ADD - where to go from here?
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13-10-2021 5:10pm#1
I think one of my kids has ADD (attention deficit disorder). I've suspected for a while but the situation is becoming more difficult. Does anybody have experience of ADD, especially in girls? I'd like to get her assessed. I've seen in some places that it's best to go through the GP and in others that the child can be referred by the school. Is it both? Which is better? What are the waiting times for assessment like? Thanks.
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You haven't said what age your child is, but they are reluctant to assess for ADHD until the child has finished senior infants. Up until then, it is difficult to separate ADHD from a number of other psychiatric disorders, and even from a neurotypical child. This reluctance has increased in the last year and a half as there could be traits visible that are a reaction to the strangeness of the various COVID restrictions. Obviously, if your suspicions predate covid, then make sure to document them for any assessment.
You also haven't said what is leading to your suspicion, and if it is in multiple locations. The ADHD assessment aims to screen out any potential for an environmental cause to the traits.
There is a long wait for assessment if you are going public, but more than that if you are in the public system then there is a long . If you are going private, you will still be waiting at least 3-6 months for a psychiatric assessment. You may be able to get a psychologist's assessment quicker.
If you suspect ADHD then:
1 Keep a log of all of the incidents that are leading you to believe this. Separate out the log by location, as during the assessment they will want to know if the traits are only apparent in one location (meaning it may be environmental) or multiple locations. There will also be a questionnaire sent to the school for them to give their opinions on a bunch of different aspects of the child's personality. If you can, record videos of examples of behaviour that is causing your concerns. Children have a knack of behaving themselves perfectly when they're in the doctor's office, but having complete meltdowns to the same situation elsewhere. This is especially true for ADHD children, as they are getting the stimulation they crave from the new environment and new people, and it can mask their symptoms.
2 Be careful with who you go to for your referral. A psychologist can diagnose ADHD, but they cannot medicate for it, eliminating one of the possible treatment options. If you are considering medication, if appropriate, then you are better off going private if you can. The public system is quite stretched, meaning a large delay between appointments, and getting the medication right can take a few visits. Once the medication dosage is stabilised and correct, then the number of visits goes right down. Medication can make a huge difference to some people with ADHD, but if the dosage isn't correct or the timing of administration isn't correct then it can have a negative impact. The most common medications are a type of amphetamine, but have a different reaction to someone neurotypical taking amphetamines. Appropriateness depends on the individual, and you would have to discuss it with a clinician. Without knowing the clinical history and the appropriateness of dosage, you can't compare the effects two patients will have from the drug. For a psychiatric assessment, the referral has to come from your GP, and the only child psychiatrist that is currently accepting referrals (that I could find) is in VHI Paediatric ADHD Clinic in Dundrum. You have to be a VHI member to access this service. If you get a psychologist's assessment and then decide that you would like to consider medication, then a psychiatric assessment is required. You will not get a prescription based on the psychologist's assessment.
3 ADHD tends to have a high genetic component. If nobody else in the family displays any ADHD symptoms, then there is a lower likelihood of it being ADHD. Evaluate both parents especially, and any siblings.
4 ADHD has multiple sub-types. Don't look at a list of ADHD symptoms and expect your child to display all of them.
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This is all very helpful. Thank you. I had not realised I’d need to have notes so will start making some ASAP.
My daughter’s in 5th class now. She’s always been a ‘spirited’ child - lots of energy, very curious, big emotions, big ideas. She's our oldest so we just thought it was normal. As a young child she was a whirlwind. Even as a baby she never sat still. She’s very athletic now. It's really the inattention side that's giving us more trouble though. She just can’t seem to stay on task, whether it's doing her homework or getting dressed. I know this is a problem at school too. Having said that she can get totally engrossed in things she enjoys and finds it difficult to move on. She has intense emotions and regularly has tantrums at home, though never at school. Recently she’s been having almost daily tantrums after school and I suspect that as the schoolwork gets more difficult, school is taking more out of her than in the past.
Her teacher says she wouldn’t rule out ADHD but that she has met other kids who stood out as having it more than our daughter. I do wonder if this is partly because she has the inattentive type more than the hyperactive type. She's also very bright so she does reasonably well on her school work though I believe she has the potential to do a lot better.
Regarding the genetic component, the more I read about ADHD the more I suspect I had it myself as a child but was never picked up. I also found out last week that my brother has recently been referred for an ADHD assessment. Our other kids are younger. They were all unusually active as young kids but they haven't (yet) shown the same level of distractibility our oldest has.
Is it common for children to be prescribed medication for ADHD when they're first diagnosed here? To be honest, I hadn't really considered medication. For some reason I associate it more with very hyperactive kids and that's not really our problem. I don't think we'd go for medication as a first step anyway. I'm hoping that if she is diagnosed, we would be helped with strategies to manage her behavior better and maybe CBT or similar therapy to help her deal with her own symptoms. Is this something that's available?
Thanks again for your lengthy response. It's really very helpful.
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Hi, I see your post is from 2021, can you advise how is your daughter now and what you guys did the last 2 years? I am suspecting my eldest son ass ADD and exploring how to get him assessed.
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My son was diagnosed with ADHD. He's going into third class. Assessments etc all started in 1st class. Just through being fairly intelligent he can manage to get through class work and homework quite well and has no issues with reading or maths etc. But because he is extremely inattentive and has major issues with emotional regulation, he has started to fall behind because he can't just figure it out on his own anymore, he needs to be able to take in information from someone else and apply it but that's where he struggles and that will get worse as he goes through his school life.
School psychologist advised he has autistic traits and possibly ADHD. Private psychologist confirmed same. Both advised he needs an SNA, OT and other advise for school and ourselves to give him the best chance going through primary school. School principal already advised that the resources aren't there and she knows she will get nowhere with it, she's great and has been very helpful and doing her best but unless a child is extremely severe then there will be no resources provided.
GP brought his case up at board that discuss each case, he got letter back to say he doesn't meet criteria of a severe case and therefore no assistance will be provided. By the way, this is the man who decides what happens to children in the south east and who gets assistance and who doesn't: Dr Albert Amaechi Okoye. Do a google search on him and look for the Irish Examiner article where the HSE defended hiring him. Ridiculous carry on.
So despite having a public and private psychologist both advising he needs resources and has ADHD and other issues, until we get an assessment through CAMHS nothing more can happen. We have now found out that the referral that was put through nearly a year ago never went through at all and it's starting to seem we may have to put it through and start waiting again. Waiting to hear more on this.
So despite doing everything we possibly can, our son will not get any assistance until at best maybe 5th or 6th class the way things are looking, if at all.
An adult with ADHD can privately get an ADHD diagnosis, get medication and also free access to courses and support groups immediately (Diagnosed with ADHD as an adult myself) A child cannot and must wait for CAMHS regardless of any diagnosis and recommendations already made. I don't want my son to deal with some of the same difficulties I had myself growing up but even if I wanted to pay for someone to help him the system is set up in such a way that I must wait years for CAMHS to give the go ahead. Absolute shambles!
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Could you get him privately assessed for ADHD? And then provide that private diagnosis to the school in order for them to apply for SNA assistance? Or did the school psychologist provide him with an official diagnosis?
My son is autistic. He's just started in senior infants. We applied last year to have him assessed publicly but know full well that that assessment may take years. We paid privately for an assessment before he started in junior infants (got 50% of the cost back on the VHI - €300 a year for the premium) and got the report which stated that he could go to a mainstream school but would need a full time SNA. We provided the report to the school in the April before he started, and the principal applied for an SNA through the local SENO. He didn't get approved for a full time SNA, but shared one with another autistic boy in the class. Incidentally, the other little boy hadn't yet been diagnosed - he'd only started his public assessment process - but still got approved for 50% of an SNA. So its not true that you need a diagnosis to get SNA approval. That said, the other little boy was clearly autistic and it was obvious he had a high level of need. He has since got his diagnosis and has received approval to attend an ASD unit, so has left mainstream school.
Now, we were also told that without an official diagnosis it was unlikely the SENO would approve a SNA. Public health nurse, GP and psychologists letters help, but if there is a shortage of SNAs in the area, they will only approve them for those that have a black and white report blatantly stating that an SNA is required. I guess its because the parents of a child with an official diagnosis would have a watertight High Court case whereas those parents who only have letters stating "X diagnosis suspected" will not have one. So its a bit of a postcode lottery. That said, I'd be getting the principal to make the application anyway.
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fcuking hell, threads like this would just make you extremely angry, i have asd, adhd and dyslexia, diagnosed later in life, what a fcuking disgrace that families have to go through such bullsh1t, what a train wreck our whole system is, this will unfortunately cause irreversible problems for those affected...
try not put too much pressure on your kids folks, you know school is extremely difficult for them anyway, try not get too hung up on the completion of homework, as school can be extremely exhausting, resulting in burn out after the fact, just try make sure theyre eating and sleeping as well as can be, and of course regularly exercising....
best of luck
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hi juzt wondering is there any other child psychiatrist that is accepting referral's privately ? or can anyone recommend anyone ? im looking for a assessment for ADHD for my child
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