ADHD is a condition characterised by the three “core” symptoms of hyperactivity, inattention and impulsivity. Some children may be predominantly hyperactive and impulsive and some may be predominantly inattentive. ADHD affects around 5% of school age children in the UK. When considering the diagnosis, the symptoms must be present in two or more settings (usually home and school) and have a significant impact on the child’s life such as their social, emotional, psychological and educational functioning when compared to children who do not have ADHD.
ADHD in children often co-exists with other conditions such as Autism Spectrum Disorder, conduct problems, anxiety, depression, learning difficulties (including dyslexia) and difficulties with coordination and movement (dyspraxia or “DCD”).
If ADHD is not diagnosed and treated it can go on to have serious effects on a child’s social and emotional wellbeing, underachievement at school and cause significant family stress and disruption.
We offer the following ADHD assessments for children at the Centre:
ADHD Diagnostic Package
This assessment is carried out by two health professionals, one of our experienced Psychologists and one of our Child and Adolescent Psychiatrists. Information from school will be collected and evaluated prior to the assessment, including Conners questionnaires. These questionnaires are specifically designed to look for the key features of ADHD and also assess the possibility of other “co-existing” conditions which may be present. A thorough developmental history and interview with the parents/carers is carried out, as well as a QB Check (a computerised assessment for ADHD). We also complete a detailed cognitive assessment for your child, to look for any specific learning difficulties. If a diagnosis of ADHD is made, a full explanation will be given and advice regarding further management, including medication, which can be started on the same day.
A full written report is produced for all patients.
Cost of ADHD assessment £1450
Combined ADHD & Autism Diagnostic Package
In view of the fact that ADHD and Autism often overlap with other conditions, we also offer this more comprehensive package which would be recommended for children who may have more complex difficulties. The assessment is carried out by two clinicians, one of whom will be a Child and Adolescent Psychiatrist. Prior to the appointment, questionnaires will be sent out to home and school and as much information as possible is gained from other sources. These screening questionnaires are scored in advance of the appointment and are useful tools for assessing the possibility of ADHD, Autism and a number of other related conditions which may “co-exist” with ADHD and autism.
The assessment itself takes around three and a half to four hours and includes an ADOS-2, developmental history, QB Check and a cognitive assessment. The cognitive assessment measures intellectual ability and includes assessment of comprehension, reasoning, working memory and processing speed. Difficulties in some of these areas are sometimes seen in children with ADHD/Autism and if identified, measures can be put into place in school to help your child. The ADOS-2 (Autism Diagnostic Observation Schedule) is a semi-structured assessment of communication, social interaction and play (or imaginative use of materials) carried out with your child, and the developmental history is a structured interview with parents, concentrating on early development and current behaviours. QB Check is a computerised test which adds to the ADHD part of the assessment.
We will also explore other possible diagnoses that may have been highlighted or observed. Feedback is given at the end of the session and a comprehensive report is produced with a detailed explanation of the findings and future recommendations. A follow-up session is also included, in order for you to go through the report and ask any questions.
Cost of Assessment £2400
If your child is given a diagnosis of ADHD, there is a possibility that medication may be appropriate. This will be fully discussed with you at the end of the assessment (unless this is something that you definitely do not want to pursue).
NICE (National Institute of Clinical Excellence) guidance is that children and young people over 5 years old should be offered medication if their ADHD symptoms are still causing a persistent significant difficulties after environmental modifications (at home and school) have been implemented and reviewed.
Most ADHD medications are classed as “controlled drugs” and need to be closely monitored. They must be initiated and reviewed by a specialist until a suitable dose has been reached, at which point we can then ask your GP if they would be happy to prescribe. We have a “shared care” agreement with GPs which states that we will continue to review patients at least 6 monthly thereafter.
If, following a diagnosis you would like to commence medication for your child, we are able to issue an initial prescription, provided you agree to the following treatment package, which includes:
• Initial prescription*
• Email contact after 7-10 days to review response to medication and dose adjustment if appropriate
• Two further non-face to face contacts (email or phone call, up to 15 minutes)
• Two follow-up appointments, lasting 30 minutes each. The first appointment will be 4-6 weeks after starting medication and the second, within 4-8 weeks of the first follow-up (depending on individual circumstances)
• All prescriptions required until second follow-up appointment*
• Writing and sending all consultation letters to you and your GP
• Writing and sending a Shared Care Agreement to your GP and asking them to share care with us (provided your child is stable on their medication at this stage. If this is not the case, further appointments may be required)
*Please note that the pharmacist will charge for the medication supplied and this cost may be between £25 to £150 depending on the medication issued.
This medication package covers up to a maximum of 16 weeks from the date of your first prescription
Cost of medication package: £650, which is payable before your second prescription is issued.
If your GP is able to share your care with us once medication is stabilised, the frequency of further follow-up appointments will depend upon the complexity of the case and parental request, but will be at least 6 monthly.
Cost of a follow-up appointment £225
New patient appointments
We appreciate that some patients may already have a diagnosis of ADHD but would like to visit the clinic for a second opinion or advice regarding management/medication. In these cases we would attempt to gather as much information as possible from your GP or consultant and offer a longer appointment in order to thoroughly review all of the information before offering advice.
Cost of a new patient appointment £325-£495 (60/90 minutes)
QB Check is a computerised assessment lasting 15-20 minutes and is an aid to the diagnosis of ADHD. The child is asked to respond as quickly and accurately as possible to certain shapes appearing on a computer screen by pressing the spacebar on a computer keyboard. As they perform the task, a camera located above the computer screen records their activity during the assessment.
The assessment is able to record movement, rating levels of hyperactivity, as well as readings which give an indication of the degree of inattention and impulsivity. It has been shown to be a very accurate assessment for ADHD when used in addition to the clinical interview and can also be used to assess response to treatment.
Cost of a QB Check plus written report £295