Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects the parts of the brain that help us plan, prioritise, focus on, and execute tasks. These are also known as executive function skills.

Every person with ADHD is unique. They have different strengths and face different challenges. Symptoms and intensity can vary but the key characteristics of ADHD are inattentiveness, impulsivity and hyperactivity.

It is estimated that around 4% of children in the UK have ADHD and around 3-4% of adults.

Signs of ADHD are often noticed at an early age and most cases are diagnosed when children are under 12 years old. However, ADHD can be diagnosed later in childhood. When the symptoms were not identified during childhood, ADHD is diagnosed in adults. Diagnosis among adults is becoming increasingly common, and ADHD is recognised as a condition that both affects children and adults. 

Many people with ADHD have traits that fall within all these areas, but this is not always the case. For example, around 2-3 in 10 people have problems with concentrating and focusing, but not with hyperactivity or impulsiveness. This form of ADHD was historically known as attention deficit disorder (ADD). Today, three types of ADHD are identified.

Many people with ADHD experience emotions differently to others and it is estimated that emotional dysregulation – that is, difficulty controlling your emotions – affects around 1 in 3 children with ADHD and 1 in 2 adults with ADHD. 

Alongside the core traits and emotional dysregulation, people with ADHD can also have other neurodevelopmental conditions and mental health conditions.

ADHD affects girls and boys about equally, but it manifests differently in girls and can be harder to spot. This can lead to girls being less likely to be diagnosed and get the help they need.

Many children go through phases where they are restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD.

But you should discuss your concerns with your child’s teacher, their school’s special educational needs co-ordinator (SENCO) or a GP if you think their behaviour may be different from most children their age.

To find out more about ADHD assessment for children and young people aged 6-18 years please visit the ADHD team page on the Berkshire Healthcare website. It is important to understand that CAMHS will not accept a referral for ADHD until a child has reached their 6^th Birthday. Click here

It’s also a good idea to speak to a GP if you’re an adult and think you may have ADHD but were not diagnosed with the condition as a child. Click here

Please read the information below from Berkshire Healthcare NHS Foundation Trust if you are wondering if a child or young person may benefit from an assessment for ADHD. This will guide you through the best way to help the child or young person.

• They can offer ADHD assessments for children and young people aged 6–17 years.
• They do not offer assessments for children under 6.
• For young people aged 18 and above, please visit our Adult ADHD service. 
• Before referring, please make sure a school support plan has been in place for at least 10 weeks.
• The child or young person must be registered with a GP in Berkshire.

They are an experienced multi-disciplinary team made up of consultant psychiatrists, speciality doctors, clinical nurse specialists, non-medical prescribers, assistant psychologists, and children’s wellbeing practitioners.

The assessment

An assessment usually takes place over two appointments. One appointment is to complete a computer-based task which takes around 15-20 minutes to complete. The other is an appointment with an ADHD clinician which takes around 1 ½ hours. Before the assessment they will also gather some additional information from home and from school which will help streamline the assessment process and mean that they can make a decision as quickly as possible.  

Not everyone referred will get a diagnosis of ADHD. Some things which may look like ADHD can often be due to other things and the clinician will consider any other support the young person may need.  

When they make a diagnosis of ADHD they will offer recommendations on how to support the young person with their ADHD. This will include a discussion about whether a trial of medication might be appropriate. However, medication will not be suitable for all and would be considered for moderate to severe impact of ADHD.  Generally other forms of support should be in place first at school and at home before medication is trialled.

What happens after the assessment

They will discuss the outcome of the assessment with both you and your parent/carer. You may receive individual support to help you manage difficult feelings or behaviours. It may be that your parent/carer finds behavioural support in the form of parenting interventions helpful. This may vary according to your local authority.

If it is felt appropriate you may be offered a trial of medication. This may help young people with severe ADHD concentrate, focus, and think about things before doing them. There are different types of medication, with different effects and strengths. They will discuss these with you and your parent/carer to make sure they are the best fit for you. Once we have found a helpful routine of medication, a clinician from our team will check how you are getting on every six months.

For more information and advice please click on the following link : 

https://cypf.berkshirehealthcare.nhs.uk/adhd-and-autism-neurodiversity/adhd/

NICE guidance describes the standards expected for assessment, treatment and management of ADHD. Click here

The National Institute of Clinical Excellence (NICE) guidance recommends the following for children and young people: information about ADHD, advice on parenting strategies, in some cases a parent training programme, medication if ADHD symptoms are still causing persistent difficulties, after other strategies have been tried, consider offering Cognitive Behaviour Therapy (CBT) in certain circumstances (where medication has helped but there are still issues).

NICE also emphasise a balanced diet, good nutrition, and regular exercise. Click here

Medicines can help some people with ADHD concentrate better, be less impulsive, feel calmer, and learn and practice new skills.

Learning from and getting support from others is important and there are numerous support groups and people willing to help.

Regardless of the difficulties people with ADHD may face, it shouldn’t stop them from thriving in their lives and accomplishing their goals.  Here are some examples of people who live with ADHD and have been successful, Harry Potter star Emma Watson, Michael Jordan, Bill Gates, Simone Biles, Justin Timberlake, Whoopie Goldberg, Will Smith, Ant McPartlin, Britney Spears, Heston Blumenthal, James Haskell – there are many more.

Do make sure your child feels loved and accepted. Help him/her to understand that ADHD has nothing to do with his/her intelligence or his/her ability and that it is not a flaw.

Choose a time when you are not likely to be interrupted and leave some time for follow up.

Do let your child know they are not alone. Let your child talk to someone in the family or a friend who has ADHD.

Do not be surprised if your child does not respond immediately or seems uninterested. It takes some children, particularly younger ones, time for new information to make sense, or to know what questions to ask.

Do learn more about ADHD.

Focus on their strengths, what they do well, and praise their accomplishments so they can pursue their interests and do well with your support.

Do not let your child use his/her ADHD as an excuse. Parents need to help their child understand that ADHD is not a reason to not turn in homework, to not try their hardest, or to give up.

Keep the dialogue going, talk about school, their friends, homework, extracurricular activities, and keep a positive attitude.

The above tips were sources from WebMD.

The following ten-minute videos produced for parents by the UKADHD charity may be helpful. Click here

Your child’s school special educational needs coordinator will be able to advise as each school must follow national guidance on the inclusion of children and young people with ADHD in schools and further educational settings.

Living with ADHD provide tips for teachers about how to take a strength-based approach to supporting young people in school. This will involve staff talking to parents and finding out about the young persons’ strengths when they are at home and in school.

The Joint Council for Qualifications notes that there are special arrangements for teenagers diagnosed with ADHD who are sitting GCSE or A levels. These include.

• supervised rest breaks
• a prompter
• separate invigilation in another room
• extra time
• a reader
• a tablet/laptop/computer
• a scribe
• coloured overlays (for those who find this makes print clearer)

Berkshire Healthcare Children, Young People and Family services website have some useful ideas about how schools can support your child. Click here

Janssen and Me have a very useful guide for working with your child’s or young person’s education provider. Click here

East Berkshire services

Berkshire Healthcare Foundation NHS Trust ADHD team for children and young people Click Here

Berkshire Healthcare Foundation NHS Trust ADHD team for adults Click Here

Parenting Special Children; provide specialist parenting support to parents and carers of children and young people with Special Needs, so that they can create positive change in their lives Click Here

Bracknell Forest SEND Local Offer: a guide to services available for children and young people in Bracknell Forest with special educational needs and/or disabilities aged from birth to 25. Click Here

Bracknell Forest Information and Advice Service: provides confidential and impartial advice and information to support parents or carers and children and young people who have, or may have, Special Educational Needs and Disabilities (SEND) in Bracknell Forest by Click here

RBWM SEND Local Offer: provides information on local services and support available for families including children and young people aged 0 – 25 years with special educational needs or disabilities Click Here

RBWM Information and Advice Service: free, impartial and confidential information, advice and support to children and young people with Special Educational Needs and Disabilities (SEND) up to age 25, and their parents/carers. Click Here

Slough SEND Local Offer – information and advice for children and young people with Special Educational Needs and Disabilities (SEND) and their families about education, health, social care and other services in Slough Click Here

Slough SENDIASS – Information Advice and Support Service: a confidential and impartial support and advice service for parents, carers and children and young people (aged up to 25 years) on issues to do with special educational needs and disabilities and needs of children/young people with special needs. Click Here

Special Voices – Slough Parent Carer Forum: raise awareness about the rights and needs of children/young people with special needs and to ensure that they and their families are consulted and involved in any decisions made during planning or developing services for them Click Here

AADD-UK – Site for and by adults with ADHD: raising awareness of ADHD in adulthood Click Here

ADDISS – Attention Deficit Disorder Information and Support Service: information and resources about Attention Deficit Hyperactivity Disorder to anyone who needs assistance – parents, sufferers, teachers or health professionals Click Here

ADDItude a US online magazine for young people and adults with ADHD, parents, professionals Click Here

ADHD Foundation: an integrated health and education service offering a unique lifespan – strength based service, for the 1 in 5 people who live with ADHD, Autism, Dyslexia, Dyspraxia, Dyscalculia and Tourette’s syndrome. Click Here

ADHD Wise UK – Information, support and resources for ADHD for people with ADHD, parents and professionals:  set up by adults who are diagnosed with ADHD themselves and use it to good effect, to ‘promote positive outcomes’ for those with ADHD Click Here

ADHD and You – ADHD information website for parents and carers, young people, adults, and professionals with tips and downloadable resources Click Here

CHADD Children and adults with attention deficit/hyperactivity disorder Click Here

NHS Choices: overview of Attention Deficit and Hyperactivity Disorder Click Here

UK ADHD Partnership: video resources and support groups for parents and professionals Click Here

National links for disability

Cerebra – children with a brain condition: advice and support on subjects including education, Disability Living Allowance (DLA), toilet training and sleep Click Here

Chatterpack – a voluntary-run, special educational needs and disabilities hub free SEND resources for families, schools and other professionals Click Here

Choice Support – social care charity working across much of England to provide the best possible support to people with learning disabilities, autism and mental health needs Click Here

Contact – for families with disabled children: supporting families with the best possible guidance and information Click Here

Disability Law Service – free advice via information, factsheets, training courses and telephone and written advice in areas relevant to people with disabilities and their carers Click Here

IPSEA – Independent Provider of Special Education Advice: information and training on the support disabled children are legally entitled to at school, including Education Health and Care Plans (EHCPs) Click Here

Mencap – The Voice of Learning Disability: information about learning difficulties and learning disabilities related to autism, Down syndrome and other conditions Click Here

Sibs – for siblings of disabled people: Sibs aims to enhance the lives of siblings of disabled people by providing them with information and support, and by influencing service provision throughout the UK Click Here

Sunflower – Hidden Disabilities: information about Sunflower lanyards, increasingly used to  discreetly indicate to people around you including staff, colleagues and health professionals that you have a hidden disability and you may need additional support, help or more time Click Here

The Continence Foundation – treatment, prevention, causes, types and living with continence issues Click Here

Ways Into Work – Supported Employment, Supported Internships, Recruitment and Workplace Support for disabled people Click Here

ACAMH – Association for Child and Adult Mental Health: online portal with professional seminars on topics related to autism and ADHD Click Here

Anxiety UK: supporting people with anxiety, stress, anxiety-based depression or a phobia with downloadable guides and online or helpline support Click Here

CALM – Campaign Against Living Miserably (mental health support for men): a free and confidential helpline and webchat – 7 hours a day, 7 days a week for anyone who needs to talk about life’s problems Click Here

Childline: support for children’s metal health online and by telephone Click Here

Family Lives – supporting parents and families in crisis: family support services offered through helpline, and offering tailored support around issues such as bullying, special educational needs, and support for specific communities Click Here

Harmless – Self Harm Support: a national voluntary organisation for people who self-harm, their friends, families and professionals Click Here

Mental Health Foundation: aims to find and address the sources of mental health problems so that people and communities can thrive, to help people understand, protect and sustain their mental health Click Here

Mind – mental health charity: provide advice and support to empower anyone experiencing a mental health problem Click Here

Salvesen Mindroom Centre– Back to School Toolkits for children, parents and carers and teachers Click Here

The Samaritans: 24 hours a day suicide prevention support online or by telephone Click Here

Young Minds: fighting for children and young people’s mental and emotional health. Support for parents and carers as well as young people Click Here

Emotionally related school avoidance (ERSA) or Emotional Based School Avoidance (EBSA) describes a group of children and young people who experience difficulties attending school which can be linked to school, parents, carers or child factors as well as wider societal factors. ERSA can range from children and young people who are still attending school, but present with anxiety through to those with no attendance at school for an extended period. Although children’s and young people’s behaviours might not be recognisable as ERSA at the early stages, they highlight their vulnerability to becoming ERSA if action is not taken. Children and young people with ERSA often do want to attend school, however, their anxiety and absence of necessary coping skills leaves them unable to do so.

The 2022 Attendance Audit from the Children’s Commissioner found that in Autumn 2021, 1 in 4 children were persistently absent. In 2018/2019, this figure was 1 in 9 – meaning that persistent absence has more than doubled in this time.

An ERSA guidance and toolkit has been developed and shared with all schools across the Royal Borough of Windsor and Maidenhead.

You can access the guide for secondary aged children here.

The ERSA toolkit is a set of guidance intended to support schools completing early intervention work to support children and young people presenting with ERSA to attend school.

The ERSA toolkit includes a graduated response guide, outlining to schools the appropriate resources, measures, and referrals to be implemented at the varying stages and severity of ERSA.

Please contact the ERSA email for school training, advice and signposting support from the ERSA coordinator. Email: ersa@achievingforchildren.org.uk