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What is the BFC Call to Action?

What are the symptoms of ADHD?

Who is most likely to be affected?

Who can diagnose ADHD?

Do teachers need training on how to assess pupils with ADHD?

Will teachers need to gain parental permission prior to screening a child with the SDQ questionnaire?

What is the difference between screening and assessment?

Will this put too much responsibility/pressure on teachers and take it away from the parents?

Will teachers/parents receive support once a diagnosis is made?

Will screening lead to more children being prescribed medication for ADHD?

Is the NHS ready for the influx of children that will be diagnosed with ADHD?

What will happen once a child is identified and they show symptoms of ADHD?

If a child is diagnosed with ADHD, will it be compulsory to have them statemented?

How will parents be informed and educated?

Why wait until the second fixed term exclusion instead of assessing children as soon as they exhibit symptoms?

Does this mean children with ADHD cannot be excluded?

What is the impact of diagnosis on exclusion rates?

What will happen once a child is assessed and the results suggest they do not have ADHD?

Shouldn't we be screening children for all special educational needs? Why focus on ADHD?


What is the BFC Call to Action?

We recommend that in all children who receive two fixed term exclusions from school, ADHD is considered and if appropriate, an assessment process initiated.

What are the symptoms of ADHD?

The core symptoms of ADHD are inattention, hyperactivity and impulsivity. People with ADHD often have difficulty focusing, are easily distracted, have trouble staying still and frequently are unable to control their impulsive behaviour.37

Who is most likely to be affected?

ADHD is one of the most common psychiatric disorders in children and adolescents10 but although many people tend to think of ADHD as a childhood problem, up to 65 per cent of children with ADHD may still exhibit symptoms into adulthood.39

Who can diagnose ADHD?

Proper assessment and diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD.31 However, key behaviours related to ADHD are readily observable in children at school and it might be advantageous for teachers to be able to recognise those pupils who may have ADHD.31 We would encourage teachers and SENCOs to initially screen children for ADHD using the simple yet scientifically respectable questionnaire such as the existing Strengths and Difficulties Questionnaire (SDQ) (www.SDQinfo.org), which will indicate whether multi-agency assessment is needed.

Do teachers need training on how to assess pupils with ADHD?

Assessment and diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD.31 We would encourage teachers and SENCOs to screen children for ADHD using the simple yet scientifically respectable questionnaire such as the existing Strengths and Difficulties Questionnaire (SDQ) (www.SDQinfo.org), which will indicate whether multi-agency assessment is needed. However, improving teachers’ knowledge of ADHD alongside providing advice on how to work with children who might have ADHD may improve outcomes for identifying and working with children with ADHD. To achieve this, teachers need to be equipped with information about the behavioural problems that children with ADHD are likely to exhibit in the classroom, possible reasons for that behaviour, suggestions for its management and information about seeking further help with particular children.31

Will teachers need to gain parental permission prior to screening a child with the SDQ questionnaire?

Parental permission is not compulsory however in practice it is preferable to be in contact with the parents and if a teacher is concerned that a child may be suffering from ADHD, it is likely that they have already spoken to the child’s parents over their concerns. One study in the UK showed that two-thirds of parents of children with ADHD had been in contact with teachers about their concerns.32

What is the difference between screening and assessment?

Key behaviours related to ADHD are readily observable in children at school and it might be advantageous for teachers to be able to recognise those pupils who may have ADHD. 31

We would encourage teachers and SENCOs to initially screen children for ADHD using the simple yet scientifically respectable questionnaire such as the existing Strengths and Difficulties Questionnaire (SDQ) (www.SDQinfo.org), which will indicate whether multi-agency assessment is needed. Assessment and diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD. 31

Will this put too much responsibility/pressure on teachers and take it away from the parents?

Key behaviours related to ADHD are readily observable in children at school and it might be advantageous for teachers to be able to recognise those pupils who may have ADHD. Children with ADHD are at risk academically and socially, and they can be difficult to manage in the classroom. Since teachers work with these children for several hours each day, they are in a position to be able to implement strategies in the context of the school environment.31

We would encourage teachers and SENCOs to screen children for ADHD using the simple yet scientifically respectable questionnaire such as the existing Strengths and Difficulties Questionnaire (SDQ) (www.SDQinfo.org), which will indicate whether multi-agency assessment is needed.

Will teachers/parents receive support once a diagnosis is made?

For teachers - Following a diagnosis of ADHD in a school-age child or young person healthcare professionals should, with the parents’ or carers’ consent,  contact the child or young person’s teacher to explain:31

  • the diagnosis and severity of symptoms and impairment
  • the care plan
  • any special educational needs

For parents - If the child or young person has moderate levels of impairment, healthcare professionals should offer parents or carers referral to a group parent-training/education programme either on its own or together with a group treatment programme (CBT and or social/skills training) for the child or young person.31

Will screening lead to more children being prescribed medication for ADHD?

Initial screening by teachers using the SDQ questionnaire can be seen as the first stage of the referral mechanism. Proper assessment and diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD.31 Appropriate diagnosis will mean that the child with ADHD can get the appropriate support with the aim of preventing their behaviour spiralling out of control and reaching the point of exclusion.30

Is the NHS ready for the influx of children that will be diagnosed with ADHD?

According to NICE, ADHD is associated with a significant financial and emotional cost to the healthcare system, education services, carers and families and society as a whole. Providing effective intervention could improve the quality of life of individuals with ADHD, their carers and their families, while also reducing the financial implications and psychological burden of ADHD to society.31

What will happen once a child is identified and they show symptoms of ADHD?

If a teacher and/or SENCO believe a child may be suffering from ADHD, the SENCO may then organise a full diagnostic assessment if needed. The Special Educational Needs Code of Practice34 further describes the kind of assistance, which may be required by particular children, including those who demonstrate the symptoms of ADHD. The teacher may also wish to implement some key strategies for proactive management of children with ADHD symptoms to see if they help. Teacher-led educational interventions mainly consist of managing academic activities or adapting the physical environment.31

If a child is diagnosed with ADHD, will it be compulsory to have them statemented?

No it is not compulsory but, if appropriate, it may be useful as statementing means that a child would receive a number of extra resources including Teaching Assistant support.

How will parents be informed and educated?

When a child or young person with disordered conduct and suspected ADHD is referred to a school’s special educational needs coordinator (SENCO), the SENCO, in addition to helping the child with their behaviour, should inform the parents about local parent training/education programmes. There is evidence that advice to teachers as an added intervention to a parent-training programme is effective in reducing children’s ADHD core symptoms.31

Why wait until the second fixed term exclusion instead of assessing children as soon as they exhibit symptoms?

There is no reason to wait until the second fixed term exclusion to assess a child who is exhibiting ADHD symptoms, in fact, it is highly probable that early identification and treatment of children showing ADHD behaviours could dramatically reduce the numbers of children with permanent and temporary exclusions. 30

However exclusion is sometimes the first event that can label a child 'a problem'. Children with untreated developmental problems like ADHD cannot properly moderate their behaviour without the right support, so they are very likely to be excluded more than once. This is an indicator of underlying behavioural problems. If these behavioural problems can be identified before leading to permanent exclusion from school, it is possible for the child’s behaviour to be managed appropriately and the negative impact of permanent exclusion on the child’s education and future avoided.

Does this mean children with ADHD cannot be excluded?

No, whether or not a child is excluded will depend upon the individual situation. What it will mean is that if a child is identified as having ADHD at second fixed term exclusion they may receive the treatment and management of the condition they need which in turn may help them reach their potential in full-time education.

What is the impact of diagnosis on exclusion rates?

Whilst we do not know what the positive impact of diagnosis has on reducing exclusion rates, a report called ‘Paying Enough Attention’ conducted by ADDISS amongst child and adolescent psychiatrists and paediatricians, highlighted the impact of undiagnosed and untreated ADHD.33 Over 98 per cent of those surveyed believed that undiagnosed ADHD has a serious impact on a child’s academic progress and 97 per cent stated that children with undiagnosed ADHD are more likely to drop out of school several years earlier than their peers.33

What will happen once a child is assessed and the results suggest they do not have ADHD?

Teachers need to consider other issues as to why the child is struggling in school such as whether the curriculum is set at too high or too low a level or other conditions such as dyslexia.

Shouldn't we be screening children for all special educational needs? Why focus on ADHD?

Yes but with ADHD we are talking about children who have a very distinct set of symptoms which will require a specific course of action and management and should not be confused with co-existing conditions. We also know that children with ADHD are more likely to be excluded:30

  • Children with ADHD have more than 100 times greater risk of being permanently excluded from school than other children
  • 39% of children with ADHD have had fixed-term exclusions from school
  • 11% of excluded children with ADHD have been excluded permanently