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ADHD

ADHD In Childhood

types-of-adhd-and-what-they-mean-for-your-child

Research indicates that the brains of children with ADHD work differently from the brains of other children. To send messages between cells, the brain uses chemicals called neurotransmitters. In children with ADHD, levels of both dopamine and noradrenaline are found to be lower than in children without a neurodevelopmental condition.

  • Dopamine is responsible for attention, learning, responding to rewards, and motor control. This can explain the attention difficulties common in people with ADHD.
  • Noradrenaline enhances the formation and retrieval of memory, focuses attention; and increases restlessness and anxiety. This can explain some of the hyperactivity and sleep difficulties common in people with ADHD.
  • ADHD can also affect the brain's executive functions which are responsible for:

    • Organization
    • Sustaining focus and attention on tasks
    • Regulating alertness, effort, and processing speed
    • Managing frustration and modulating emotions
    • Memory
    • Symptoms of ADHD are typically divided into 3 main areas:

    Inattention

    Concentration and focus

    Hyperactivity

    Over-activity

    Impulsivity

    Saying and doing things without
    thinking them through

    Inattention

    Children with ADHD often struggle to pay attention. Inattention can cause people to become easily distracted. They may drift from one activity to another due to boredom. They may not seem to listen when you speak to them and often find it very hard to concentrate.

    Hyperactivity

    Children with ADHD are more active than other children. Hyperactivity makes it difficult for children to stay still. They may squirm in their seat, fidget and get up all the time. They never seem to run out of energy and may run around and chatter constantly. As children get older this behavior tends to reduce. However, even adults with ADHD can get restless.

    Impulsivity

    Children with ADHD often do not stop to think before they act. Impulsive
    children seem impatient and constantly interrupt. They may talk at school when
    it is not their turn, or touch things that they are not supposed to. Children may
    be accident-prone or do dangerous things, such as running across a road
    without looking.

    Assessment
    Child playing

    ADHD Assessment

    Receiving a diagnosis of ADHD for your child can assist you in accessing appropriate services and support for your child. The diagnosis can be helpful to schools and places of employment to ensure young people with ADHD are given equal opportunities. This may include putting in place extra provisions to help manage the symptoms of ADHD.

    Additionally, a diagnosis can help young person understand more about themselves and explain why they experience some difficulties that others do not.

    The comprehensive assessment will cost you £970, which is payable in advance. Assessment is an online consultation with a consultant psychiatrist or nurse prescriber. This is usually an hour but may take longer depending on the need. Price will cover the initial assessment, diagnosis, clinical recommendations, treatment plan, and report. Prior to an assessment, you may be asked to complete the Conners Continuous Performance Test (CPT). This is used to gather more information. Once the assessment has been completed, we will write a report for your GP which will include a clinical diagnosis and further recommendations on how to manage your ADHD symptoms.

    Reaching out for help can be challenging but when the difficulties associated with ADHD are impacting on your day-to-day life, a decision to seek the help of a highly trained clinician for accurate and structured ADHD testing can be life-changing.

    Following the ADHD assessment and clinical diagnosis, your psychiatrist or nurse prescriber will analyze your individual profile of needs and personalise your treatment plan accordingly.

    We also offer a post-diagnostic psychoeducational discussion about the other psychosocial interventions that can be implemented to manage ADHD symptoms. This includes pharmacological intervention and many other resources that are highly recommended for further reading.

    Medication

    Medication can play an important role in managing moderate to severe ADHD. It can help reduce hyperactivity, and improve concentration, focus and self-control. Medication works by altering the levels of the chemicals in the brain which are associated with ADHD (dopamine and noradrenaline). This enables your child to think more clearly and feel calmer.

    Before meeting with Psychiatry For All clinicians, consider the areas where your child is struggling and ask whether these will be improved by the use of medication, or if there are other strategies that may be effective. Medications used to treat ADHD are broadly divided into two groups; stimulants e.g. Methylphenidate (Medikinet XL or Delmosart) and non-stimulants e.g. Atomoxetine.

    Stimulant medication (methylphenidate) is usually recommended, though the type of medication prescribed will depend on many factors including physical health considerations, symptoms, need, and availability of medication.

    The side effects of (stimulant) medication for ADHD can include:
    • Difficulty sleeping and appetite loss (common)
    • Irritability and mood swings, lower mood, headaches, upset stomach, dizziness, tics (uncommon)
    • Racing heartbeat and high blood pressure (very rare)

    Medication is only prescribed to children who have been professionally assessed and diagnosed by an expert and will be reviewed regularly. There may be a period of trialing different medications and doses to find the best fit for your child.

    Most young people need medication until they finish their education, though some may continue into adulthood to improve focus at work. Some children need medication only at specific times e.g., only during school hours.

    Medication is not always the right option and investigations may be conducted to assess if medication is suitable and appropriate. Please speak to your AMHS clinician for more information and to discuss your options.

    Medication is not always the right option and investigations may be conducted to assess if medication is suitable and appropriate. Please speak to your CAMHS clinician for more information and to discuss your options.

    Treatments

    Stimulants

    • Are highly effective
    • Have been available for decades
    • Has been very well studied
    • Safe when prescribed to healthy patients and under medical supervision 

    Are available in two different release forms:

    Short - intermediate release preparations

    Requires the administration of repeated doses during the day. More adverse effects have been related to these, as well as the stigma associated with taking these medications at school.
    Extended-release preparations
    Are preferred over short-acting medications. Patients tend to have better compliance and the medicines are less likely to be diverted.
    *Strattera (Atomoxetine) 10, 18, 25, 40, 60, 80, 100 mg capsule.
    Is the non-stimulant medication that is approved to treat children >6 years/adolescents with ADHD
    Non-Stimulants
    • Are highly effective and a good alternative for young people who do not respond well to stimulant medications
    • Are indicated for young people at risk for substance abuse
    • Are a good option for young people who have other conditions alongside ADHD such as anxiety disorders or Tic Disorders
    Should be considered if problematic side effects arise with stimulants
    *Are considered as first-line treatment for ADHD
    If medication is recommended for your child and you make a formal decision to choose this option, you will be required to have your child’s blood pressure, pulse, weight, and height checked before medication is started. This can be done at the GP or at home using a blood pressure machine that may be purchased from our site if preferred.
    Certain conditions may require ECG and blood tests prior to commencing medication. These are checked during the assessment process. This can be arranged with your GP and we will provide the necessary paperwork to request this.
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