Diagnostic assessments for Attention Deficit Hyperactivity Disorder in children and young people with a Learning Disability: Challenges and ideas for practice

There is increased awareness of possible Attention Deficit Hyperactivity Disorder (ADHD) in children and young people, with referral rates for diagnostic assessments continuing to rise nationally. However, within the population of children with co-occurring learning disabilities (LD), the assessment and diagnosis of ADHD presents unique challenges that are often overlooked in research and clinical practice. There are many challenges we encounter in assessing ADHD in children with LD in our service, such as the suitability of the diagnostic criteria, lack of standardised assessment tools, overlapping traits with other neurodevelopmental conditions and limited research guidance. In response, our service has developed a tailored diagnostic approach that aligns with NICE (National Institute for Health and Care Excellence) guidelines while adapting criteria and tools to reflect the developmental, cognitive and communication needs of children with LD. This includes increasing the applicability of the diagnostic criteria, amending semi-structured interview tools, developing play-based assessment practices and observing children and young people across different settings. By sharing our practice, we hope to contribute to the broader dialogue around ADHD assessments and generate discussion among professionals in children’s LD services to enable learning from good practice examples, increase awareness of ADHD in children with LD and highlight the need for further research.