Neurodevelopmental disorders are a group of conditions that impact on brain functioning and neurological development.
Attention deficit hyperactivity disorder (ADHD) and autism spectrum condition (ASC) are the most common neurodevelopmental disorders, and can result in difficulties in social, cognitive and emotional functioning.
The onset of neurodevelopmental disorders usually takes place during early development, and are typically identified in toddlers, children and adolescents.
Our child and adolescent mental health service (CAMHS) specialist neurodevelopmental services assess children aged between six and 17 for ADHD and ASC.
The ADHD service provides assessment and treatment for children and adolescents for whom there are concerns about ADHD.
The complex neurodevelopment service provides specialist assessments and treatment plans for children and adolescents with possible neurodevelopmental or neuropsychiatric disorders, including ASC, Tourette’s syndrome, obsessive compulsive disorder (OCD) and more complex presentations of ADHD.
The three main symptoms of ADHD are inattention, impulsivity and hyperactivity.
Children or young people who have ADHD may have a short attention span, struggle to sit still for sustained periods of time, or may appear to act before they think.
There is more information on ADHD available on the NHS website and the ADHD UK website.
The assessment process
Prior to a first appointment, parents, teachers and, if old enough, the child or young person, will be asked to complete some questionnaires.
These are so that the team can learn about the child or young person ahead of meeting them in our clinic, and help to standardise the assessment process.
Please note that all patients are required to complete these forms, even if a child or young person has already been assessed and diagnosed by a clinician in the private health sector.
Once a patient's questionnaires are returned to the service, the forms will be screened. If an ADHD assessment is appropriate based on the screening, the patient will be added to the waiting list.
To help gather more information for an assessment, the team may also ask permission to observe the child or young person’s learning and behaviour at school.
When the child or young person reaches the top of the waiting list, their family will be invited to an initial assessment.
When the assessment is complete, the clinician will provide the family and the child or young person, if appropriate, with feedback.
If an ADHD diagnosis is made, the child or young person’s GP will receive a report providing confirmation of the diagnosis and how this was made. With the family’s consent, a copy of this report can also be sent to the child or young person’s school.
If the child or young person is found not to have ADHD, the rationale for this decision will be explained and alternative explanations for their difficulties will be provided.
Treatment options
Treatment of ADHD consists of a range of therapeutic options. The two interventions with most evidence for effectiveness are parenting programmes and medication.
Parenting programmes are usually the first interventions used. They can help parents learn to use more specific skills to help their child accept limits and boundaries, prevent difficult behaviour and deal with its consequences.
The ADHD service runs a termly ADHD family support package (FSP) for parents or carers of children or young people diagnosed with ADHD in the service. To find out more about the FSP, please ask your consultant for a flyer.
There may be other parenting programmes available, depending on your area. Please speak to your consultant for more information.
Medication can be useful alongside parenting programmes, but is not a cure for ADHD — it can simply help other interventions at home and at school be more effective.
Not all parents or children/young people decide to have ADHD medication, and the pros and cons of medication and any alternatives will be discussed carefully. The child or young person’s height, weight and blood pressure will be regularly monitored if medication is prescribed.
Other treatments provided by the service include talking therapies such as cognitive behavioural therapy, family therapy or psychotherapy. Please discuss with you consultant any concerns that may be appropriate regarding treatment with talking therapy.
Autism spectrum condition (ASC) is the medical term for autism.
Every autistic person is different, but some features of ASC include social communication difficulties, restricted behaviours or interests, and sensory sensitivities.
More information on autism is available on the NHS website and the National Autistic Society website.
It is common for people with ASC to have other conditions, such as ADHD, anxiety, depression, OCD, eating disorders, sleep disturbance/disorders, and tic disorders, including Tourette’s.
The assessment process
Prior to a first appointment, parents, teachers and, if old enough, the child or young person, will be asked to complete some questionnaires. These are so that the team can learn about the child or young person ahead of meeting them in our clinic, and help to standardise the assessment process.
Please note all patients are required to complete these forms, even if a child or young person has already been assessed and diagnosed by a clinician in the private health sector. Families will also be asked for permission to contact relevant agencies for further information before assessment.
Once a patient's questionnaires are returned to the service, the forms will be screened. If a complex neurodevelopmental assessment is appropriate based on the screening, the patient will be added to the waiting list.
When the child or young person reaches the top of the waiting list, the family will be invited to an initial assessment.
Assessments are conducted by a multidisciplinary team consisting of a child and adolescent psychiatrist, a clinical psychologist, and child and adolescent psychotherapist. There are usually other members of the team also present.
When the assessment is complete, a report will be provided with a summary of the team’s conclusions and how these were reached. Families are encouraged to share this report with the child or young person’s school so appropriate accommodations can be made.
What happens after the assessment?
Follow-up assessment appointments are often required. These may include:
- observation of the child or young person in a different setting, for example in school
- cognitive or neuropsychological assessment
- specialist diagnostic assessment, for example autism diagnostic observation schedule
Following the assessment, some children/young people are followed up in our clinic. Others are seen within our wider CAMHS service for the recommended interventions, such as child psychotherapy or family therapy.
Some children/young people are referred to local or other CAMHS services if more appropriate.
The ADHD and complex neurodevelopment services accept assessment referrals for children and adolescents aged between six and 17 who have a Camden or Barnet GP and live in either Camden or the Barnet postcodes of NW2, NW11 or N3.
Please note that for patients with a Camden GP, referrals to the complex neurodevelopment service are only accepted for complex presentations of ADHD. Referrals of Camden patients for ASC assessments only will not be accepted.
Referrals must be made in writing by a GP, paediatrician, teacher, psychiatrist, or another CAMHS professional. Referrals must include information on:
- what symptoms of ADHD/complex neurodevelopment the child or young person displays
- how long the symptoms have been present
- whether the young person exhibits these symptoms at school, at home or in other settings
- the child or young person’s background, such as family set up, social services involvement, whether they have moved from a different city or country, and languages spoken at home
All referrals are screened by the team before a patient is accepted into the assessment clinic.