The National Institute for Health and Care Excellence (NICE) have recently published guidelines for diagnosis and management of Attention Deficit Hyperactivity Disorder (ADHD) on 13th March 2018.
The guidelines are available on the NICE website.
These guidelines aim to improve the lives of people with ADHD by providing detailed information on common symptoms, diagnostic criteria and multiagency management. Furthermore there is guidance on training and information for the general public including useful links to support groups. Importantly for Paediatric physiotherapists there are several paediatric populations where ADHD is potentially more prevalent. These populations include; pre term infants, looked-after children and young people, children and young people diagnosed with oppositional defiant disorder or conduct disorder, children and young people with mood disorders (for example, anxiety and depression), people with a close family member diagnosed with ADHD, people with epilepsy and people with neurodevelopmental disorders (for example, autism spectrum disorder, tic disorders, learning disability and specific learning difficulties). Furthermore the guidance makes the point that that ADHD is more common in females than males and that children and adults may have been underdiagnosed and wrongly diagnosed with another mental health condition or a neurodevelopmental disorder.
The guidance presents information on the process and pathway for getting a diagnosis and also how health and social care professionals can approach the management of children with ADHD. Key considerations include ensuring continuity of care for people with ADHD, a comprehensive, holistic shared treatment plan that addresses psychological, behavioural and occupational or educational needs. Health professional including physiotherapists need to take into account the severity of ADHD symptoms and impairment, and how these affect or may affect everyday life (including sleep), their goals, their resilience and the relative impact of other neurodevelopmental or mental health conditions. Important in the management are conversations with young people and their families about the importance of adherence to medication when prescribed, the importance of a balanced diet and the role of diary, the role of a healthy lifestyle and exercise are highlighted with links to supporting evidence. As Paediatric physiotherapists we have an important role in public health conversations and we are in a prime position to provide guidance to young people, their families and colleagues in schools, community settings and hospitals about suitable types of exercise and physical activity programmes.
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