmes, which provide strategies to manage ADHD symptoms effectively.

School and Social Support

Children with ADHD may face difficulties in school settings. Schools can provide support through individual education plans (IEPs) and accommodations, such as extended test times or breaks during lessons. Social support, including peer support groups and extracurricular activities, is also crucial in helping children build self-esteem and social skills.

Online Assessments

We offer online ADHD assessments for convenience. These assessments use digital tools to gather information and conduct interviews. Online options are particularly beneficial for families with access difficulties or during times when face-to-face meetings are challenging.

Importance of Early Detection

Early detection and treatment of ADHD in children are essential. Recognising the signs and symptoms early helps in implementing effective treatment plans. ADHD can impact academic performance, social interactions, and family relationships. Timely intervention ensures children receive the support they need to thrive.

Role of Healthcare Professionals

Our psychiatrists collaborate with families, schools, and other healthcare providers to create comprehensive care plans. Ongoing support and regular reviews are critical to ensure treatment remains effective and adjusted to the child's evolving needs.

Key roles of healthcare professionals:

• Diagnosis and assessment
• Medication management
• Therapeutic interventions
• Support and guidance for families

ADHD in Children: FAQs

Who carries the ADHD Assessment out?

ADHD assessments for children are carried out by our Consultant Child & Adolescent Psychiatrists, all of whom are fully registered with the GMC and are entered as CAMHS consultants on the Specialist Register of the GMC. All have extensive expertise in identifying ADHD symptoms.

Age Range for Assessments

Our Consultant Child Psychiatrists assess children between 6 and 18 years old. Over 18’s are assessed by General Adult Psychiatrists.

Post-Assessment Steps

After the assessment, the specialist discusses the results and possible next steps with the parents or guardians. This might include behavioural strategies, school support, or medication.

Medication Prescription

If medication is deemed necessary, the child will be prescribed and monitored for any side effects or necessary adjustments. As these often involve Controlled Drugs there are specific statutory requirements regarding these prescriptions, which can be found on our general information pages.

Recognition by Schools/GPs

Given that we are an independent sector clinic, it is prudent to check with schools and GPs their willingness to collaborate with our clinicians, during as well as after the assessment phase. It is also useful to check with the school that they are happy to formulate an Individual Education Plan (IEP), which can be informed by the findings in the assessment report the parents receive within two weeks after assessment.. This plan helps tailor educational approaches to meet the child's needs.

‍