ebook_ADHD2019_engl.
The World Federation of ADHD Guide 59 screen for comorbidities is included in ACE+. A child version of the ACE is also available online in the same site. It always important to remember that ADHD symptoms will not always be ob- served during the assessment process, and that an absence of symptoms in the clinic should never be used as a reason to rule out a diagnosis. An important final part of the assessment process is the sharing of the findings with the patient, the family, and any other important stakeholders. It is helpful to be able to refer back to the phrases and problem definitions that they themselves used at the beginning of the procedure and to link the conclusions to these. When a diagnosis is made, it is important to explain which of the problem behaviors are part of a consistent clinical picture that is a known and valid diagnostic entity and how these fit together. This, of course, also applies to every comorbid diagnosis that is identified. Also to symptoms that may have been judged either not to be clinically significant or to be relevant but not a formal part of the diagnostic cri- teria, as is often the case for symptoms like irritability, emotional dysregulation and mind wandering; these can be considered to be commonly associated clinical features of ADHD that support the diagnosis. A full psycho-educational discus- sion of the diagnosis should be provided, such that the patient and parents are equipped with enough knowledge and information about the problems that have been identified and empowered to make use of this in making decisions about and planning treatment and in their daily lives. Any misconceptions and misunders- tandings should be identified and carefully reframed (see chapter on talking with families). There should be space for parents to mourn some lost potential of their child and adaptation to new and more adequate expectations, but also room for hope, because ADHD is one of the childhood developmental disorders with the largest possible treatment effects. 18 Indeed, many adults with ADHD have positi- ve, fulfilling and successful lives. When a child does not fulfill the criteria for a diagnosis of ADHD, an alterna- tive explanation for the problem behavior needs to be offered. This could be ano- ther diagnosis or a description of an imbalance between the burden on a child and its overall maturation or capacities. General advice on how to get help to lower the burden or increase coping skills then needs to be offered. 18 COMPLEMENTARY INFORMATION FROM GUIDELINES There are several guidelines available in the literature that can help clinicians in the assessment of ADHD. We have presented two of them since they are both open access and were updated in 2018. Although each guideline has its peculia- rities, these two do not bring information that is markedly different from the one presented above, but they can be good reference for systematizing an ADHD as- sessment. The last revision of the National Institute for Health and Care Excel-
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