ebook_ADHD2019

Following diagnosis, all children with ADHD will require some form of intervention and most will require treatment over a relatively prolonged period of time. Before starting a child on medication for ADHD, it is important that both the treating doctor and parent (carer) have a good understanding of the child’s ADHD; a full history which includes environmental exposures and stress in pregnancy and early childhood; exclusion of conditions that may mimic ADHD (although can often be associated with ADHD), a thorough assessment with includes information from se- veral sources, and an assessment of comorbidities associated with ADHD. Managing ADHD can be a complex task where good communication with your patient, family and other allied professionals will greatly enrich this journey. Studies agree that there are currently significant variations in the delivery of ADHD care both between (e.g. Hinshaw et al. 1 ) and within countries and even wi- thin specific regions of a country (e.g. Australian Comission on Safety and Quality in Health Care 2 ). Unfortunately attempts to explain the reasons behind these within and between country variations in care have been largely unsuccessful. 3 Clearly the availability of medications will impact on prescribing patterns but differences in the way services are funded will also make a difference. Some countries like the USA rely almost completely on privately delivered healthcare services whilst servi- ces are almost all publicly funded in others (e.g. UK, Scandinavia). Whilst others have ORGANIZING AND DELIVERING TREATMENT FOR ADHD David Coghill Wai Chen Desiree Silva 5