Attention Deficit Hyperactivity Disorder (ADHD)

Shortages of some ADHD medications

Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-developmental condition where children have difficulty with attention and/or hyperactivity and controlling impulses. Their difficulties must be evident in more than one setting (for example, at school and home) and be significant enough to interfere academically and/or socially. In most circumstances, we see school-aged children for assessment and would normally only be able to diagnose after the age of six.

There doesn’t have to be behavioural difficulties or learning difficulties. ADHD can present in various forms, such as a person not being able to concentrate or organise themselves. They will not necessarily be hyperactive. Although these traits can be distressing and cause problems for some, they provide creativity, energy and determination. In fact, several famous people have disclosed they have ADHD. These include the most decorated Olympian Michael Phelps, TV chef Jamie Oliver, musician Will.I.Am, and actor Emma Watson.

Many of the behaviours commonly associated with ADHD can also be explained by other factors including early life experiences, poor sleep or a range of other developmental conditions. Part of our assessment process involves evaluating how much of a role, if any, these other factors play and attempting to identify and exclude these. This is vitally important because, although getting a timely diagnosis of ADHD is important, it is also crucial that a child or young person isn’t wrongly diagnosed with ADHD. For example. there could be other explanations or underlying conditions that are causing the challenges they are facing, so we need to make sure that they can get the correct support and guidance at the right time.

How is ADHD assessed at Alder Hey?

ADHD is diagnosed through the assessment and review of the problem both at school and at home. It is not diagnosed with blood tests or scans. The main sources of information will be school and home and will be gathered in the form of specific questionnaires.

If you have any additional information, for example school reports and Ed Psychology reports, please provide these as they can also give us useful supporting evidence at referral.

Referral to us: The first step is for School Special Educational Needs Coordinators or an appropriate member of the teaching staff to submit the referral form below. If a GP wants to make a referral they can do so, but we will then need to contact the school and request the information. So, if possible, it is much quicker if the school can make the referral in the first place.

If the evidence in the referral form meets our criteria for acceptance, which is drawn from the DSM 5 and NICE guidance for ADHD, then we will send out ADHD Questionnaires to parents to be completed by parents/carers and school. These questionnaires are tools that have been researched and seen in published work to be valid for assessing the likely presence of signs of ADHD.

Your child will be accepted within the Alder Hey ADHD Service ONLY on receipt of all these documents. If we do not get a response, your child will be discharged from our service because we can’t proceed without them. It’s therefore really important to let us know if there are any problems getting the forms back to us.

Once returned, the information will be assessed, the questionnaires scored to determine if they reach the clinical threshold for ADHD. If this is the case, you will be invited to attend a Neurodevelopmental History Appointment, where a team member will take a detailed family history and a history of the child or young person’s life from pregnancy through to present day. We don’t expect the child or young person to attend this meeting with their parent/carers but may ask for them to be present for part of it for us to make some direct observations. We will agree with you which is the best way as it will depend on whether the appointment is virtual or face to face and whether there are any other opportunities to observe your child.

Please note, if you fail to attend your child’s Neurodevelopmental History appointment without notifying us in advance or calling to rearrange then you will be discharged from the service at this point.

If the information available doesn’t give us strong enough evidence on which to make a decision, then we may arrange a further assessment using a QB test (this is a computer based test designed to contribute to an ADHD assessment) or Specialist School Observations (in the classroom/playground) to provide us with more detailed or specific information. None of these tests can diagnose ADHD by themselves but can add valuable missing information that when put with the other details help us to decide whether your child has ADHD or not.

If the evidence presented at any stage of the assessment is not suggestive of ADHD, we will not continue but may discuss alternative services or lines of enquiry at this point the child or young person will be discharged as we have completed our work at this point.

Any re-referrals to the service will require additional supporting information to that wasn’t evident in the initial referral and will be accepted after 6 months.

Once we confirm that a child or young person has ADHD, parents/carers will be invited to attend an ‘ADHD Information Workshop’. Attendance at this Workshop is essential prior to starting medications. We will discuss how we made the diagnosis, different treatment options and provide you with information and links to useful websites and organisations. You will be given a chance to ask any questions you might have to a team member.

If you decide to go for the ‘medication approach’, you will be booked into one of our ‘Medication Initiation Clinics’. This is a clinic where a team member will carry out a physical assessment and discuss the prescribed medication and side effects, they will also let you know when the next follow up appointment should be.

If you do not want medication, then you will be discharged into the care of your GP with information about other services that offer support and guidance around ADHD. The GP can refer your child or young person back in to the same point of the service at any time in the future.

If for any reason you are unable to keep your clinic appointment, please contact the ADHD Team and request to re-schedule. Contact details can be found at the bottom of this page.

Please note

Please note that it is a parent’s / carer’s responsibility to provide up to date contact details and notify us of any changes in these. Otherwise we will be unable to contact you for appointments and the child or young person may be discharged from our service.

Referral form

Please find below the link to our newly launched ADHD online referral platform. This will now be the quickest and most effective method of referral for ADHD, making the referring and tracking progress of referrals easier. Please also find guides below for using the online platform. If you are experiencing any significant problems with the online referral platform, please revert to using the paper referral form as normal.

Online referral platform

The paper referral forms can still be used in the event of a system error on the online referral platform. If you are experiencing any significant errors please use the below link to access the paper form. This referral form can be submitted electronically by saving it into a PDF format and emailing it over to our Booking & Scheduling team [email protected]. Further guidance is attached to the form itself.

Download the Alder Hey Referral Form (64kB)

QbTest information

The QbTest is a clinical, computer-based test for ADHD that objectively measures the three core symptoms: inattention, hyperactivity, and impulsivity. Find out more.