14yo Son - possible ADHD

[car1sberg]

Hi, we suspect our 14yo son has ADHD, he ticks a lot of the boxes. His schooling is becoming more affected, and I feel that we can’t ignore the possibility of ADHD any longer; which is probably what we have been doing for fear of labellling him. I’m still scared to be honest but I feel like we musr advocate for him and at least go down that route to find out either way.

We are keen to get a private diagnosis as I’ve heard the wait time with the NHS can be years? I had a look at the Right to Choose website, it seems very simple and straightforward, is it? Or are there other places to go to? We’re clueless what to do really. Would we pay for just the ADHD assessment or the one that includes the medication initiation service too? What if we don’t want to go down the route of medication or he may not even need it?

any help would be much appreciated, thank you! X

Right to Choose isn’t one place. There are multiple places one can be referred to under Right to Choose. However, some ICBs have paused RtC referrals. The process and waiting times depend on which provider. With RtC, you don’t pay.

If you go private, what you pay depends on what you want and what provider you go with. Some offer medication services, some offer coaching, some only diagnostic assessment. If affording ongoing private prescriptions would be an issue, you should check your GP will take on shared care once titrated, not all will now for the diagnosed privately.

Have you spoken to the SENCO at school? Support in school is based on needs rather than diagnosis, so the school should be providing support and making reasonable adjustments now.

Right to choose is an NHS/ GP route using private providers. So if you do that, it will be quicker than the standard route (though still slower than completely private) and you'll choose from a list of preferred providers I believe.

If you pay privately then first check your GP's rules around shared care agreements. This means that you'll pay for the assessment, but any recommended treatment plan (which will most likely include prescribed medication) will either need to be paid for by you monthly, or transferred over to your GP for repeat prescriptions meaning you won't have to pay for those. In both cases though, your ds will initially be tritrated - this is where they get your ds stable on the medication and is done via the private provider initially before handing over to your GP to pick up repeat prescriptions. Every time his medication needs review (at 14 he's growing quickly, so while the medication may be ok for a few months, there will come a time when the dosage will need to be upped) it will need to be done by the private provider. To do this, you will need to pay an annual fee, in addition to his assessment fee.

Definitely check shared care, as some GPs won't take it on - though if you use one of the providers they use for right to choose, then they'd struggle to defend not taking on shared care. Ask for a list of accepted providers.

At your son's age, going into GCSEs, I'd recommend private if you can afford it because time is of the essence. Either of the NHS routes will take too long to get treatment started and taking effect ahead of his exams.

Assuming he has adhd, once he's been assessed and has the diagnosis report and treatment plan, make sure you get a meeting with the senco to discuss exam access arrangements and anything else they can put in place to support him to stay on task during lessons. I'll be honest, if your ds is 'doing ok' but not massively disruptive and missing his MTGs by a couple of grades and still likely to pass, I'm not confident in the additional support you'll receive. In our experience, schools still don't really understand adhd when children are merely failing to reach their potential as opposed to causing problems in class. Much of the scaffolding he'll need will most likely need to come from you and your own research (adhd friendly revision techniques, apps to assist with executive function etc). I can recommend a book - Smart But Scattered Teens - if your ds fits this profile.

Good luck.

@Whatafustercluck thank you SO SO much…

@car1sberg

Depending on what you want option wise...

Option of medication: careful as you will want the person diagnosing to be able to provide medication - not all do. Then you need to find someone eg psychiatrist to provide and need to be stable to transfer to NHS GP shared care. Eg) we had a diagnosis along with ASD but the peadatrician didnt prescribe so had to search and wait (as all full) for a psychiatrist. The cost after the diagnosis was as follows: £850 initial emergency appointment, £245 each follow up, (~every 6weeks).£50 to get the prescription outside of appointment ..and then the cost of filling depends on the pharmacy.

Make sure anyone you use follows NICE guidelines

Psycoeducation - hard to get unless you pay. We pay £100 per week and use our DC DLA for this.

The royal college of psychiatrists have a good podcast and one episode on adhd in children. Talks about the best outcome being a mix of interventions

www.rcpsych.ac.uk/news-and-features/podcasts/detail/children's-mental-health-listen-up-adhd-in-children-and-young-people