In a fast-paced world brimming with stimuli, maintaining focus and attention can be a challenge for many individuals. For those with Attention Deficit Hyperactivity Disorder (ADHD), this challenge is taken to a whole new level. ADHD is a neurodevelopmental disorder that affects both children and adults, influencing their ability to regulate attention, impulsivity, and sometimes hyperactivity.
The ADHD Clinical Team at Kingsbridge Hospital can help determine its symptoms, causes, diagnosis, and propose management strategies that allow individuals with this condition to excel.
Defining ADHD
ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning or development. It's important to note that ADHD exists on a spectrum, and individuals may experience varying degrees of symptoms. There are three subtypes of ADHD:
- Predominantly Inattentive Presentation: Individuals with this subtype struggle primarily with maintaining attention and organisation. They may seem forgetful, have difficulty following instructions, and often overlook details.
- Predominantly Hyperactive-Impulsive Presentation: This subtype is marked by hyperactivity and impulsivity. Individuals may fidget, interrupt others frequently, and struggle with patience. Children with this subtype are often perceived as "always on the go."
- Combined Presentation: This subtype includes symptoms of both inattention and hyperactivity-impulsivity, which is the most common presentation of ADHD.
Symptoms and Challenges
The symptoms of ADHD can manifest differently based on age, individual personality, and subtype. In children, ADHD might present as difficulty sitting still, frequent forgetfulness, impulsiveness, difficulty with organising tasks, and challenges in following instructions. Adolescents and adults may experience restlessness, difficulty managing time, forgetfulness, difficulty with organisation, and impulsiveness that can affect relationships and work performance.
Individuals with ADHD often face challenges in various aspects of life, including academics, work, relationships, and personal organisation. These difficulties can lead to low self-esteem, frustration, and even mood disorders.
Causes and Neurobiology
The exact causes of ADHD are complex and not entirely understood, but a combination of genetic, neurological, and environmental factors likely contribute to its development. Studies have shown that certain genes related to brain function and neurotransmitter regulation are associated with an increased risk of ADHD. Neurobiologically, ADHD is linked to imbalances in the neurotransmitters dopamine and norepinephrine, which play crucial roles in attention, motivation, and impulse control.
Diagnosis and Treatment
Diagnosing ADHD involves comprehensive assessments by Consultant Clinical Psychology & Consultant Psychiatry. The process typically includes interviews with the individual and their family, gathering information about symptoms across different settings, and ruling out other possible explanations for the behaviours.
Effective management strategies for ADHD often involve a multimodal approach, including:
- Behavioural Therapy: This type of therapy aims to help individuals develop coping strategies, organizational skills, and improved impulse control.
- Lifestyle Adjustments: Creating structured routines, setting up reminders, maintaining a healthy diet, regular exercise, and ensuring adequate sleep can significantly improve symptoms.
- Supportive Environment: Providing a supportive and understanding environment at home, school, or work is crucial for individuals with ADHD to thrive.
- Medication: Stimulant medications, such as methylphenidate and amphetamine-based drugs, are commonly prescribed to manage symptoms. These medications enhance neurotransmitter activity in the brain, improving attention and impulse control.
ADHD Pathway For Children at Kingsbridge Hospital (per NICE Guidelines)
Requirements Prior To Assessment
- Referral from GP outlining concerns consistent with need for ADHD assessment
- A recent school report or school summary of difficulties, available for first appointment or with referral
- Aged 6 to 17 years 11 months.
Diagnostic Pathway
Diagnosis is carried out by a Consultant Child Psychiatrist or a Consultant Child Clinical Psychologist ‘in conjunction with medical assessment by Consultant Paediatrician’ (for patients 14 & under) and involves:
1. Initial Consultation- *(A decision will be made on the rest of the pathway based on the initial (1 hour) appointment)
- A full clinical & psychosocial assessment, which will include all symptoms and behaviours in the different settings in the child’s life AND
- A full developmental (including neurodevelopmental), family and mental health history.
- If evidence suggests ADHD assessment to be pursued, Connors’ Parent and Teacher Rating Scales will be sent to parents to be completed and sent back to the clinic within 3 weeks of the first appointment.
- If evidence suggests ADHD is NOT the correct pathway, the Consultant will charge for the initial consultation ONLY and a summary letter will be provided outlining reasons for decision.
2. Connors Forms Scored & Analysed- Both forms will be scored and analysed before the third appointment (1 HOUR)
3. Medical Assessment by a Consultant Paediatrician (cost £200 – this is included within the total £1,200 package cost).
- For patients over 14 years old no paediatric assessment is required.
4. Third Assessment Session Child And Parents (45/60 MINS)- the third session, approximately 4-6 weeks after the initial, will involve a short interview and direct observation of the child by the Consultant. In addition, final clarification questions will be addressed with parents before giving the conclusion of the assessment- an ADHD diagnosis or not. Brief information will be provided for next steps including support services and future medication (*please note medication is NOT the first line of intervention).
5. A Comprehensive Report will be provided of the assessment results and brief recommendations, sent to GP and parents.
ADHD Assessment & Diagnosis Package Price
- For patients 14 years and under the ADHD Package Cost is £1,200, which includes the Consultant Paediatrician Medical Assessment and QB Check
- For patients over 14 years the ADHD Package Cost is £1.000
Additional Intervention Services
- The Consultant Clinical Psychologist can offer further session(s) for parent; advice/support for their child following diagnosis.
- The Consultant Paediatrician along with the Consultant Child Psychiatrist can offer further appointments to consider medication once other interventions are in place, but symptoms are still causing a persistent significant impairment in at least one domain.
Patient Testimonials
If you would like to book an appointment or require further information on the available options, please do not hesitate to contact our private patient booking team via our online enquiry form.
Alternatively, email Kingsbridge Private Hospital
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