The diagnostic criteria for Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents typically occur before age twelve. In line with NICE guidelines, the symptoms must be consistent across at least two settings, such as school/neutral setting and home.

Inattentiveness

• having a short attention span and being easily distracted
• making careless mistakes – for example, in schoolwork
• appearing forgetful or losing things
• being unable to stick to tasks that are tedious or time-consuming
• appearing to be unable to listen to or carry out instructions
• constantly changing activity or task
• having difficulty organising tasks

Hyperactivity and impulsiveness

• being unable to sit still, especially in calm or quiet surroundings
• constantly fidgeting
• being unable to concentrate on tasks
• excessive physical movement
• excessive talking
• being unable to wait their turn
• acting without thinking
• interrupting conversations
• little or no sense of danger

These symptoms can cause moderate to severe challenges in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with complying to expectations of discipline.

I think my child might have ADHD – what do I do now?

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Step 1

If you are concerned that your child may have ADHD speak to your GP or your child’s school. The conversation should be around any difficulties your child is facing and whether there may be an underlying cause for them that would warrant further assessment. There are many causes of difficulties in a child’s development and the question of ADHD will be considered as part of the whole picture

Your GP, school SENCo or supporting professional can make a referral. Young people cannot refer themselves or parents, but Young people over the age of 16 years can contact their GP for support with a referral if they wish to, however parents will need to be consulted. Looked after child , their guardian will be consulted up to the age of 18 years.

Step 2 (Option 1) NHS Referral – Local

ADHD assessments are completed by the MK CAMHS ADHD team  

Speak to an education, health or social care professional who is involved with your child eg the GP, School SENCO, School Nurse, Social Worker. They will be able to complete an on-line referral for you via the CAMHS website using the referral form. 

GPs already have this form available on their system as an electronic referral. 

Step 2 (Option 2) – NHS Referral – Right to Choose 

The government have also introduced something called “ Right to Choose”. This means that, for instance, should you decide the waiting time for your child’s ADHD assessment in your local area is too long, then you can choose alternative providers.

You can learn more about right to choose in the link below. This will show you the providers located across England, including wait times. Please note there may not be providers based in Milton Keynes. 

Right to Choose - ADHD UK

Step 2 (Option 3) Seeking out a private assessment provider

Long waiting lists and lack of accessibility of Right to Choose throughout the UK means private diagnosis and treatment is a serious consideration for many, despite the financial cost often being a significant sacrifice.  Most private assessment providers do not require a GP or School referral for a Private Assessment.

This is the process if you have been referred through to the MK CAMHS ADHD  service: 

The referral is triaged

All referrals are triaged by the ADHD multi professional team and if accepted for screening further information is requested from school and home. A screening questionnaire (Conners 4) and information pack will be provided for home and school to complete, including space for information about concerns from yourself and from your child. 

Once the questionnaires are received back from yourselves and the school/neutral setting the information is reviewed by the ADHD multidisciplinary Team. If your child meets the criteria for assessment, they will be added to the waiting list for a full ADHD assessment, to await allocation to an ADHD clinician.

 Once the young person is allocated to an ADHD clinician an appointment will be sent to you directly. The appointment will be face to face at CAMHS MK SP.  The ADHD team work hard to be flexible in their assessment approach. If a young person is not attending school, then additional observations can be completed at home or in a neutral setting. The clinician can discuss the additional information required to complete the ADHD assessment during the clinical screening appointment and create a plan on how this can be collated.

 If following review of assessment packs, the team do not feel the criteria for assessment of ADHD is met, they will provide information and signposting to appropriate services for support. Sometimes this may involve being referred to other services to support mental health and well being: How you feel matters or it may involve recommendations for a referral to the Community Paediatrics team to explore other possible causes of your child’s difficulties

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The assessment will usually involve a face to face appointment at the CAMHS clinic in Eaglestone Health Centre. Please find the link to see the department and get a tour from Jess, who uses the service, before you come along.

This appointment looks at all aspects of your child’s development and in particular any areas that they find challenging. It usually lasts between 60 and 90 minutes and will involve questions for yourself and age appropriate questions for your child. In some cases, this may include an observation of your child in their natural environment

The aim of the assessment is to establish whether there is a likely underlying developmental cause for any difficulties your child has and to use the information from the questionnaires that you and the school have already completed. 

This appointment includes a baseline Qb (Quantitive Behaviour) Test .The Qb Test is a computer-based test that combines attention and impulse control measurements. There are 2 different tests, depending on the age of your child or young person and information leaflets on them can be found below.  

Further information can also be found on Qb Test:

Qb Test patient information

Qb Test parent information

When the assessment has been completed, there is a multidisciplinary team meeting to compare the results with the diagnostic criteria (DSM 5).  A follow-up appointment with an ADHD practitioner will be arranged with you to discuss  the outcome of your child’s assessment. This could be on the telephone or face to face.   

If your child is given a diagnosis of ADHD, your clinician will discuss management strategies and changes that can be made at home and school to support your child. CAMHS understand that;

ADHD can significantly affect family dynamics and home life, potentially leading to prolonged stress and increased tension. While all families experience stress, ADHD can heighten these challenges due to potential issues such as disorganization, messiness, disruptive noise and possible emotional outbursts in affected children.

Given the unique nature of each child and their circumstances, a one-size-fits-all solution is not practical. However, the following resource provides strategies and approaches aimed at creating a more calm and harmonious home environment.

Understanding and supporting my child's ADHD booklet. 

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Many families find that having the diagnosis in itself can be very helpful in understanding their child’s difficulties better and how to better support them. Older children often also find the diagnostic process helpful in understanding their own difficulties. It is important to share the report with your child’s school and The CAMHS team have produced a useful guide for schools with information on the reasonable adjustments that schools can make to support your child LINK

Some children with ADHD may benefit from medication. If this is being considered for your child, the benefits and risks will be clearly explained to you and a decision made as to whether your child is placed on the medication pathway 

If a child or young person requires medication for a diagnosis which was not given within Milton Keynes ADHD CAMHS, either privately or by another NHS provider, CAMHS would require a copy of the diagnostic report along with a completed referral form from your GP. The Multidisciplinary Team will then review the report to ensure the assessment has the evidence to meet NICE guidance and criteria for ADHD. Your child will then be put onto the ADHD medications pathway. If your child is already taking medication that is privately prescribed, this will need to continue via the private provider until your child is seen by the ADHD CAMHS team.

Your child will need to be seen by an ADHD Nurse Prescriber for an initial appointment. 

There will also be physical health checks such as blood tests and height/weight. 

Please be aware that there is a waiting time for the prescription of ADHD medications and if you have a private prescription for the medication, you will need to continue this route until your child has been seen by CAMHS and medication has been approved.

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There are lots of great resources and advice online about ADHD and the ones below have been suggested by the MK Parent carer forum, PACA MK.

Online support groups:

Elsa support 

Sibs 

Podcast from ADHDWISE

General ADHD information and advice:

BLMK Healthier Together

ADHDWISE 

ADHDWISE Facebook page 

ADHD Foundation 

Video resources on the MK Local Offer 

ADHD booklet downloadable from ADHD Foundation 

All dogs have ADHD

The Umbrella Gang

https://www.definefine.org.uk

https://missingthemark.co.uk/index

https://www.newboldhope.com

https://www.russellbarkley.org

Zones of regulation, free resources

Supporting sleep from The Sleep Foundation

Supporting sleep from The Sleep Charity

This link was shared by a parent - 20 ways to de-escalate emotional situations

CAMHS have also created a guide for teachers to use for the classroom

This team is based in Eaglestone Health Centre and consists of the following roles:

A psychiatry consultant provides support to young people diagnosed with ADHD, and potentially other co-occurring conditions or challenges. The consultant oversees ADHD assessment consultations and contributes to the diagnostic conclusion.

A specialty doctor plays a key role in multi-disciplinary assessment consultations, supporting young people who require medication to manage their ADHD symptoms.

A non-medical prescriber assists and prescribes ADHD medication for young people diagnosed with ADHD.

A nurse consultant oversees the ADHD assessment process and ensures its efficiency.

Specialist nurses conduct ADHD assessments and collaborate with the multi-disciplinary team to determine each young person's diagnosis.

A specialist support worker administers the QB test and supports young people within the ADHD medication pathway.