Neurodivergence

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental difference which is described through behaviour, inattention, impulsivity and hyperactivity. While everyone will show these behavioural traits sometimes, someone with ADHD will present with one or more of these difficulties persistently. Someone with ADHD may find it hard to sit still, concentrate and can act on impulse, all of which impacts on their everyday life.

Like everyone, people with ADHD are individuals and their experiences will be different, but it's important to remember that each of the three characteristics have advantages as well as challenges.

The Amazing Things project have produced a number of videos about neurodivergence. You can learn about ADHD through the eyes of Molly, a young person with ADHD, in this animation.

A range of support is available for children and young people with ADHD. Find out more:

• Educational support for children and young people with special educational needs
• Local and national support

ADHD diagnostic assessment process

What to do if you think your child might have ADHD

Receiving support at the earliest stage without the need for a diagnosis is really important to help you and your child. While ADHD-like symptoms are found in many people some of the time, in people with ADHD they are severe, constant over time and lead to clinically significant impairments in daily functioning. The patterns of behaviour are usually more extreme than seen in children at a similar age of development. Symptoms of ADHD will be present across multiple environments and settings, such as home and in education settings.

If you think your child may have ADHD, talk to a health, education or social care professional. They can help you consider if your child might be showing signs of ADHD. These are different from one person to another but may include any of the following:

• Hyperactivity - Unable to sit still, fidgety, fiddling with things and problems with sleep
• Inattention - Difficulties concentrating, disorganised, forgetful and struggle to complete tasks
• Impulsivity - Speaking out and acting without thinking, interrupting others, difficulties waiting their turn

The professional should work with you to put in place adjustments or strategies to help meet the needs of your child and help them focus more. These are made as part of a graduated response of support and are a combination of academic adjustments made in an education setting and strategies to try at home to help daily life. It may also involve small adjustments made to usual school processes that make the child's life easier, or onward referral to services that provide support. What this looks like is different for every young person.

Help for parent carers

Parenting can be challenging, and when your child has additional needs, it's especially important to take care of yourself so you can best support them. Navigating the complexities of their needs can be overwhelming, especially while waiting for appointments or guidance. To help during this time, there are online resources, workshops, and parent support groups available that provide valuable tools and insights. To help support parents and carers, the resources on the Local Offer and parenting workshops cover subjects other parents have found useful. You don't have to wait to have a diagnosis to access these workshops for parents and carers:

How a child or young person is referred for a diagnostic assessment

Referrals can be made by staff working in educational settings and health professionals. A referral should be made only once reasonable steps have already been made to support the young person and family in line with the graduated response. To refer a child into the CAMHS (Child and Adolescent Mental Health Service) for an ADHD assessment, the child must meet the below criteria:

• Registered with a Herefordshire GP
• Aged between 7-18 years old
• Showing core symptoms of inattention, hyperactivity or impulsivity for at least 6 months
• The symptoms must be persistent at home and in school
• The symptoms must be impacting the child's ability to carry out day-to-day tasks

To understand this, the assessment team require some detailed information to begin the process. The information provided forms part of the child or young person's assessment if they are accepted for the assessment pathway. The information consists of the following part which needs to be completed in full before the referral can be considered:

• A referral form with sections completed by the GP on behalf of the parent or carer and education setting (or alternative setting if the child does not attend school)

Where a child or young person does not attend an education setting, a report will be required from another setting the child goes to such as an activity or sports club.

What happens next

The referral information provided will be reviewed by a senior clinician or doctor and member of a multi-disciplinary team of healthcare specialists. A decision will then be made to either accept or reject the referral. Further information may be requested to support the referral. If the referral is accepted you will be offered an appointment:

Initial appointment

Once accepted, an initial appointment will be held with you and your child. The healthcare professional will decide if any further assessments are needed to help understand your child's needs better. If needed, further assessments are carried out by the appropriate professionals and tailored to the individual needs of your child.

This might also involve consideration of co-occurring or alternative explanations for the young person's areas of difference (for example medical or genetic needs, attachment, or the impact of difficult life events they may have encountered).

The diagnostic assessment

The specialist neurodevelopmental disorders multi-disciplinary team will review the evidence collected and a diagnosis of ADHD will be considered. The final decision will always include a senior clinician. A diagnosis of ADHD may or may not be given.

Feedback appointment

An assessment report will be produced detailing your child's strengths, areas of challenge and strategies to support daily life at home and in education. If it is needed, an in-person appointment may be held with the child or young person and their family to go through the feedback and the assessment report. This will involve a discussion about the strategies most suitable to support your child at home and in an education setting. Medication options may also be discussed.

Waiting times

The CAMHS Team understands that everyone wishes to be seen as soon as possible. Please be reassured that your child will be offered an appointment as soon as one becomes available.

Choosing a different provider

In England under the NHS, you now have a legal right to choose a different provider of ADHD or ADHD assessments, this is called Patient Choice and sometimes Right to Choose. This means that, should you decide the waiting time for your assessment is too long, then you can choose to leave the NHS waiting list and go to an alternative provider. The provider must supply the service to the NHS somewhere in England. Your GP can tell you which providers are able to offer Patient Choice assessments and refer you. NHS Herefordshire and Worcestershire are developing a list of quality-assured Patient Choice providers. The link to this list will be added shortly. In the meantime, these are some of the providers of Right to Choose Assessments for Autism and ADHD.