Neurodiversity – ADHD (attention deficit hyperactivity disorder) & ASD (Autistic Spectrum Disorder)

 

The information below is designed to allow you to understand neurodiversity and the processes by which you can approach a formal diagnosis and assessment. Please note that whilst these conditions are relatively common, an assessment is only required if it is significantly impacting on daily life.

 

ADHD and ASD: Understanding the Conditions and Seeking a Diagnosis

What is ADHD?

 

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects concentration, impulse control, and energy levels. ADHD symptoms can vary from mild to severe and are generally categorised into two main types: Inattentive and Hyperactive-Impulsive.

 

ADHD affects both children and adults, though symptoms may appear differently in each. Many adults with ADHD may have gone undiagnosed during childhood, as awareness of ADHD has increased in recent years.

 

 

Common Symptoms of ADHD:

 

·         Inattentive Symptoms: Difficulty focusing on tasks, being easily distracted, frequently losing items, and struggling with organisation.

 

·         Hyperactive-Impulsive Symptoms: Restlessness, difficulty staying still, excessive talking, impulsivity, and interrupting others.

 

What is ASD?

 

Autism Spectrum Disorder (ASD) is a lifelong developmental disorder that affects communication, social interaction, and behaviour. It is called a “spectrum” disorder because it encompasses a range of symptoms and abilities.

 

Each person with ASD is unique and may have different strengths and challenges. ASD can sometimes be accompanied by other conditions, such as ADHD, anxiety, or learning disabilities.

 

 

Common Symptoms of ASD:

 

·         Communication and Social Challenges: Difficulty understanding nonverbal cues, trouble forming relationships, and challenges with verbal communication.

 

·         Behavioural and Sensory Differences: Preference for routine, strong interest in specific subjects, sensitivity to sensory stimuli (e.g., loud noises or bright lights).

 

Seeking a Diagnosis for ADHD and ASD in the UK

 

1.      Talk to Your School team to request a referral – if <18 years old

 

·         Often referrals from schools or community groups can help provide more supporting information to help with a diagnosis. Referral forms can be found on CAMHS website. Attention Deficit Hyperactivity Disorder (ADHD) – CAMHS and Hampshire and IOW - The Owl Centre for ASD

 

2.      NHS Pathway for Diagnosis

 

·         ADHD: An ADHD diagnosis typically involves a detailed assessment of symptoms, a medical history review, and may include input from people close to you, such as family or teachers. This process is usually managed by a specialist in mental health or neurodevelopmental conditions. The provider in Hampshire is PHL ADHD Service - PHL Group Ltd

 

·         ASD: An ASD diagnosis is usually conducted by a multidisciplinary team. The assessment often involves interviews, questionnaires, and observing behaviours. The provider in Hampshire is OWL Hampshire and IOW - The Owl Centre

 

·         Wait Times: NHS assessments can have long waiting times, sometimes up to several months or years. 

 

·         Right to Choose - patients have the right to choose a provider that has a contract with an NHS body. An up-to-date list of these is on the ADHD UK website Right to Choose - ADHD UK.  Please seen further detailed information about this process below.

 

 

3.      Private Diagnosis Options

 

If wait times for an NHS assessment are too long, you may consider a private diagnosis. Private assessments can be more costly, but they may offer faster access to support. Private healthcare providers and clinics in the UK often offer ADHD and ASD assessments, but it’s essential to choose a reputable provider with experience in diagnosing these conditions.

After Diagnosis: Available Treatments and Support

Once diagnosed, several options can help manage ADHD or ASD symptoms and improve quality of life.

 

ADHD Treatment and Support

 

·         Medications: Stimulant medications (e.g., methylphenidate) and non-stimulant medications (e.g., atomoxetine) can be prescribed to help manage ADHD symptoms. These medications must be prescribed and monitored by a specialist.

 

·         Behavioural Therapy: Cognitive behavioural therapy (CBT) and other behavioural therapies can help with organisational skills, impulse control, and social challenges.

 

·         Lifestyle and Support: Regular exercise, a structured routine, and support with organisational skills can make a significant difference. Support groups like ADHD UK and ADDISS provide resources and community connections.

 

ASD Support and Interventions

 

·         Therapies: Speech and language therapy, occupational therapy, and behavioural interventions can help manage communication and social skills, as well as daily living skills.

 

·         Educational Support: Many children with ASD qualify for additional support in school through an Education, Health, and Care (EHC) plan, which can provide tailored support to meet their needs.

 

·         Support Groups and Charities: Organisations like The National Autistic Society (NAS) and Ambitious about Autism offer resources, helplines, and community support for people with ASD and their families.

 

Other resources, to help effectively manage symptoms of ASD & ADHD, give guidance and offer local support include:

 

love the way I am

 

ADHD (attention deficit hyperactivity disorder): What Is It?

 

Support Groups | The UK ADHD Partnership

 

Brain In Hand > Personalised Digital Support for Neurodivergent Needs

 

Parents & Carers – CAMHS

 

IMPORTANT INFORMATION ABOUT THE RIGHT TO CHOOSE PATHWAY 

   

There are some things you need to be aware of regarding the Right to Choose (RTC) pathway.

 

 

You may be seen sooner under the RTC programme, but the provider may not be suitable for a Shared Care agreement with the GP and the GP practice would not be able to issue the medication. Shared care is a contract between the ADHD service and the GP where the GP prescribes the medication, and the specialist provides the monitoring required both for the condition and for the safe prescribing of the medication.

 

The GP practice will consider Shared Care Prescribing if this in line with our locally agreed guidelines and with a RTC provider (one that has an existing NHS contract).

 

If the RTC provider do not meet these requirements, your prescriptions will not be able to be provided by the GP practice but the specialist is likely to be able to prescribe and monitor this for you so it doesn’t mean that you cannot continue with the assessment.

 

The requirements of a Shared Care Agreement agreed locally in Hampshire are outlined in the following letter which you can use to approach RTC providers before requesting a referral.

One important component of the agreement is that ALL PHYSICAL MONITORING is carried about by the RTC provider and not the GP practice.

 

 

If you would like a referral, please get in touch with the practice and speak to our referrals team who can send/discuss with you the required paperwork.

 

 

Below is a right to choose provider form, please copy & paste and fill out where necessary:

 

 

 

Right to Choose Provider – Shared Care Enquiry

 

Dear Provider 

 

I am seeking a Right to Choose referral for ADHD assessment. My GP will agree shared care for ADHD medications if the below conditions are met. Please can you confirm that you are able to meet these requirements: 

 

Requirements from Provider (must be met for shared care to be agreed):

·         Conduct baseline investigations prior to initiation. These are set out in section 8 of the shared care guidelines for the relevant drug: methylphenidate, dexamfetamine, lisdexamfetamine, atomoxetine, guanfacine. These are also available via https://tinyurl.com/shared-care     ·         Refer directly for further tests or speciality opinions where needed for the initiation or continuation of medication.    ·         Counsel the patient appropriately on the medication to enable informed consent on prescribing.    ·         Ensure the patient knows that failure to attend monitoring or treatment review will result in discontinuation of the drug.    ·         Initiate and titrate medication until the patient has been stabilised for at least 4 weeks. Then complete the shared care documentation and send to the patient’s practice detailing the diagnosis, brand to be prescribed, dosage, relevant test results (for GP information only), when the next monitoring will take place and direct access contact information for GP queries.    ·         Conduct the required monitoring (as described above) and communicate the results to primary care. This monitoring, and other responsibilities, must be carried out by a healthcare professional in secondary care with expertise and training in ADHD.    ·         Resume prescribing where the patient is a woman who is, or wishes to become, pregnant.    ·         Provide advice to primary care when required.    ·         Continue prescribing in the event that the practice withdraws from shared care arrangements.

 

Once you have confirmed that these requirements can be met for shared care, I will request referral to your service. Please note, GPs are not obliged to accept shared care and may serve notice at any time following acceptance of a shared care agreement. 

 

Yours sincerely