Strategies – therapies

Many children go through phases where they are restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD

However, you should consider raising your concerns with your child’s teacher, their school’s special educational needs co-ordinator (SENCO) or GP if you think their behaviour may be different to most children their age.

Richmond & Kingston Borough Councils operate the SPA service (Single Point of Access) which is the first port of call for diagnosis of ADHD. Tel: 020 8891 7969 (Monday – Friday, 8.00am to 6.00pm) Out of hours Tel: 020 8770 5000 www.richmond.gov.uk/single_point_of_access

It’s also a good idea to speak to your GP if you are an adult and you think you may have ADHD, but you were not diagnosed with the condition as a child.

Treating ADHD often requires medical, educational, behavioural and psychological intervention. This comprehensive approach to treatment is sometimes called “multimodal” and, depending on the age of the individual with ADHD, may include: parent training, medication, skills training, counselling, behavioural therapy, educational supports, education regarding ADHD.

Working closely with health care providers and other professionals, treatment should be tailored to the unique needs of each individual and family to help the patient control symptoms, cope with the disorder, improve overall psychological well-being and manage social relationships

An early diagnosis can make a big difference.

ADHD Family Coaching is available to help you and your child from Achieving for Children in Richmond and Kingston. Please speak to your family support worker or social worker for further details. Or you can email strengthening.families@achievingforchildren.org.uk

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Who to see: read this blog for helpful tips on which professionals will see your child during the diagnosis process. Also see the Pathways tab on this website

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Medications (see our Pathways tab)

Medication does not cure ADHD – it can only reduce the difficulties it causes. ADHD is often treated with stimulant medication. The theory is that medication can either reduce the uptake or increase the production of the neurotransmitters, so increasing the levels in the brain.

 

 

 

They are very powerful drugs – some are classed as amphetamines – and can carry other health risks.

The long-term effects of stimulants on young, developing brains are still not fully known and children and adults with existing heart conditions are at risk of heart attacks if they take stimulant medications. Stimulants can also trigger or exacerbate hostility, aggression, anxiety, depression and paranoia – anyone with a personal or family history of suicide, depression or bi-polar disorder is at very high risk and should be closely monitored.

The reported side effects of stimulant medication for ADHD/ADD include some of the problems for which they are prescribed. They include: restlessness, difficulty sleeping, irritability and mood swings, depression, loss of appetite, headaches, upset stomach, dizziness, racing heartbeat and tics. For these reasons, stimulant medication should only be prescribed to children who have been professionally assessed and diagnosed by an expert, and should be reviewed regularly.

Medication can help to control the core symptoms of ADHD i.e. to increase the dopamine levels in the brain, and provide children with a ‘window of opportunity’ to be more focused and concentrate better. Doctors recommend that medication is prescribed in conjunction with specialised behaviour management advice for both parents and schools. Education about ADHD enables parents and teachers to give crucial practical and emotional support. Not all affected children need medication. On average the medication dosage should equal 1mg per 1kg of body weight. Consultants, at first, will always offer the local NHS-chosen medications before considering other types e.g. Intuniv which is a 3rd-line treatment

Watch this video

What medications are used to treat ADHD?

Stimulants:
Methylphenidate is most commonly used in the UK to treat ADHD. Its’ brand names include Medikanet, Ritalin, Equasym, Concerta, Matoride and Xenidate. This stimulant drug provides short-lived improvements after each dose. They’re available in liquid form.

You may wish to read this research on methylphenidate and watch this video from YoungMindsUK featuring a boy who takes methylphnidate

Dexamfetamine (brand names include Dexedrine) is also a stimulant and similar in its actions to methylphenidate. It sometimes works when methylphenidate does not. Available in liquid form.

Elvanse capsules contain the active ingredient lisdexamfetamine dimesylate, which is a type of medicine called a stimulant. Lisdexamfetamine is converted into dexamfetamine, which works by affecting some of the natural chemicals that are found in the brain. In particular, it increases the activity of chemicals called dopamine and noradrenaline in areas of the brain that play a part in controlling attention and behaviour.

Non-stimulants:

Intuniv is a long-acting form of guanfacine. It is not a stimulant. However, it may be prescribed in combination with ADHD stimulant medication. It is often prescribed for children who cannot tolerate stimulants, or for parents who prefer not to use stimulants. It’s believed that Intuniv strengthens receptors in the brain, improving memory and attention, reducing distractions, and controlling impulses. It can help reduce symptoms of ADHD. Watch this video

Atomoxetine (which goes by the brand name of Strattera) is a non-stimulant drug. Each dose provides a short-lived improvement which last approximately 24 hours. It is available in liquid form.

There is a wide range of second line drugs that are sometimes used in specialist practice, including Clonidine, certain antidepressants and mood stabilisers.

Listen to this BBC Radio 4 All in the Mind clip about mediation

Are the medications for ADHD addictive?
Dexamfetamine and methylphenidate are controlled drugs and can in theory be abused. However, the low and steady doses used to treat ADHD do not lead to dependence. Research suggests that children with ADHD are somewhat more likely to use illegal drugs, but that the risk actually falls if they are treated with stimulants.

Watch this video with leading ADHD specialist Prof. Peter Hill:

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Non-medical ways of managing ADHD include exercise, healthy diet, sleep management and behavioural therapies. Read on …

123 magic

ADHD Richmond partners with Achieving for Children to produce excellent 123 Magic Parenting courses . The NICE guidelines say you should attend these courses alongside any other treatments your child may be receiving.

.Register your interest with this Parenting_Self_Referral_Form_Sept_14__1_  or contact Karen Williams on 020 8547 6965 or 07771 974388 . Ask her too about upcoming evening sessions

AfC Parenting Support

Read the AFC_Parenting_courses_booklet_-_May_2015_FINAL___1_

Watch this video from the man who created 123 Magic

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Can a bad diet and too many additives cause ADHD?
There is no concrete evidence to suggest that ADHD is caused by bad diets or too many additives, but they might make a tendency worse. However, when food does contribute to a child’s problems it is not exactly a ‘bad diet’. Children can react badly to any of a range of foods, and it can be different for each individual child. Sometimes additives are the culprit but sometimes it is quite natural foods such as wheat flour, cow’s milk or citrus fruit. Doctors are not sure how many children with ADHD are affected by reactions to food but most think it is a small minority.

Can fish oil or mineral supplements help to treat ADHD?
Science has not fully answered this one yet. There is some evidence emerging that fish oils can be helpful in treating ADHD, but as yet there is no large scale study to prove or dispute its effectiveness.

Watch our video of nutritionist Deborah Colson. Check out her company here ; See her PowerPoint Deborah Colson – nutrition slides ; and contact her:

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Neurofeedback: this treatment is valued by those who have tried it. Here’s our video of Dr Neil Rutterford at our July 2015 meeting:

Our thanks to Dr Neil Rutterford for his excellent Talk to our group on  7 July.  Watch this video, check out his company here and see his PowerPoint: Dr Neil Rutterford – LANC – pp

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Challenging behaviours: here are some information leaflets which will guide you to some best practice: Sheets 1   2   3

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Private #ADHD #child #psychologists in Richmond, Kingston & London areas – The Association of Child Psychologists in Private Practice  …

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Counselling Directory may point you towards independent professional support

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BMJ

Listen this British Medical Journal audio on treatment

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SLT photo

Speech & Language Therapy can help ADHD children and young people with Attention and listening; coping with instructions; communicating appropriate for their age; social interaction and play. Read this: Speech and language therapy for children and young people in Richmond – information for parents

Contact the Richmond team: Tel: 020 8973 3512

Kingston Tel: 020 8339 8000) http://www.yourhealthcare.org/early-years

Independent SaLT practitioners can be found @ http://www.helpwithtalking.com/Find-a–SLT

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Occupational Therapy can benefit children with ADHD –  with sensory skills, physical coordination, organization, controlling energy levels, hyperactivity, working out anger and aggression, improving focus, handwriting, social skills, time management.

Here’s the application form for Richmond and Kingston: 2017_AFC_Social_services_OT_referral_blank_form_AFC_June_2017

For independent services visit: https://www.cotss-ip.org.uk

Find out how OT can help your ADHD child here

Here are the Richmond ADHD & OT Website Slides from our Talk on Occupational Therapy by Samantha Platt and Sandra Newbery

 

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Emotional Health Service: Tier 2 CAHMS Service offers an early response to children and young people experiencing poor emotional well being and mild-moderate mental health issues. Find out more

Art Psychotherapy:  offered by the Emotional Health Service working with children with ADHD and their parents.

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CaptureThe Department for Education and Department of Health have a resource called ‘MindEd’ for concerned children and their families to seek help. Search for ADHD on the  link

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The NHS website has some useful information

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Wellbeing – Look after yourself                                                                                                            

As your child’s role model and most important source of strength, it is vital that you live a healthy life. If you are overtired or have simply run out of patience, you risk losing sight of the structure and support you have so carefully set up for your child with ADHD.

  • Take care of yourself. Eat well, exercise, and find ways to reduce stress, whether it means taking a nightly bath or practicing morning meditation. If you do get sick, acknowledge it and get help.
  • Seek support. One of the most important things to remember in rearing a child with ADHD is that you don’t have to do it alone. Talk to your child’s doctors, therapists, and teachers. Join our support group for parents of children with ADHD which offers a forum for giving and receiving advice, and provides a safe place to vent feelings and share experiences.
  • Take breaks. Friends and family can be wonderful about offering to babysit, but you may feel guilty about leaving your child, or leaving the volunteer with a child with ADD/ADHD. Next time, accept their offer and discuss honestly how best to handle your child.

Richmond Carers Centre –- 12 weeks of free, one-to-one counselling for carers registered with Richmond Carers Centre. Counsellors are either fully qualified volunteers or students on placements. All students are fully supervised by their college or university. Tel: 020 8867 2380 Website: www.richmondcarers.org Email: info@richmondcarers.org

Richmond Wellbeing Service is a free and confidential service for local people who experience depression, anxiety, sadness, anger, extreme shyness, obsessive behaviour, phobias, relationship difficulties or other psychological issues. It offers group workshops, counselling, self-help courses, a range of talking therapies and computer-based therapies. The service is run through a partnership between East London NHS Foundation Trust and Richmond Borough MIND. Contact: NHS Richmond Wellbeing Service Richmond Royal Hospital, Kew Foot Road, Richmond upon Thames, TW9 2TE Tel: 020 8548 5550 / 020 3513 3266 http://www.nhs.uk/Services/clinics/Overview/DefaultView.aspx?id=103378

Live Well Richmond is a free health improvement service available to anyone over the age of 16 who either lives or is registered with a GP in Richmond. It offers free help and advice to help you develop a healthy lifestyle and improve your health and wellbeing. Tel: 0208 487 1745 www.livewellrichmond.org.uk/richmond/ Email: info@livewellrichmond.org.uk

 

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