The emerging paradigm of integrated services across health, social care and education and integrated commissioning of services will inevitably impact service design and delivery for those professionals working with patients living with and requiring treatment for ADHD.
Stigma and misunderstanding may have prevented many parents and adults seeking a diagnosis and support. Research suggests that undiagnosed, untreated ADHD increases the risk of mental health problems such as anxiety, depression, addiction, eating disorders, self-harm, attempted suicide and personality disorder.
So what is ADHD?
ADHD is a thoroughly researched condition and it is estimated that approximately 5% of children have ADHD and while it is considered a lifespan condition, by adulthood, many people have learned to live happy, health and successful lives using a range of interventions and strategies. These include medication, daily exercise, healthy nutrition, stress management strategies and what are known as ‘executive functioning skills’ to help them plan and organise their lives, especially in schools and in the workplace.
ADHD has three main attributes;
- Hyperactivity – lots of energy and feeling the need to move about or fidget and sometimes resulting in poor sleep.
- Impulsivity – an inability to self regulate thoughts, feelings and actions.
- Inattention – difficulty concentrating and remembering information.
Many clinicians now include the following in their diagnostic assessment:
- Low emotional resilience and predisposition to other mental health difficulties
- Poor executive functioning skills – an inability to organise and plan thoughts, emotions and actions that can impair daily functioning
Children and adults with ADHD will have varying degrees of these difficulties and will not all present with the same symptomology. The reclassification of ADHD from a behavioural disorder to a ‘neurodevelopmental’ disorder reflects the evidence that not all children or adults with ADHD display inappropriate or distressed behaviours.
What causes ADHD?
While genetic in origin, research suggests that environmental factors such as parenting, education, traumatic experiences, brain injury, epilepsy, and coexisting cognitive impairments such as dyslexia, autism, dyspraxia, dyscalculia and Iren’s syndrome will ultimately determine the severity of ADHD across the lifespan.
Therefore a comprehensive assessment by a trained clinician or psychiatrist will be required to discern how ADHD is impacting on the patient’s quality of life and daily functioning so the most appropriate treatment can be prescribed.
The role of schools in supporting assessments
Schools play a valuable role in gathering information to support a diagnostic assessment.
Poor behaviour is not always a sign of ADHD. Poor behaviour in school may often be a result of children learning how to behave inappropriately in a school context. Learning is a trial and error process involving family and school to socialise the child to support their healthy psychological, social and intellectual development.
Schools should meet with both the child’s parents and teacher and discuss the following;
- Is the child paying attention and able to concentrate?
- Is the child showing any delay in learning?
- Is the child forgetting things?
- Is the child unable to be still when required?
- Is the child appearing anxious about learning and homework?
- Is the child appearing tired or daydreaming in class?
- Is the child able to organise and plan their school work properly?
- Does my child find it difficult making and keeping friends?
- Is the child having difficulty with sleeping?
- Have these difficulties been occurring for more than 6 months?
Note: These characteristics and concerns must be evident in both the home and school.
To read the rest of this article and more, visit the ADHD Foundation UK website here