Assessment and Treatment of ADHD

Established: July 2008

Convenor: Dr. Kapil Sayal (Senior Lecturer in Child & Adolescent Psychiatry) & Professor Chris Hollis (Professor of Child & Adolescent Psychiatry), Section of Developmental Psychiatry, Division of Psychiatry, University of Nottingham. (Contact: kapil.sayal@nottingham.ac.uk)

Remit and aims
The convenors are members of the NICE Guideline Development Group (GDG) for ADHD (publication due 2008). This GDG is chaired by Professor Eric Taylor, a member of our MHRN group. We intend to build on the multi-disciplinary work carried out by the GDG. As part of developing the guidelines and making clinical practice recommendations, we have already carried out systematic reviews, meta-analyses where appropriate, and identified important gaps in research evidence to support research recommendations. Through this MHRN group, we will take forward the development of these recommendations with inter-disciplinary collaborations across psychiatry, psychology, paediatrics, education, nursing, pharmacy, health economics, sociology, and user and carer collaboration.

We intend to develop multi-site studies that build on efficacy studies and other work. Examples include cost-effectiveness RCTs (for medication, behavioural and nutritional interventions), testing of protocols to improve ADHD diagnostic practice in routine NHS settings, assessing the acceptability and utility of computerised cognitive assessments, and evaluations of service developments such as transition services.


Clinical Importance of Topic
ADHD affects about 5% of school-age children. There is increasing evidence that it persists into adulthood resulting in impairment. It is a risk factor for children’s development, other mental health disorders, poor educational outcomes, substance misuse, and offending. National data suggest that less than half of affected children have been diagnosed and received treatment. However, large scale trials from the U.S. have identified efficacious pharmacological and behavioural treatments. The improved identification of these children, improved access to and optimisation of treatments in routine practice, and the receipt of appropriate interventions at times of transition (e.g. leaving school) are of key research and clinical importance.

Membership
Professor Chris Hollis (Joint convenor) Child and adolescent psychiatry University of Nottingham
Dr. Kapil Sayal (Joint convenor) Child and adolescent psychiatry University of Nottingham
Professor Philip Asherson Adult Psychiatry (ADHD) Kings College London, Institute of Psychiatry
Professor Jennifer Beecham Health Economics PSSRU, London School of Economics & University of Kent
Dr. Wai Chen Child and adolescent psychiatry University of Southampton
Dr. David Coghill Child and adolescent psychiatry University of Dundee (Scotland)
Dr. David Daley Developmental Psychology University of Bangor (Wales)
Professor Alan Emond Developmental Paediatrics University of Bristol
Dr. Jonna Kuntsi Cognitive Developmental Psychology Kings College London, Institute of Psychiatry
Professor Tomáš Paus Cognitive Neuroscience University of Nottingham
Dr. Katya Rubia Cognitive Neuroscience Kings College London, Institute of Psychiatry
Dr. Ilina Singh Sociology and Qualitative research London School of Economics and Political Science
Professor Edmund Sonuga-Barke Developmental Psychology University of Southampton
Professor Eric Taylor Child and adolescent psychiatry Kings College London, Institute of Psychiatry
Professor Anita Thapar Child and adolescent psychiatry Cardiff University (Wales)
Dr. Margaret Thompson Child and adolescent psychiatry University of Southampton
Professor Peter Tymms Education University of Durham
Professor Ian Wong Pharmacy London School of Pharmacy
Leading Clinicians
Cathy Laver-Bradbury Nurse Consultant ADHD Ashurst Child Development Centre
Dr. Daphne Keen Developmental Paediatrics St. George's Healthcare NHS Trust
Dr. Nicola Salt General Practice Thurleigh Road Surgery, London
Dr. Paramala Santosh Child and adolescent psychiatry Great Ormond Street Hospital NHS Trust
Medicines for Children Research Network (MCRN) Link
Dr. Alan Smyth Director, Trent Local Research Network University of Nottingham
User and Carer involvement
Andrea Bilbow ADDIS (Attention Deficit Disorder Information and Support Service)
Moya Stevenson Carer of a young person with ADHD

Service user and carer input
The group includes Andrea Bilbow from ADDISS (the National Attention Deficit Disorder Information and Support Service) and Ms. Moya Stevenson (the carer of a young person with ADHD). This will be further enhanced in the coming year as the convenors have recently secured funding to set up and develop a Managed Innovation Network for ADHD that spans a wide range of agencies and services in Nottinghamshire. Users and carers are key partners in this research network. A key aim of this network is to identify and engage users and carers to enhance their involvement and participation in research around ADHD.

We have a strong track record of user involvement in our existing research. For example, we have carried out focus groups with young people with ADHD. In another study, we are developing carer-derived quality indicators for primary care child and adolescent mental health which strongly reflects the user perspective. This work will create parent/carer-developed quality of care measures that address access to care for child and adolescent mental health problems. There is a user advisory group to enhance the user perspective in the study’s strategy. This group is constituted from representatives from support groups for parents and caregivers such as ADDISS and Young Minds, an NHS Trust PPI (Patient and Public Involvement) co-ordinator, a parent development co-ordinator with Connexions, and a carer.