ADHD support from the Integrated Neurodevelopmental Team

Families can get ADHD support from the Integrated Neurodevelopmental Team (INDT).  

The service provide: 

• assessments to diagnose young people presenting with attention, hyperactivity and impulsivity difficulties 
• support to manage medication from diagnosis up to the age of 18 

The team is made up of a:

• Consultant Psychiatrist
• Principal Clinical Psychologist and team manager
• Clinical Nurse Specialists and Prescribers
• Advanced Pharmacist
• Healthcare Assistants.

Who to refer a child or young person to
INDT work closely with:  

• child and adolescent mental health services (CAMHS) 
• Community Paediatrics 
• IND ASD Team 

 If a child or young person with possible ADHD also needs mental health support, they should be referred to CAMHS first.  

If they present with ADHD and autism, the team can start the assessment and refer onto the ASD team for further assessment.  
How to refer a child
Schools, GPs, social care and other children's health services can refer a child if the child is registered with a Royal Greenwich GP and is aged 5 to 18.

They must provide evidence that a child or young person displays behaviours consistent with possible ADHD. They must show these behaviours in more than one setting and that they impact the child's daily life. 

Once the child has been referred families will be asked to: 

1. create an account on Oxcare, an online health record using their child's name and NHS number
2. invite the Oxleas team to link with their child's account

This allows families to:

• access reports and letters written by the team
• view the appointment diary
• message the team
• access self help and self management resources

What happens during diagnostic assessments
The team follow the National Institute for Health and Care Excellence (NICE) guidelines for ADHD assessments.

For diagnostic assessments: 

1. the team ask families and schools to complete a questionnaires before the team see them. This is a key part of the assessment. If not completed, the child will be discharged
2. once the team have received the questionnaires, they'll offer the child an appointment in clinic to complete a QB Test (a computer based task that takes around 20 minutes to complete). This tells them about a child’s levels of inattention, activity and impulsivity
3. the team will compare these levels to a sample of children the same age and gender who do not have ADHD
4. the team review the results of the QB test, questionnaires and decide the next steps
5. the team may offer some children a 45 or 90 minute follow up depending on the child’s needs. These are often remote but the team may offer families a face to face appointment if necessary

Support available following a diagnosis
Following a diagnosis, the team may offer support with: 

• behaviour 
• medication  
• training to schools on request 

 After a diagnosis, the team will: 

• invite the family to a remote parent information session 
• give the family information and resources about ADHD and behavioural support 
• phone the family after the session to answer questions and discuss medication 

 If the family do not want medication, the team will discharge them.  
If the family decide to start their child on medication:  

1. the team invite them into clinic to do a physical examination and discuss medication options 
2. they’ll get a prescription to start the medication  
3. the team ask the family to give feedback after 2 weeks  
4. the team will do a follow up session 4 weeks later 
5. the team will prescribe medication for the first 3 months and make any changes to medication as needed 
6. when the child is stable on medication, the team will share a care agreement with the GP who will then take on prescribing it and do physical checks 
7. the team will offer medication reviews at least once a year. Families can request a medication review if they have concerns.  

 The team support children until they turn 18. After that, the GP will continue to monitor medication.