ADHD

Most families arrive at PHC holding a sentence from school. Bright but not applying himself. Distracted. Careless mistakes. Talks in class. Parents describe homework that should take twenty minutes taking three hours, with someone sitting beside the child for all of it. Water bottles, tiffin boxes, sweaters and homework diaries that never come home. A child who cannot stay at the dinner table, or who interrupts every conversation and then looks genuinely surprised to be told off for it.

Other parents describe the opposite and worry it does not count. A child who is not disruptive at all — quiet, well-behaved, apparently listening, and somehow not there. Drifting. This is more often how it is described in girls, and noticed years later than the noisy version.

Adults describe it differently again. Someone who got through school and university on memory and last-minute panic and then hit a wall at work. Five projects opened and none finished. A room, a desk or an inbox that has defeated them for years. Many describe recognising something in themselves when their own child is assessed.

Almost every parent also describes the thing underneath it: a child who has started to believe they are lazy or stupid, and has stopped trying in order to stop failing.

Recognising your child, or yourself, in a paragraph on a website is not the same as knowing what is going on. Plenty of restless children do not have ADHD, and plenty of quiet ones are never asked about. This page describes; it does not assess anyone, and there is nothing here for you to score against.

You do not need the school to have raised it first, and you do not need to have tried everything else.

What a clinician pays attention to is duration, setting and cost. Difficulties that have been there for months and years rather than since a particular term, and which show up in more than one place — at home and at school, not only in one classroom with one teacher. Difficulties that are costing something: marks well below what the child can clearly do, friendships that keep breaking, or a report card that repeats itself every year.

It is also a perfectly good reason to come simply because a school has asked for a report, or because you would rather understand a child before a board year than during one.

Only a qualified clinician can tell you what is going on — a website cannot. What a page like this can tell you is that the question is a reasonable one to bring.

PHC is an assessment-first practice. Nothing is concluded about a child's attention from one conversation.

1. An initial sessionWe ask what has been going on, for how long, where it shows up and what it is costing. Nothing is administered before this conversation.
2. ADHD and autism assessmentWhere the initial session points that way, the next step is a structured neurodevelopmental assessment for ADHD and autism, administered by a qualified clinical psychologist and written up as a report. The assessment page sets out what it involves, what the report contains and who reads it. You will not be given tests you do not need.
3. A psychologist matched to what the assessment foundPsychologists at PHC are not assigned on availability. Assignment is based on speciality, the presenting needs and clinical fit — and for a child, on age as much as anything else.
4. What follows the reportFor younger children, the work is usually done through play therapy, behavioural approaches and applied behaviour analysis rather than through talking. For older children, teenagers and adults, CBT is the modality most often indicated. Alongside either, most of the day-to-day change happens at home, so parenting support is part of the work rather than an extra. Sessions are 50 minutes, in clinic at our DHA clinic or in PECHS, or online.One thing, plainly: PHC's clinicians are clinical psychologists and do not prescribe. Medication for ADHD is a psychiatrist's decision. Where it is worth considering, we say so and work alongside one.

• Learning difficulties
• Parenting difficulties
• Low self-esteem
• ADHD and autism assessment
• Play therapy