Ïã¸ÛÁùºÏ²Ê×ÊÁÏͼ¿â

Being a parent carer of a child or young person with additional needs can bring extra situations which are challenging to know how to handle. It can also be frustrating while you are waiting for your appointment, not knowing where to turn next. There are however a number of online resources, workshops and parent support groups that you can access while you are waiting. To help support parent and carers the resources and parenting workshops cover subjects other parents have found useful. 

You don’t have to wait to have a diagnosis to access these workshops for parents and carers:

• Starting Well:
• Training for parents and carers
• Support groups for parents and carers

Referrals can be made by parents or carers, staff working in educational settings and health professionals. Parents/carers and professionals will need to work together to complete the same referral form. 

A referral should be made only once reasonable steps have already been made to support the young person and family in line with the Graduated Response for Neurodivergent Children and Young People. 

To refer a child into the Ïã¸ÛÁùºÏ²Ê×ÊÁÏͼ¿â Community Paediatric Service for an ADHD assessment, the child must meet the below criteria: 

• registered with a Ïã¸ÛÁùºÏ²Ê×ÊÁÏͼ¿â GP 
• aged between 5½ to 17 years and 6 months 
• showing core symptoms of inattention, hyperactivity or impulsivity for at least 6 months 
• the symptoms must be persistent at home and in school 
• the symptoms must be impacting the child’s ability to carry out day-to-day tasks

To understand this, the assessment team require some detailed information to begin the process.  The information provided forms part of the child or young person’s assessment if they are accepted for the assessment pathway. 

The information consists of the following parts and all of these need to be completed in full before the referral can be considered:

• a referral form with sections completed by parent or carer and education setting (or alternative setting if the child does to attend school)
• last school report and educational psychology report if available
• an age-appropriate consent form

Where a child or young person does not attend an education setting, it is useful but not essential, to get a report from another setting the child goes to such as an activity or sports club. This helps the assessment team to understand how the child or young person presents in different situations.

The information provided will be assessed by a member of the ADHD Community Paediatrics Team and a decision made to either: 

• continue to a diagnostic assessment. An appointment will be sent to you for an assessment
• ask for further information. Sometimes this happens if the information supplied by home or school is not detailed enough, in which case the team will ask for additional information. The team may also think a QB test would be helpful. A QB test is a computer based test that combines attention and impulse control measurements with activity recordings collected by an infra-red camera. Your child's results are compared with a group of children of the same age and gender, who do not have ADHD
• decline a referral if the information doesn’t show a need for further assessment. In this case,  the Team will suggest referral to other services that would better meet your child’s needs

Initial appointment 

Once accepted, an initial appointment will be held with you and your child and the clinician will decide if any further assessments are needed to help understand your child’s needs better. If needed, further assessments would be carried out by the appropriate professionals and tailored to the individual needs of your child. 

These could include:

• a neurodevelopmental history
• standardised questionnaires

Not all these assessments or interventions will be required the clinician will decide which ones are most appropriate for your child.

This might also involve consideration of co-occurring or alternative explanations for the young person’s areas of difference, for example medical or genetic needs, attachment, or the impact of difficult life events they may have encountered.

The diagnostic assessment 

The Neurodevelopmental Team will consider the evidence collected and a diagnosis of ADHD will be considered. The final decision will always include a Senior Clinician. A diagnosis of ADHD may or may not be given.

Feedback appointment

An assessment report will be produced detailing your child’s strengths, areas of challenge and strategies to support daily life (home/education). A face-to-face appointment will be held with the child, young person and their family to go through the feedback and the assessment report. This will involve a discussion about the strategies most suitable to support your child at home and in an education setting. Medication options may also be discussed.

The Neurodevelopmental Team understands that everyone wishes to be seen as soon as possible and it can be difficult to wait for appointment without an idea of timescale. Due to extremely high demands on the service, it is currently difficult to outline exact waiting times for your child’s initial appointment. Please be reassured that your child will be offered an appointment as soon as one becomes available. NHS Herefordshire and Ïã¸ÛÁùºÏ²Ê×ÊÁÏͼ¿â are working with the team to bring down waiting times and provide useful information while you wait. 

In England under the NHS you now have a legal right to choose a different provider of ADHD/ ADHD assessments, this is called Patient Choice and sometimes Right to Choose. This means that, should you decide the waiting time for your assessment is too long, then you can choose to leave the NHS waiting list and go to an alternative provider.  The provider must supply the service to the NHS somewhere in England. Your GP can advise you on which providers are able to offer Patient Choice assessments and refer you.  NHS Herefordshire and Ïã¸ÛÁùºÏ²Ê×ÊÁÏͼ¿â are developing a list of quality-assured Patient Choice providers. The link to this list will be added shortly. In the meantime, some of the providers of Right to Choose Assessments for Autism and ADHD  can be found here: .