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Attention deficit hyperactivity disorder (ADHD) is a condition that affects people’s behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.
Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child’s circumstances change, such as when they start school.
Most cases are diagnosed when children are under 12 years old, but sometimes it’s diagnosed later in childhood.
Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.
The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
People with ADHD may also have additional problems, such as sleep and anxiety disorders.
The estimated prevalence of ADHD in East Berkshire is 3.1% or 14,448 people and is projected to grow to 4.2% or 19574 people by 2035 (Attain, 2019)
The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into 2 types of behavioural problems:
Inattentiveness (difficulty concentrating and focusing)
Hyperactivity and impulsiveness
Many people with ADHD have problems that fall into both these categories, but this is not always the case.
For example, around 2 to 3 in 10 people with the condition have problems with concentrating and focusing, but not with hyperactivity or impulsiveness.
This form of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.
ADHD is more often diagnosed in boys than girls. Girls are more likely to have symptoms of inattentiveness only and are less likely to show disruptive behaviour that makes ADHD symptoms more obvious. This means girls who have ADHD may not always be diagnosed.
Symptoms in children and teenagers
The symptoms of ADHD in children and teenagers are well defined, and they’re usually noticeable before the age of 6. They occur in more than 1 situation, such as at home and at school.
Children may have symptoms of both inattentiveness and hyperactivity and impulsiveness, or they may have symptoms of just 1 of these types of behaviour.
The main signs of inattentiveness are:
These symptoms can cause significant problems in a child’s life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.
In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.
As ADHD is a developmental disorder, it’s believed it cannot develop in adults without it first appearing during childhood. But symptoms of ADHD in children and teenagers often continue into adulthood.
The way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children.
For example, hyperactivity tends to decrease in adults, while inattentiveness tends to remain as the pressures of adult life increase.
Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.
Some specialists have suggested the following as a list of symptoms associated with ADHD in adults:
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 6th 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
If the GP thinks your child may have ADHD, they may first suggest a period of “watchful waiting” – lasting around 10 weeks – to see if your child’s symptoms improve, stay the same or get worse.
They may also suggest starting a group-based, ADHD-focused parent training or education programme. Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach you ways of helping yourself and your child.
If your child’s behaviour does not improve, and both you and the GP believe it’s affecting their day-to-day life, the GP should refer you and your child to a specialist for a formal assessment.
You or your child may be referred to 1 of the following types of specialists for a formal assessment:
A specialist child or adult psychiatrist.
A paediatrician – a specialist in children’s health.
An appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD
Who you’re referred to depends on your age and what’s available in your local area.
Diagnosis in Children and young people.
There’s no simple test to determine whether you or your child has ADHD, but your specialist can make an accurate diagnosis after a detailed assessment. The assessment may include:
A physical examination, which can help rule out other possible causes for the symptoms.
A series of interviews with you or your child.
Interviews or reports from other significant people, such as partners, parents, and teachers.
Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactivity and impulsiveness.
To be diagnosed with ADHD, your child must also have:
Been displaying symptoms continuously for at least 6 months.
Started to show symptoms before the age of 12.
Been showing symptoms in at least 2 different settings – for example, at home and at school, to rule out the possibility that the behaviour is just a reaction to certain teachers or to parental control.
Symptoms that make their lives considerably more difficult on a social, academic, or occupational level.
Symptoms that are not just part of a developmental disorder or difficult phase and are not better accounted for by another condition.
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. Click here
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 practise new skills.
How can people with ADHD take a strength-based approach?
Living with ADHD discusses ten ways in which people can talk about the positives of ADHD. Click here
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.
ADHD Foundation – How can schools and colleges help children and young people with ADHD achieve their potential. Click here
Janssen and Me have a very useful guide for working with your child’s or young person’s education provider. 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
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
