The role of General Practitioners in ADHD diagnosis and management
4. Diagnosis
Whilst it is not the GPs role to diagnose ADHD, understanding the diagnosis pathway will enable you to support your patients.
Unfortunately, there are no specific identifiable physical features of ADHD. There is also no definite diagnostic test, such as blood test or brain scan to confirm the presence of the disorder.
Once a referral has been sent through to secondary care the wait for an appointment can be very long. You could support your patient through this process by signposting them to online support or recommending simple tips to implement at home while they are waiting to access care.
The diagnosis process can be very long, at times up to two years. It can be difficult to know how to support patients through this process. Below, you will find a few tips to help your patients:
The video below describes some strategies to help your patients
Transcript
So in terms of strategies that parents of children who may warrant a assessment and a diagnosis for ADHD I think there are 2 key things that parents could try out at home that they would probably find really helpful. Fundamentally for a child who may be at risk for ADHD what the parent needs to understand is that they need to recruit their child’s attention. So children at risk of ADHD quite often they are inattentive, they are quite often lost in their own world, they don’t listen, they’re not listening to the environment so they wouldn’t hear a parent if they called out for them, so the parent always needs to go and recruit the child attention, they need to physically go and find where the child is, maybe go into the sitting room, crouch down, beside them, capture the child’s attention, make direct eye contact with them and then tell them whatever it is they want the child to know, that’s really really important.
The other thing that’s really important is praise, so we know from lots of really good scientific studies that ADHD children need more praise, more reward, more reinforcement than children without ADHD but actually they get less. And they get less because quite often they don’t behave in ways that would allow a parent to praise them or reward them. So parents with children with ADHD need to try and engineer situations where they can praise their child. Sometimes you have to look out for them, sometimes you have to engineer them. Sometimes the parent just has to pay attention and think actually I asked them to put their cup in the dishwasher and they did, so I’m going to actually remind the child that I’m really happy with them and say well done, thank you very much for doing that, that’s really helpful.
For adults I think the key challenges with individuals who may have ADHD themselves really is about organisation and planning. Because they’re adults there’s so much organisation and planning involved in everyday life and they really struggle to organise themselves properly because they may be inattentive, they tend to forget things because of the way the ADHD brain operates less efficiently than it should do then these individuals really do struggle with everyday organisational issues, so really organisation and planning is key and we all organise and plan differently so it’s quite important for those individuals to find ways to help them become more efficient at organisation and planning and that may be physically using lots and lots of diaries, notes and stickie’s to remind them to do things, it may be about using all the technology on their phone in terms of diaries and planners and buzzers and reminders in order to remember all the things that are important to do that day and things to do tomorrow.
It’s also important for adults with ADHD to be very aware of the impact that impulsivity may have on their everyday behaviour, so we know that impulsivity for instance influences their driving skills, adults with ADHD tend to drive less well, they drive for longer over the speed limit, they make more impulsive decisions while driving which leads to increased accident rates and also in terms of interpersonal relationships, making impulsive decisions to end relationships or starting rows and impulsively saying things that you don’t mean can have a dramatic impact on their interpersonal relationships and just bring aware of how your impulsivity may impact on your everyday life through driving or your relationships can be very helpful for those individuals.