ADHD

Help for attention and impulsivity problems

Attention-Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (AD/HD or ADHD), has been previously been referred to as Attention Deficit Disorder (ADD). It is now described as ADHD with either a hyperactivity, an inattentive, or combined presentation.

Children may struggle with inattention, impusivity, hyperactivity or emotional regulation.

They may:

  • only have symptoms of inattention (attention-deficit)

  • or, they may only have symptoms of hyperactivity and impulsivity

  • or, they may have a mix of inattentive and hyperactive/impulsive symptoms.

How can I tell if my child has Attention Deficits or Hyperactivity ?

No single test can diagnose a child as having ADHD. Although your child may appear to have symptoms consistent with ADHD, it is important to complete a full assessment, which may involve (with parental consent) your psychologist liaising with your school, your paediatrician and/or your G.P.

Assessment includes ruling out a number of other factors which can lead to ADHD type symptoms, including vision and hearing problems, anxiety, sleep problems, parenting styles and learning difficulties.

If your child has ADHD symptoms which are causing problems at home or school, early intervention can help. Effective treatment can help your child learn lifelong skills to flourish. It can be frustrating to have ADHD symptoms, and to have an impulse control or attention system that is difficult to regulate.

Research indicates that children with ADHD receive a lot of criticism, even when they may be trying hard to do the right thing, which poses risks for self-esteem. Early intervention can help parents understand the challenges their child faces and this may benefit the parent-child relationship.

Understanding ADHD

ADHD is a persistent pattern of inattention and/or hyperactivity and impulsivity that interferes with functioning or development.

While it is normal and common for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table, ADHD is more than the occasional lapses.

Persistent problems with inattention, impulsivity, emotional regulation and hyperactivity are also signs of attention deficit disorder (ADHD) which can affect your child’s ability to learn, and your child’s ability to get along with others.

ADHD is a type of neurodiversity. At Mindworx Psychology, we believe that neurodiversity is part and parcel of being human. ADHD, Autism, Dyspraxia, and Dyslexia are all neurodiverse conditions. It is estimated that up to 40% of the population may be neurodiverse, with the majority of the population described as neurotypical.

People experience and interact with the world around them in many different ways; there is no one right way of thinking, learning, and behaving, and we tend not to view differences as necessarily being deficits.

We make a distinction between neurodiversity and disability. People with ADHD tend to have high levels of creative thinking and empathy. They can also hyper focus on certain tasks. These ways of thinking can be strengths.

Equally, children with ADHD can neurocognitive deficits across working memory, set shifting, reaction time variability, response inhibition, vigilance, planning and organising. Without support these deficits can significantly impair a child’s ability to reach their full potential.

ADHD is a neurodevelopmental condition, with a genetic component. Research suggests the heretability of ADHD is approximately 74%, and that there is no single gene for ADHD.

The age of onset is unclear – it can be difficult to tease out ADHD from the large variation in toddler and preschool behaviours.

A child’s brain matures and develops rapidly – so rapidly that many experts agree that a definitive diagnosis of ADHD is often not possible prior to age 4. That said, early assessment and intervention is incredibly important when children are neurodiverse to ensure they receive appropriate accommodations and support to flourish.

Inattentive ADHD symptoms are most commonly identified in the early school years, and many parents report that hyperactivity symptoms are evident from a very young age. Emotional disregulation or emotional impulsivity are common features. By adolescence, hyperactivity can look more like fidgeting or feeling restless, or impatient.

It is important to monitor symptoms, and to re-evaluate and assess due to developmental changes.

Your child’s brain does not reach full maturity until they are in their twenties. And even then, neuro-plastic change occurs across our lifetimes. ADHD does not look the same for everyone, and it does not look the same across the lifespan.

Worldwide, it is estimated that attention-deficit hyperactivity disorders affect around 7.2% of children and 2.5% of adults.

Given our growing understanding that ADHD is a neurodevelopmental, genetic condition, it is likely that ADHD is under diagnosed in adults.

We tread carefully with the idea of treatment. It is important to remember that ADHD is a neurodevelopmental condition. That means that the symptoms, and associated behaviours are the result of a person’s brain developing differently. It is estimated that between 30% and 40% of the population are neurodiverse, and the remaining majority are neurotypical.

The goal of ADHD treatment is to ensure that people with ADHD can reach their full potential, not to “cure them” of ADHD.

Treatment can be very helpful. It may help with many challenges faced by families and individuals with ADHD. Although ADHD is often associated with stigma, there are many aspects of ADHD that can be strengths, such as hyperfocus and boundless energy.

With support, most people with ADHD can be successful in school and lead productive lives.

Cognitive Behavioural Therapy is the gold standard first intervention worldwide, and includes a strong component of parent training. Medication can also play an important role, and our team at Mindworx Psychology often work in conjunction with Developmental Paediatricians and Child Psychiatrists to achieve optimum outcomes.

Ultimately, the choice of whether or not to medicate remains with the parents. Psychologists do not give advice on, or provide medication, our specialist area is psychological interventions.

We love to work holistically, however, the research tells us that there is less evidence for neuro-feedback, dietary approaches, supplements and complimentary therapies. As Clinical Psychologists, our focus is delivering treatments most likely to work to bring you the outcome you seek.

Your Psychologist will be happy to advise and support you with a range of strategies should you wish to try them.

For adults diagnosed in later life, understanding what ADHD is may lead to a deeper understanding of the self, and awareness of helpful strategies to reduce stress.

We tread carefully with the idea of treatment. It is important to remember that ADHD is a neurodevelopmental condition. That means that the symptoms, and associated behaviours are the result of a person’s brain developing differently. It is estimated that between 30% and 40% of the population are neurodiverse, and the remaining majority are neurotypical.

The goal of ADHD treatment is to ensure that people with ADHD can reach their full potential, not to “cure them” of ADHD.

Treatment can be very helpful. It may help with many challenges faced by families and individuals with ADHD. Although ADHD is often associated with stigma, there are many aspects of ADHD that can be strengths, such as hyperfocus and boundless energy.

With support, most people with ADHD can be successful in school and lead productive lives.

Cognitive Behavioural Therapy is the gold standard first intervention worldwide, and includes a strong component of parent training. Medication can also play an important role, and our team at Mindworx Psychology often work in conjunction with Developmental Paediatricians and Child Psychiatrists to achieve optimum outcomes.

Children often have other problems that occur with their ADHD, such as learning difficulties.

Girls with attention difficulties may have their symptoms overlooked, as they may be seen to be day dreaming, or just be overlooked as they may not have symptoms of hyperactivity.

In addition, boys may more commonly have difficulties managing their temper, whereas girls more commonly have anxiety problems.

The simple answer to this is yes! We recommend that a thorough health assessment by a GP or Paediatrician, as well as vision and hearing checks. Many children with ADHD have other mental health problems such as anxiety, or learning difficulties, or conduct problems.  It is becoming increasingly recognised that, along with ADHD, children may experience symptoms of other neurodevelopmental conditions such as autism, Asperger’s, Tourette’s syndrome, Obsessive Compulsive Disorder (OCD), dyslexia, and dyspraxia.

Your Psychologist will also talk with your school and other concerned individuals if necessary to get a full picture of the problem, and how it affects your specific child.

Although we are moving closer to understanding the risk factors for ADHD, and the developmental course of this neuro-atypical disorder, research continues.

Flexible, Comprehensive, Individually Tailored ADHD Assessments and Reports

ADHD Testing

We know one size does not fit everyone.

Our testing is comprehensive – but as a practice we know that families have different reasons for seeking tests and diagnosis.

We work to industry gold standards, but equally – we won’t write or charge for extensive reports, or conduct a battery of tests if you don’t need them.

For general treatment, we can screen and make a provisional diagnosis based on clinical observations that allow us to begin treatment and to provide support.

And, when a formal diagnosis is needed, we can undertake a gold standard assessment to check if your child meets the diagnostic criteria, along with a comprehensive series of tests and assessments to check for any other learning difficulties or disorders. Such testing includes a detailed report.

We’ll discuss with you exactly what testing is needed, and helpful for your situation.

Initial Session

Before you confirm any testing with us, we ask that you have an initial assessment session with the Psychologist.  This allows us to begin assessment.

There is no single test for ADHD – in the initial session, the Psychologist will assess your needs and recommend what testing will be best for your unique needs.

We make a distinction between neurodiversity and disability. People with ADHD tend to have high levels of creative thinking and empathy. They can also hyper focus on certain tasks. These ways of thinking can be strengths.

Equally, children with ADHD can neurocognitive deficits across working memory, set shifting, reaction time variability, response inhibition, vigilance, planning and organising. Without support these deficits can significantly impair a child’s ability to reach their full potential.

We want to meet your child. ADHD, especially inattention, can be hard to see in a one-on-one novel situation, but clinical observation forms an important part of our assessment.

Parent/Carer information forms an important part of assessment. We will want to take a comprehensive developmental history of your child and discuss any significant events in their life.

*For a formal diagnosis to be made, your child will need to see their GP or Paediatrician for a thorough check up, including eye sight and hearing tests. This allows us to rule out any medical conditions that could mimic ADHD symptoms.

The diagnosis of ADHD requires multiple sources of information. Usually this involves us talking with your child’s school teacher or year advisor.

We have a range of questionnaires we administer to teachers to check on your child’s social, emotional and academic functioning at school.

Previously, we used a test of attention called a Continuous Performance Test (CPT test).

CPT tests are task-oriented computerised assessments of attention. Some children loved these tests, and others found them incredibly boring.

Ultimately, the latest research says they have little diagnostic value for ADHD, so given the added expense for parents, and the lack of benefit from administering them, we have dropped these from our test battery.

Typically we use the Wechsler Intelligence Scales for Children.

  • Fifth Edition (WISC-V, Australian Standard) for children aged 6 to 16 years.
  • Fourth Edition (WPPSI-IV, Australian Standard) for children aged 2 years and 6 months to 7 years and 7 months.

These tools can assess overall IQ, and they look at strengths across various domains and constructs of intelligence.

In terms of ADHD diagnosis, testing processes such as memory or processing speed helps us get a much more detailed picture of what is going on for your child. For example, a slow processing speed can mimic inattention, but processing speed and attention are very different. These types of tests allow us to benchmark your child against same age peers, which can be incredibly useful information.

Children with ADHD often underperform academically and these types of tests help us to understand what specifically is going on for your child, and make specific recommendations for them.

Domains and constructs of intelligence tested may include:

  1. Verbal Comprehension : the ability to use a range of vocabulary to understand and express general knowledge and explain concepts
  2. Perceptual Reasoning : the ability to solve complex non-verbal problems
  3. Working Memory : the ability to learn, manipulate and retain information to complete new tasks
  4. Processing Speed : the ability to quickly process and make judgements about information

We screen for a range of psychiatric disorders and neurodivergence, not just for ADHD.

Many children have what is termed as a co-morbid disorder, such as anxiety, or other forms of neurodivergence such as autism.

We use a wide range of gold standard assessments, these are chosen by the Psychologist based on your child’s functioning and developmental history.

*please note that ADHD testing screens for, but is not a diagnostic test for Autism.

These tests and assessments are used to measure your child’s academic ability in a range of areas including reading, writing, spelling, arithmetic, listening comprehension, and oral expression.

Results can provide a profile to assist parents and schools with the development of individual intervention and learning plans.

Report writing is usually the most time consuming part of the process for your Psychologist, who will need to score and interpret all of the test results.

The more comprehensive and complicated an assessment is, the longer it takes to interpret results and to write an informative report.

Our reports provide a summary of all test results and what they mean, and include specific recommendations for your child.

We will provide the written report, read through the report and discuss the results with you, giving you the opportunity to ask questions.

We aim to have our feedback sessions within two weeks of testing when possible.

Specific, tailored to your child and included as standard in your report.

Optional.

– billed at your Psychologist’s hourly rate.

Neuroimaging research on attention-deficit/hyperactivity disorder (ADHD) continues growing in extent and complexity, although it has yet to become clinically meaningful.

Current guidelines (DSM5-TR, 2022) state that no form of neuro-imaging can be used for the diagnosis of ADHD.

Therefore, in line with the guidelines we do not use neuroimaging to inform clinical practice or for diagnosis of psychiatric disorders.

Gold standard, evidence based testing is individually tailored to your specific needs.

After the initial assessment, we will be able to provide a quote for testing based on your specific needs.

At Mindworx Psychology our Psychologists charge by the hour for their time. Our team are experienced and we work efficiently.

As a general guide, for comprehensive testing we suggest to allow 2-3 hours for developmental history/school liaison, and up to 4 hours for IQ and academic testing.

Scoring, interpretation and report writing time will be from 4 hours, and dependent on the volume of administered tests and complexity of diagnosis. We can quote this for you when the Psychologist confirms which tests are being administered.

Our feedback sessions are usually an hour, when the written report and written recommendations are provided to you. You will be able to share this report with others involved in your child’s care if you wish.

You may be able to access Medicare rebates or private health fund rebates (check with your fund what is covered) for part of the process, we can discuss this with you.

TIPS FOR PARENTING CHILDREN WITH ADHD

ROUTINES

Try to keep the same routine every day, from wake-up time to bedtime. Use visual reminders.

Include time for homework, outdoor play, and indoor activities – and allow extra time to reduce stress.

Keep copies of your schedule on the fridge, or on a bulletin board in the kitchen.

ORGANISE EVERYDAY ITEMS

Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.

Use age appropriate labels and pictures.

Encourage children to complete tasks e.g. part of taking off shoes is putting them away in the right place

BE CLEAR AND CONSISTENT

Children with ADHD need consistent rules they can understand and follow.

Having a neuro-atypical brain means that routines can be more challenging to learn. Make it easier by being as consistent as possible.

GIVE PRAISE OR REWARDS WHEN RULES ARE FOLLOWED

Children with ADHD often receive a lot of criticism, even when they may be trying their best.

Look for good behaviour, and praise it. Don’t wait for perfect, praise the attempt, praise the effort.

BE KIND TO YOURSELF !

Parenting children with ADHD can be filled with joy, and it can also be complex, challenging, frustrating and demanding!

Make it a priority to build in time for yourself to recharge and refresh, even if it is just a five minute walk each day.

GET PROFESSIONAL SUPPORT

It is important that children learn how to successfully master tasks. This can’t happen if they are placed in situations they are not able to cope with.

Professional advice can help you understand exactly what your child struggles with, and provide you and their teachers with strategies and solutions to help.

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Suite 206, 10 Century Circuit, Norwest Central, Baulkham Hills, NSW 2155

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Fees & Insurance

You do not need a GP referral to book an appointment at Mindworx Psychology.

Medicare Rebates are available if you have a valid referral from a GP, Psychiatrist or Paediatrician.

Your Private Health Fund may offer cover for Psychology Services – you can check this directly with your fund.