What is ADHD and neurodiversity?

Attention deficit hyperactivity disorder (ADHD) is a childhood behavioural disorder, although some symptoms may continue into adult life.  Symptoms of ADHD include inattention (struggling to focus might walk off), hyperactivity (fidgety, ‘always on the go’) and impulsiveness (suddenly doing/saying something without considering consequences).  Symptoms must be present in 2 or more settings and not better explained by another disorder e.g. Autistic Spectrum disorder.  Some children may present with inattention, hyperactivity and impulsivity but be below the threshold for diagnosis.   Symptoms tend to be noticed at an early age but become more noticeable when the young person starts nursery or school.  ADHD affects on average 1:5 children globally.   ADHD is often diagnosed in childhood but sometimes in adolescence or later. 

ADHD Traits that young people have described to us (ADHD Nurses)

• Difficulty concentrating
• Hyperfocus – concentrating so hard it’s difficult to break away
• Hyperactivity – sometimes physical and sometimes thoughts (busy head)
• Rejection sensitivity – instructions can be received as criticism, needing to be liked, rejection can feel extra hard for those with ADHD
• Disorganisation – losing things, forgetting appointments or homework, or what was just said to them
• Interrupting – ADHD brains work so fast the person often speaks before you’ve finished – this isn’t deliberate rudeness – it’s speedy runaway brain
• Being good in a crisis – those with ADHD are often good under pressure, if someone needs help, or quick decisions need to be made
• Good at seeing things others miss – in problem solving those with ADHD are able to consider many scenarios etc all at once. Many entrepreneurs have ADHD because of their creative and systemic thinking.
• Dislike unfairness – to them and those around them. This could be because ADHD traits are often confused with bad behaviour, those with ADHD get told off a lot because of their traits. They feel the unfairness of this and are able to empathise with others in unfair situations as they may have had a lot of experience of unfairness. People with ADHD will stick up for people who are being treated unfairly.
• Creativity – art, music, problem solving, filming, photography – ADHD brains are often creative. There are many examples of famous artists/musicians that have been diagnosed with ADHD.

Referral

30-60 minutes online

A referral can be made into the NELFT Kent and Medway Single Point of Access (SPA) from a parent/carer or a professional that knows your child well i.e. GP, teacher, early help worker

The referrer will need to complete a Single Point of Access (SPA) referral form.

Triage

5 working days. Clinical review of referral information.

Once the fully completed referral is submitted to the SPA team, discussion will be carried out to review the young persons referral and decide if they meet the threshold to be put forward for a full ADHD diagnostic assessment. If other additional mental health needs are indicated on the referral, the SPA team will direct the referral to the most appropriate service or pathway within our service as part of the triage process. 

Screening

4-8 weeks (Dependent on return the completed screeners) —    Neuro Diverse  Screening  Tools are used to determine Criteria Met for Autism Assessment

If the referral information is indicating that an ADHD assessment is an appropriate response, you will be sent additional forms that are called 'screeners' to complete and send back to us. These questionnaires are usually completed by the family and educations setting (If not in education, this will not exclude you.)

Outcome

Waiting times for an Autism Assessment can be up to four years

If the child/young person meets the criteria for an ADHD assessment, they will be added to the waiting list and a letter of confirmation will be sent to the parent/carer, school and GP. If the child/young person does not meet the criteria for an ADHD assessment, you will receive a letter informing you of the outcome. If you have indicated additional emotional wellbeing or mental health concerns on your referral, you may be directed to, or be offered other support. The outcome letter will also provide a list of further resources that may be helpful, including how to access our online drop in clinic if your child is awaiting an assessment.

The length of wait for a neurodevelopmental assessment is both a local and national recognised problem, and, as a Trust, we are working hard to assess as many young people as quickly as possible. Further, we have procured specialist training in neurodevelopmental assessments for our mental health staff in the locality teams across Kent and Medway, to enable us to increase our assessment rates over the coming year.

We would also like to assure you that the waiting times are a primary focus in the Kent and Medway area. NELFT have been working with Kent and Medway ICB to look at a system wide approach to managing the unprecedented demand for assessments and to explore other approaches going forward. This new workstream for neurodevelopmental assessment and support is being led by the Children’s Partnership Board by the Children’s lead from the ICB alongside NELFT and other providers, working together to look for new solutions to what is a challenging local and national picture. We do support children and families by ensuring that they have contact details and support materials whilst awaiting diagnostic assessment, and we make wellbeing calls to each family every six to twelve months. Families can also access our Single Point of Access for further advice and help or if they have concerns about their child's mental health.

Whist you are waiting for your assessment, please  visit our Support while you wait page

Who can refer

We accept referrals from parents, carers, school, GP and other professionals. The most important thing is that we have all of the required information that we ask for so that our triage team can ensure the young person is directed to the most appropriate support.

How to make a referral

You can refer using our Single Point of Access referral form – please make sure you clearly state any mental well being concerns as well as indicating if you are seeking an ADHD diagnosis. Our ADHD diagnostic service is only for diagnosing ADHD and isn’t specifically for family or mental health support for those with ADHD. If you think the child or young person has additional mental health concerns, please make this clear on your referral information so that the team can ensure the right support is considered.

Initial assessment

This is the first part of the ADHD assessment carried out by a specialist ADHD nurse, who will complete a detailed developmental history. This involves asking questions about the child's early years, toddlerhood and when they were at primary school. We will also ask you questions about their current behaviours. This normally takes around 1.5 hours. A decision will be made at this assessment if your child should be put forward for a diagnostic assessment with a specialist consultant. 

Diagnostic assessement

This part of the assessment will be carried out with a specialist consultant who will assess and diagnose your child with ADHD and feedback accordingly. Or the specialist consultant will decide that an ADHD diagnosis for your child is not applicable and the case will be closed, unless they are receiving treatment or intervention elsewhere in our service. 

Treatment

Once a diagnosis is given, Psycho Educational treatment options will be discussed in the first instance. i.e. sleep, hygiene and ADHD management. 

During the first appointment, the nurse may need to take your child's weight, height and blood pressure as a baseline measurement. If medication is started, your child will visit the ADHD clinic every 3-6 months to be reviewed. A review with the nurse will be carried out six weeks from diagnosis, where medication can be discussed and further initiated with a specialist consultant.