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ADHD
What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects how children and young people pay attention, manage their activity levels and control impulses.
ADHD is not caused by parenting and is not something children grow out of by “trying harder”. It can affect children and young people in different ways and may change over time.
How ADHD may affect children and young people
Children and young people with ADHD may experience difficulties with:
- Sustaining attention or concentrating
- Managing activity levels or restlessness
- Impulsivity, such as acting without thinking or finding it hard to wait
- Organisation, planning and following instructions
- Emotional regulation, including becoming upset or frustrated quickly
Difficulties may present differently at home, in school or in other settings.
Strengths associated with ADHD
Many children and young people with ADHD also have strengths. These may include:
- Creativity and problem-solving skills
- High energy and enthusiasm
- Determination and persistence
- Thinking differently and offering new ideas
Support should focus on reducing barriers while also recognising and building on strengths.
When to seek help or advice
You may wish to seek help or advice if difficulties with attention, behaviour or emotional regulation are affecting a child or young person’s learning, wellbeing or day-to-day life.
Start by speaking to one of the following:
- Your child’s health visitor
- Their teacher or school’s special educational needs co-ordinator (SENCO)
- Any health or care professional that knows your child well
Support can be put in place based on a child or young person’s needs and does not require a diagnosis.
Parents, carers, schools and settings do not need to wait for an assessment outcome before offering support.
Did you know?
Bromley Children Project (BCP) offers a wide range of free parenting courses and online seminars, designed to build confidence and support positive parenting approaches. These include courses that support parents of children with ADHD type behaviours, attention difficulties and challenging behaviour, helping families develop practical strategies and improve communication and relationships at home.
Discover Bromley Children Project’s parenting courses. Read the flipbook.
ADHD referral and assessment
The ADHD service supports children and young people in Bromley who are over 6 years old and experiencing difficulties with attention, concentration, or behaviours associated with ADHD.
Before a referral can be made for children aged 5 to 6, parents or carers are required to attend one of the many parenting courses offered through the Bromley Children Project (BCP).
Making a referral
Referrals should come from your child’s school or education setting and include:
- A referral letter, outlining the school’s concerns
- A completed Vanderbilt ADHD Diagnostic Rating Scale (VADRS) questionnaire from both parents/carers and school
- A completed school ADHD report form
Your child’s school can access these documents on the Bromley Education Matters website.
If your child is not currently in school, observations can be provided by another professional involved in your child’s care (e.g. speech and language therapist, educational psychologist, behavioural therapist, tutor, music teacher, or youth group leader, etc). These observations should describe the difficulties your child is experiencing.
How is the assessment pathway decided?
All referrals for ADHD, autism and other neurodevelopmental concerns are reviewed by a senior clinician. The clinician reviews the information provided and decides which assessment pathway is most appropriate for your child.
Based on the information available, referrals may be identified as:
- ADHD
- Autism (ASD)
- A combined ADHD and ASD assessment
- Another neurodevelopmental need that requires a different assessment approach.
The clinician will consider the range of your child’s needs and whether they would benefit from a specialist assessment pathway. Some children may require a more detailed assessment because of additional developmental needs or other factors that may affect their development.
This helps make sure your child receives the most appropriate assessment and support.
What happens during the assessment?
The assessment may include:
- Discussion about your child’s development and current needs.
- Information from parents, carers, schools and other professionals.
- Consideration of whether ADHD, autism (ASD), or both should be assessed.
- A physical examination where clinically indicated.
Following the assessment, families will receive feedback, recommendations and information about any next steps, including support, further assessment or treatment where appropriate.
FAQ: Assessment pathway changes
Autism and ADHD Assessment Pathway Changes
Information for parents and carers.
Why is the pathway changing?
The number of children referred for autism and ADHD assessment has increased significantly in recent years. This reflects a greater awareness and improved understanding, so more children who may benefit from assessment are being identified.
As a result, waiting times have increased. We are improving how the service works so more children can be seen sooner, while maintaining safe, high-quality care.
What is changing?
We are introducing a revised way of assessing children and young people.
All referrals will still be reviewed by senior clinicians, but children may now be seen by different professionals depending on their needs.
This includes trained clinicians who specialise in child development, as well as doctors.
Who will assess my child?
Your child will be seen by a clinician with the right skills and experience for their needs. This could be a doctor or another professional who specialises in working with children and young people.
All clinicians work as part of the same team and follow the same clinical standards.
Will my child still see a doctor?
Some children will be seen by a doctor, and some will be seen by another trained clinician, depending on the outcome of the initial assessment and complexity of their needs.
Doctors remain involved in the pathway. They review referrals, support clinical decisions, and see children where medical input is needed.
What does this mean for my child?
- Your child will still be assessed if they meet the criteria
- They will be seen by the most appropriate clinician
- The pathway aims to reduce delays where possible
- Children with more complex needs will continue to receive specialist care
How are decisions made about my child?
All referrals are reviewed by experienced clinicians.
Decisions are based on available information, including input from parents, schools and other professionals, as well as questionnaires and developmental history.
Will this affect the quality of the assessment?
No.
All assessments follow national clinical guidance and the same clinical standards.
The pathway includes senior clinical review, and doctors remain involved where needed. This helps ensure assessments are safe and consistent.
What happens next?
- Your referral will be reviewed through the new pathway
- We will contact you when your child progresses to the next stage
Support while waiting
You can get support from:
- Your child’s school or SENCO
- Your GP
- Local support groups
Please contact us if you need guidance.
Contact us
bromh.cypqueries@nhs.net
0300 330 5777
Why might my child need treatment or additional support?
ADHD can affect different areas of a child or young person’s life, including learning, friendships, emotional wellbeing and self-esteem.
If you child is diagnosed with ADHD, the doctor may discuss treatment or additional support when difficulties:
- Are having a significant impact on daily life
- Continue despite support already in place
- Are causing distress to the child or young person
Treatment does not mean there is “something wrong” with your child. The aim is to reduce barriers, support wellbeing and help them reach their full potential.
Treatment and support may include:
- Parenting groups or workshops to help manage challenging behaviours
- Medication depending on the severity of the condition
ADHD treatment and medication; what parents and carers need to know
Not all children and young people with ADHD will need medication. Where medication is considered, it is usually one part of a wider support plan, alongside strategies at home and in school.
Important points to know:
- Medication is only prescribed following a specialist assessment
- Decisions are made jointly with parents, carers and (where appropriate) the child or young person
- Medication is regularly reviewed and monitored by health professionals
- Families can ask questions, raise concerns and review decisions at any time
Medication aims to help some children manage symptoms such as attention, impulsivity or hyperactivity. It is always optional, and families should be supported to make informed decisions.
Supporting your child or young person at home (tips for parents and carers)
Many children and young people with ADHD benefit from consistency, structure and clear expectations. Strategies that may help include:
Create a structured environment
- Establish clear routines and set consistent rules to provide a sense of order.
- Use checklists or visual charts to help your child stay organised.
Help them manage energy levels
- Encourage physical activities that allow them to burn off excess energy, such as sports or outdoor play e.g. trampolining, use of a treadmill.
- Include regular breaks during homework or tasks that require focus.
Break down tasks
- Divide larger tasks into smaller, more manageable steps.
- Use timers or apps to help your child stay on track and complete tasks within a set time frame.
Promote positive behaviour
- Use a reward system, such as a sticker chart, to reinforce good behaviour and effort.
- Focus on praising achievements and progress, rather than highlighting mistakes.
Limit distractions
- Create a quiet workspace for homework or reading, free of unnecessary distractions such as a TV or noisy gadgets.
- Use tools like noise-cancelling headphones or fidget items to help your child stay focused.
Supporting children and young people in early years settings and schools
Early years settings and schools can adopt various strategies to help children with any type of special educational need and this is not reliant on either a diagnosis or an education, health and care plan (EHC plan, often referred to as an EHCP). The SEND code of practice provides statutory duties and guidance for school to follow.
Schools in Bromley have access to a SEN tool kit and support from the Inclusion Support Advisory team (ISAT) and the SEND Advisory Team (SENDAT). Some examples of what schools may put in place as reasonable adjustments and where a diagnosis is not needed, are:
Movement breaks
- Allow frequent short breaks to help the child release excess energy and refocus.
Seating arrangements
- Place the child in a low-distraction area, such as near the teacher or away from windows and doors.
Chunking tasks
- Break down tasks into smaller, manageable steps and provide clear instructions.
Positive reinforcement
- Use reward systems like sticker charts to motivate and reinforce good behaviour or task completion.
Fidget tools
- Provide sensory tools such as stress balls or fidget toys to help maintain focus.
Support should be reviewed regularly and adapted as needs change.
Working collaboratively with your child's education setting
Building a positive relationship with your child’s nursery, preschool or school can make a big difference. You know your child best, and working together helps ensure they get the right support at the right time.
Who to speak to
When you know what education setting your child or young person will attend, it’s important to make contact early. You can speak to the SENCO about your child’s or young person’s needs. Starting these conversations early helps the setting understand your child’s needs and plan the right support to give them the best possible start to their education.
What is a SENCO and how can they help
A SENCO (Special Educational Needs Coordinator) is a member of staff responsible for making sure children and young people with additional needs receive the help they need.
They are your point of contact and can help:
- the identification of children and young people with special educational needs
- planning and reviewing support (such as SEN support or individual plans)
- putting support in place, including interventions or resources
- working with you to make sure your child is receiving the right help for them
- linking with other professionals, such as educational psychologists
A SENCO’s role is to help develop ways of overcoming barriers to your child’s or young person’s learning so they can thrive.
Find advice on how to speak to your SENCO on Scope’s website.
When to get in touch
It’s helpful to contact the SENCO as early as possible if:
- You think your child may have additional needs
- Your child already has a diagnosis
- Your child is starting or moving to a new setting
You can ask about:
- Support plans (for example SEN support or IEPs)
- Extra help in class or small group work
- Specialist support or interventions
- Support for exams (for older children), such as extra time or a reader
Try to keep conversations open and collaborative. You and the setting are working together to support your child.
How to prepare for a conversation
It can help to write down a list of things you have noticed to help you feel more confident.
This could include:
- what you have noticed about your child’s learning or development
- any concerns you have
- what other people (such as nursery staff or health professional) have said
- what works well at home
- any difficulties your child or young person experiences outside of their education setting
You could also ask:
- What support can the setting offer?
- What can you do at home to help?
Top tips for working with your education setting
- Keep a record of emails, meetings, reports and agreed actions
- Ask for information in writing if you are unsure
- Be open and honest about your child’s needs
- Remember that your knowledge as a parent or carer is important
- Work in partnership with the setting
There is useful guidance on how to communicate with education settings on the Information, Advice and Support Service (IASS) webpage. Visit the IASS website.
ADHD and SEND support pathways in Bromley
Children and young people with ADHD may be supported through:
- Ordinarily available provision
- SEN support in early years settings and schools
- An education, health and care (EHC) needs assessment, where appropriate
Local support groups in Bromley
- Bromley Mental Health Hub: Supporting mental health of children, young people and their families.
- Bromley Y: Support with emotional wellbeing and mental health for children, young people and their families.
- CANDI (Creative And Neuro-Diverse Innovations): Providing opportunities for volunteering, employment, training, socialising, communication, and confidence building for the Bromley area neurodiverse community.
- Destiny Children & Family Support Group: Provides creative social activities for children with special educational needs or disabilities, and a support group for families with children who have autism, ADHD, speech and language, social, emotional, or other special needs.
- Rhiannons Café: Staffed by a neurodivergent team, Rhiannon’s Café is a safe and welcoming space for everyone. 21 Widmore Road, Bromley, BR1 1RW
Useful services for information and self-help guides
- Bromley 0 to 19 Public Health Service: Provides information on ADHD, including referral processes, treatment options, and useful resources.
- HelpGuide.org: Offers comprehensive articles on managing adult ADHD, focusing on organisation, time management, and productivity strategies.
- Additude Magazine: Provides a complete playbook for social challenges associated with autism and ADHD, including early signs, coping strategies, and support resources.
- Amazon: Hosts a variety of books offering comprehensive information on ADHD and autism, including self-help guides and workbooks.
Engaging with these local support groups and utilising available resources can provide valuable assistance and guidance for families during the waiting period for a diagnosis.
Remember to take time for yourself to recharge. Supporting a child with additional needs can be demanding, so ensuring your own well-being is essential.
Areas of need
Your child will be seen by a clinician with the right skills and experience for their needs. This could be a doctor or another professional who specialises in working with children and young people.
All clinicians work as part of the same team and follow the same clinical standards.