Frequently Asked Questions

People are very much encouraged to speak to the LANC staff if they have concerns about the assessment or would like to clarify questions.

This is certainly not the case. The LANC staff always go to great lengths to ascertain whether or not a child or adult has AD/HD, whether he or she meets the criteria and whether there is significant impairment. The clinic is also careful to assess associated complicating and coexisting conditions. If the staff feel that a child has reasons to explain the symptoms other than AD/HD or Asperger’s Syndrome etc., then that will be clearly stated and appropriate support given.

In years gone by, broader, non-medical diagnoses, such as Asperger’s Syndrome, dyslexia etc. were made, which often failed to recognise the coexistence of AD/HD. There has been a very strong trend in recent years to split the diagnosis up and recognise that many conditions coexist, rather than using diagnoses that tend to lump symptoms together, such as dyspraxia, dyslexia, Asperger’s Syndrome.

One of the concerns about the over-diagnosis of Asperger’s Syndrome in the past for example has been that it precludes the diagnosis of AD/HD rather than recognising the frequent association of these conditions and it has generally been a nice, safe diagnosis where the possibility of the use of medication to strengthen concentration or help with impulse control is therefore also precluded.

A comprehensive assessment is always done to ascertain whether or not a child has ADHD and/or related neurodevelopmental difficulties. There are very clear criteria for making a diagnosis of  ADHD and such a diagnosis will not be made unless these are clearly met. The assessment also carefully evaluates the presence of any other associated difficulties such as Conduct Disorder, dyslexia, autistic spectrum difficulty etc.

A diagnosis of AD/HD in no way automatically assumes that medication would be considered. A decision on this is always up to the parents and child, if appropriate, or the adult being assessed. A careful explanation of the risk profile, the possible benefits and side effects is made and if medication is started it is always for an initial trial period.Educational and behavioural strategies are always important.

AD/HD is an internationally recognised condition for which there are clear guidelines both in the USA and Europe (European Guidelines for Hyperkinesis; NICE Guidelines 2008 – www.nice.org.uk ). It is also a recognised disability. It is very much part of the special needs spectrum and must be considered in effective provision of children’s and adult mental health services and in educational services.

There has been an inordinate amount of pseudo-controversy about AD/HD, however, it is critical to appreciate the reality of AD/HD and its treatability, given the very serious negative impacts it can have on a child and family. I have recently seen the Panorama programme – read the tabloids on AD/HD and I am concerned that the side effects of medication have been mentioned. It is important to keep the side effects in perspective and recognise that most tabloids are out to create a hyped up story.

There is absolutely no doubt that the reality of ADHD and its impact on the child and family have tended to be very significantly under-rated in the press, whereas the alleged side effects of medication have been exaggerated. As with any medication there can be some short term side effects, especially involving appetite suppression or sleep difficulty, but there is no evidence of long term side effects with the use of such medications. Any medication for any medical condition can have possible side effects. The issues around medication must always be placed in context relative to the complications of having untreated ADHD and related neurodevelopmental difficulties. ADHD is an extremely treatable condition.

It is not up to teachers to decide whether or not medication is appropriate. The clinic requests information from teachers and it is essential to know exactly what the child is doing and how he/she is behaving in the classroom. However, it is not up to teachers to either make a firm diagnosis or to decide on medication.

That is part of the comprehensive assessment in which teachers take part, but the final decision is made jointly between the family and the clinical specialist.

The LANC runs a seamless service with transition from childhood to adolescence. The adolescent and adult clinic Link to Adult assessment page is collated by Mr Nigel Humphrey, our Clinical Psychologist, Mrs Brigit Solomon, ADHD Specialist Practitionerand Dr Sanjay Jain, Consultant General Adult Psychiatrist. It is clearly recognised now that at least 80% of children with AD/HD transition with the problems through into adulthood. The LANC is very aware that the transition period from leaving school and getting into a career pathway can be extremely difficult for those with AD/HD.

Frequently we find that one or other parent discovers, as part of the assessment process on their child, that he or she might have ADHD and need an assessment themselves. Prescribing issues are generally managed well by GP’s these days. There is increasing recognition in clinical experience, international literature, by the 2008 NICE report, and also by the British Psychopharmacology Association, that AD/HD is a condition of adulthood. The majority of GPs are now supportive of prescribing in these circumstances.