Attention Deficit Hyperactivity Disorder (ADHD)
Children with ADHD present with different problems. Most commonly (ADHD), they are noisy, non–stop hyperactive, easily distracted and distracting of others. They find it hard to settle, often fail to reach their potential at school, and find it difficult to rein in their emotions. These children can often ‘hyperfocus’ on things that give a lot of stimulation such as mobiles, tablets and gaming devices, but find it extremely difficult to sit still and concentrate, especially if they struggle with the subject anyway. However, not all are hyperactive and noisy. Certainly, those symptoms are the commonest, but children with the predominantly inattentive (poor concentration type – ADD) can be quiet, day dreamy and in a world of their own much of the time. You can imagine how this affects school performance, but they can easily be missed as they are rarely disruptive. Some children have friendship problems. They are fun to be with, but other children can tire of them as they don’t know when to stop, stick at the rules of the game poorly, and can be unnecessarily silly.
Young people have less obvious hyperactivity than younger children but often describe themselves as feeling restless and unsettled. If ADHD has not been diagnosed by teenage years, a young person’s self esteem can be in tatters, along with exam prospects. It’s not too late to help though and young people in their 20’s seek advice and diagnosis from Healthcare4Kids.
Children with suspected ADHD or the inattentive form ADD (Attention Deficit Disorder) need a very careful clinic assessment, along with essential in-depth home and school questionnaires and other information. The detailed feedback of teachers who knows the child well is far more helpful than a brief ‘snapshot’ observation by a professional. The diagnosis may only be made by a Paediatrician, Child Psychiatrist or Specialised Nurse (working as part of an ADHD Team) as accurate diagnosis is essential.
National guidelines and international research have found medication to be first–line treatment for those who are impaired by their ADHD/ADD, but this must be combined with consistent, firm and caring parenting.
At Healthcare4kids, we have qualified clinicians to assess, diagnose and treat ADHD and ADD, and have many, many years of experience. We also assess for other conditions frequently existing alongside ADHD, as solving half the puzzle is not enough to help a child flourish. We can also provide long term follow up in conjunction with your GP and ensure that school staff understand how to help your child.
Children and young people with Autistic Spectrum Disorder (ASD) can have variable difficulties with speech and language, social ability, and friendships, play skills, inflexibility, sensory issues and anger. These problems are often more pronounced at home in comparison to school.
Diagnosis should be given if it helps the child understand themselves and their strengths and weaknesses, if it helps others to understand that child without allocating blame, and if it helps the child get help such as special educational provision and help in exams. Autistic Spectrum Disorder often occurs with other specific difficulties and medical conditions such as ADHD and Dyspraxia, and it is essential to see the child as a whole and look for anything that can be improved.
Healthcare4kids runs a private Autistic Spectrum Disorder diagnostic service (including the subtype Pathological Demand Avoidance and High–Functioning Asperger’s Syndrome). We see Pathological Demand Avoidance as a subtype of ASD, sharing many similarities but being distinctly different and importantly, with a different management approach. Many CAMHS teams do not seem to accept PDA as a diagnosis, but PDA has a full page on the national ASD umbrella organisation National Autistic Society website. Distinction between PDA and ASD allows the correct management strategy to be adopted and for ‘disobedience’ to be seen as demand avoidance, thus understanding the intentions and needs of the child better.
National guidelines require an assessment by at least two appropriately experienced and expert professionals, one of whom should be a Paediatrician or Child Psychiatrist. Our joint approach complies with the most recent national standards. Dr Jo Jones has been working at a senior level in this area since 2003. Unlike the vast majority of diagnostic teams who do not contain a Paediatrician, her experience as a Paediatrician enables her to also assess for the cluster medical conditions that often accompany autism, such as ADHD and Dyspraxia, as well as spot but not diagnose specific learning difficulties, and to optimise any medical conditions. Jo can accurately assess a child in the context of a pre-existing medical condition such as visual impairment, epilepsy, ex prematurity or a chromosomal syndrome rather than make often-inaccurate assumptions, as non-medically trained professionals are sometimes at risk of doing, and she has a robust understanding of a child’s physical health as well as their mental health. This, and the ability to assess for cluster conditions, means that the child is fully ‘understood’.
At Healthcare4kids, we do the assessments in a particular way, as that is how we’ve found that we can achieve a responsive, speedy and efficient service without losing any accuracy. We have the experience and expertise to spot even the most subtle cases, often missed by standard diagnostic teams working to tight and sometimes inflexible agendas. It is important to note that ‘subtle’ does not equal ‘mild’, and undiagnosed children and young people often present in their late childhood and teens with anger, anxiety and depression, without an understanding of what is actually driving those destructive emotions that arise from having to cope with their poorly understood difficulties. We liaise with schools, maximising understanding, and are happy to continue to work with a child and family after diagnosis, as separate and additional work, in order to offer support and understanding of both the child’s needs and also, more holistically, those of the family including siblings.
We also screen for Attention Deficit Hyperactivity Disorder (ADHD and ADD). We have 30 years of experience in ADHD. Approximately 30–40% of children with ASD/Asperger’s have ADHD, so it is not something to be missed. We also look at other possibly associated conditions such as Dyspraxia, Specific Learning Difficulties (SLD) (although we can raise suspicions about the latter, we are not qualified to actually assess for SLD such as dyslexia, dyscalculia and dysgraphia), Tourette’s and Obsessive Compulsive Disorder (OCD). We look for Sensory Processing difficulties as these are quite common, especially in ASD.
Behavioural problems (moderate to severe)
Parents want to feel that they are in control of their children without being unnecessarily strict. It’s great to be able to go out for lunch with confidence that everyone will have a good time, including Mum and Dad! If everything with your toddler, child or teenager seems like a battle, no-one has a good time.
I use proven behavioural techniques to help parents feel in control at home and out and about, no matter how severe the problems are. This benefits the whole family.
I’ll make sure that any possible uncommon underlying conditions such as ADHD (Attention Deficit Hyperactivity Disorder), Autism or Learning Difficulty are considered, and can help you if I diagnose them. I may refer to my colleague, a highly experienced Child Psychologist, for more in-depth work if necessary.
Motor delay and Cerebal palsy
Cerebral palsy affects a child’s brain and therefore their development. It ranges from mild disability that does not hold a child back in life to severe problems with all aspects of a child’s health and development. Children and parents may need a huge amount of extra help and resources, and the children often need very careful monitoring from different health professionals.
I have a great deal of experience in diagnosis of and working with children with cerebral palsy and similar conditions, to make sure they achieve their very best.
I have a great deal of experience in working with children with different degrees of cerebral palsy, and similar conditions, to make sure they achieve their very best. Working holistically, I concentrate on all needs as well as physical symptoms. Where necessary, I work with my colleagues in Physiotherapy, Speech and Language Therapy and Occupational Therapy to provide the best possible assessment and treatment for your child.
I may recommend however that your child is best looked after long term by your local Child Development Centre.
Development problems (moderate to severe to generalised)
When does a ‘late’ walker or talker actually have a problem? Sometimes, a careful assessment followed by reassurance is all that is needed. At other times, a comprehensive assessment is essential to ensure that your child receives all the help necessary to achieve their best in life.
I’m qualified to assess anything from minor speech and language delay or delay in walking, through to more complex or severe general delay. I may need to arrange blood tests or scans to make sure that any underlying cause is looked for.
Sometimes, I work with specialised colleagues in fields such as Physiotherapy, Speech and Language Therapy and Occupational Therapy. Together, we can speedily assess your child and start accurate, effective treatment if a significant developmental delay is suspected which is unlikely to sort itself out on its own.
I can also liaise with Education to make sure that any disability, no matter how small, is taken into consideration.
Epilepsy can show up as strange movements, ‘blanks’ or funny spells. Other causes such as heart problems or psychological problems can look like epilepsy.
Diagnosing epilepsy is complicated and can have serious consequences if mistakes are made. Children need assessment from an experienced doctor trained specifically in childhood epilepsy so that the diagnosis is not missed, or equally importantly, not made incorrectly.
My considerable experience and higher qualifications qualify me to treat children with mild to moderate epilepsy according to national ‘best practice’. Those with complex epilepsy should be looked after by an Epilepsy Specialist such as those at Birmingham Children’s Hospital.
Global Development Delay
A child who seems far behind other children of a similar age always causes great concern. For some children, there is an underlying cause which needs to be examined, but many children will have lots of tests without an eventual diagnosis.
The most important thing is to make a full assessment looking at the child as a whole. I’ll look at all aspects of their health, development and behaviour, involving my colleagues in Speech and Language Therapy, Physiotherapy and Occupational Therapy where necessary. Any other necessary therapists can then be involved to make sure that advice and treatment is of the very best.
I have the experience to assess your child holistically when you are concerned that they are not achieving what you expected. I’ll look at all aspects of their health, development and behaviour, involving my colleagues in Speech and Language Therapy, Physiotherapy and Occupational Therapy where necessary. We will work with you to help your child reach their full potential.
We all want our children to do as well as possible at school. Children who struggle academically lose confidence and self–esteem. An important task is to make sure they are proud of themselves and can do other activities that they feel they can succeed in.
I’ll assess your child holistically to make sure that any underlying causes have been looked at. I can work closely with school and the Local Authority to ensure that your child receives the help they need to achieve their very best. I may refer you to expert Educational Psychologist colleagues whose work I know well and who have expertise in cognition, processing, specific learning difficulties such as dyslexia etc. This will make clear what your child is capable of, and also what can be done to then help them achieve their true potential. Please note that whilst I can spot cognitive problems and specific learning difficulties, I am not qualified to formally assess.