ADHD

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

ADHD can occur in people of any intellectual ability but people with ADHD tend to have other learning difficulties too although this isn't always the case.

Causes of ADHD 

The exact cause of ADHD is not fully understood, but a combination of factors is thought to be responsible.

Genetics

ADHD tends to run in families. In most cases, it is thought the genes you inherit from your parents are a significant factor in developing the condition.

Brain Function and Structure

Research has identified a number of possible differences in the brains of people with ADHD compared to those who don't have the condition.

Some studies have suggested that people with ADHD could have an imbalance in the level of chemicals in the brain. These chemicals are called neurotransmitters, or that these chemicals may not work properly.

Other Possible Causes

Various other causes have also been suggested as having a role in the development of ADHD, including:

Being born prematurely (before the 37th week of pregnancy)

Having a low birthweight

Brain damage either in the womb or in the first few years of life

Drinking alcohol, smoking or misusing drugs while pregnant

Exposure to high levels of toxic lead at a young age

However, the evidence for many of these factors is inconclusive, and more research is needed to determine if they do actually contribute to ADHD.

Symptoms of ADHD 

The symptoms of ADHD can be categorised into two sets of behavioural problems These categories are inattentiveness & hyperactivity and impulsiveness.

The majority of people with ADHD have problems that fall into both these categories, but not always.

For example, some people with the condition may have problems with inattentiveness, but not with hyperactivity or impulsiveness. This form of ADHD is also known as attention deficit disorder (ADD), and it can sometimes go unnoticed because the symptoms may be less obvious.

Symptoms Of ADHD in Children and Teenagers

The symptoms of ADHD in children and teenagers are well outlined, and they are usually noticeable before the age of six & will be displayed at home & at school. Main symptoms include...

Inattentiveness

Short attention span & easily distracted

Making careless mistakes in things such as school work

Appearing forgetful or losing things

Being unable to stick at tasks

Appearing to be unable to listen to or carry out instructions

Constantly changing activity or task

Having difficulty organising tasks

Hyperactivity and Impulsivenes

Being unable to sit still  in calm or quiet surroundings

Constant fidgeting

Being unable to concentrate on tasks

Excessive physical movement

Excessive talking

Being unable to wait their turn

Acting without thinking

Interrupting conversations

Little or no sense of danger

Although not always, some children may also have signs of other problems or conditions alongside ADHD. These include...

Anxiety disorder. This causes your child to worry and be nervous much of the time. It may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness

Oppositional Defiant Disorder (ODD) This is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers

Conduct Disorder. This often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals

depression

Sleep Problems. Finding it difficult to get to sleep at night, and having irregular sleeping patterns

ASD This affects social interaction, communication, interests and behaviour

Epilepsy.  A condition that affects the brain and causes repeated fits or seizures

Tourette’s Syndrome. A condition of the nervous system, characterised by a combination of involuntary noises and movements called tics

In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.

ADHD is a developmental disorder. It is believed that it cannot develop in adults without it first appearing during childhood. However, it is known that symptoms of ADHD are often present from childhood into a person's teenage years, and then adulthood. 

An estimated 15% of people diagnosed with ADHD as children will at 25 years old still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives.

The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD

Possible Symptoms Of ADHD in Adults

Carelessness and lack of attention to detail

Continually starting new tasks before finishing old ones

Poor organisational skills

Inability to focus or prioritise

Continually losing or misplacing things

Forgetfulness

Restlessness and edginess

Difficulty keeping quiet and speaking out of turn

Blurting out responses and often interrupting others

Mood swings, irritability and a quick temper

Inability to deal with stress

Extreme impatience

Taking risks in activities, with little or no regard for personal safety or the safety of others

One of the most common conditions that can occur alongside ADHD is depression. Other conditions that adults may have alongside ADHD include:

Personality disorders

Bipolar disorders

OCD

Diagnosing ADHD 

If you think you or your child may have ADHD you should speak to your GP.

If it's your child you are worried about, it may help to speak to their teachers before seeing your GP, to find out if they have any concerns about your child's behaviour.

Your GP can't diagnose ADHD but they can discuss your concerns with you and refer you for a specialist assessment, if necessary.

When you visit your GP they may ask you questions similar to these to help. The questions could include...

Explaining your symptoms or those of your child

When these symptoms started

Where the symptoms occur eg. at home or in school

If the symptoms affect your or your child’s day to day life

If there have been any recent significant events in your or your child's life

I there is a family history of ADHD

About any other problems or symptoms of different health conditions you or your child may have.

If your GP thinks your child may have ADHD, they may first suggest a period of "watchful waiting" lasting around 10 weeks. This is to see if you or your child's symptoms improve, stay the same or get worse.

If the behaviour doesn't improve, and both you and your GP thinks it is seriously affecting day-to-day life, you should be referred to a specialist for a formal assessment.

Assessment

There are a number of specialists you or your child may be referred to for a formal assessment, including:

A Psychiatrist

A Paediatrician

A learning disability specialist, social worker or occupational therapist with expertise in ADHD

Who you are referred to will depend on your age and what is available in your local area.

There is no simple test to determine whether you or your child have ADHD, but your specialist can make an accurate diagnosis after a detailed assessment.

Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness.

To be diagnosed with ADHD, your child must also have:

Been displaying symptoms continuously for at least six months

Started to show symptoms before the age of 12

Been showing symptoms in at least two different settings eg. at home and at school

Displayed symptoms that make their lives considerably more difficult on a social, academic or occupational level. Symptoms that are not just part of a developmental disorder or difficult phase, and are not better accounted for by another condition

Diagnosis in Adults

Diagnosing ADHD in adults is more difficult because there is some disagreement about whether the list of symptoms used to diagnose children and teenagers applies to adults.

In some cases, an adult may be diagnosed with ADHD if they have five or more symptoms of inattentiveness, or five or more symptoms of hyperactivity and impulsiveness, that are listed in the criteria for children with ADHD.

As part of your assessment, the specialist will ask about your present symptoms although, under current diagnostic guidelines, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood.

If you find it difficult to remember whether you had problems as a child, or you were not diagnosed with ADHD when you were younger, your specialist may wish to see your old school records or talk to your parents, teachers or anyone else who knew you well when you were a child.

For an adult to be diagnosed with ADHD, their symptoms should also have a moderate impact on different areas of their life, such as:

Underachieving at work or in education

Difficultly making or keeping friends

Difficulty in relationships with partners

If your problems are recent and did not occur regularly in the past, you are not considered as having ADHD. This is because it is currently not thought that ADHD can develop for the first time in adults.

Treating ADHD 

There is no cure for ADHD, but treatment can help relieve the symptoms and make the condition much less of a problem day to day.

ADHD can be treated using medication or therapy, but a combination of both is often the best way to treat it.

Treatments include...

Medication

There are four types of medication licensed for the treatment of ADHD. These medications are not a permanent cure for ADHD, but they can help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practise new skills.

Some medications need to be taken every day, but some can be taken just on school days. Treatment breaks are occasionally recommended, to assess whether the medication is still needed.

If you or your child is prescribed one of these medications, you will probably be given small doses at first, which may then be gradually increased. You or your child will need to see your GP for regular check-ups, to ensure the treatment is working effectively and to check for signs of any side effects or problems.

If either you or your child begin to feel depressed or suicidal while taking this medication, speak to your doctor.

Therapy

As well as taking medication, different therapies can be used n treating ADHD in children, teenagers and adults. Therapy is also effective in treating additional problems, such as conduct or anxiety disorders, that may appear with ADHD.

These therapies include...

Psychoeducation

Psychoeducation means you or your child will be encouraged to discuss ADHD and how it affects you. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

Behaviour Therapy

Behaviour therapy provides support for carers of children with ADHD, and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their ADHD.

If your child has ADHD, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour, and removal of a privilege for poor behaviour. For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.

Parent Training and Education Programmes

If your child has ADHD, specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour. You may also be offered parent training before your child is formally diagnosed with ADHD.

These programmes are usually arranged in groups and can last several weeks. They aim to teach parents and carers about behaviour management while increasing your confidence in your ability to help your child, as well as improving your relationship. 

Social Skills Training

Social skills training involves your child taking part in role play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Cognitive Behavioural Therapy (CBT)

CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A CBT therapist would try and change how your child feels about a situation, which would in turn potentially change their behaviour.

CBT can be carried out with a therapist individually or in a group.

Living with ADHD 

Caring for a child with attention deficit hyperactivity disorder (ADHD) can be draining.

The behaviours typical of ADHD can make normal everyday activities exhausting and stressful.

Ways to cope...

Although it can be difficult sometimes, it's important to remember a child with ADHD cannot help their behaviour. People with ADHD find it difficult to suppress impulses, which means they do not stop to consider a situation or the consequences before they act.

If you are looking after a child with ADHD, you may find this advice helpful.

Plan the Day

Plan the day so your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life. 

Set Clear Boundaries

Make sure everyone knows what behaviour is expected, and reinforce positive behaviour with immediate praise or rewards. Be clear, Explaining if the boundaries are crossed there are consequences eg a privilege is ttaken away & and follow these through consistently.

Be Positive

Give specific praise. Instead of saying a general, "Thanks for doing that," you could say, "You washed the dishes really well. Thank you." This will make it clear to your child that you are pleased, and why.

Giving Instructions

If you are asking your child to do something, give brief instructions and be specific. Instead of asking, "Can you tidy your bedroom?" say, "Please put your toys into the box, and put the books back onto the shelf." This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.

Incentive Scheme

Set up your own incentive scheme using a reward chart, so good behaviour can earn a privilege. For example behaving well on a shopping trip will earn your child time on the computer or some sort of game. Involve your child in it and allow them to help decide what the privileges will be.

These charts need regular changes or they become boring. 

Intervene Early

Watch for warning signs. If your child looks like they are becoming frustrated, overstimulated and about to lose self-control, intervene. Distract your child if possible, by taking them away from the situation, which may calm them down.

Social Situations

Keep social situations short and sweet. Invite friends to play, but keep playtimes short so your child does not lose self control. Do not aim to do this when your child is feeling tired or hungry, such as after a day at school.

Exercise

Make sure your child gets lots of physical activity during the day. Walking, skipping and playing sport can help your child wear themselves out and improve their quality of sleep. Make sure they are not doing anything too strenuous or exciting near to bedtime.

Bedtime

Stick to a routine. Make sure your child goes to bed at the same time each night and gets up at the same time in the morning. Avoid overstimulating activities in the hours before bedtime, such as computer games or watching TV.

Night Time

Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make symptoms worse. Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns. Trying a sleep-friendly routine can help your child and make bedtime less of a battleground.

Help at School

Children with ADHD often have problems with their behaviour at school, and the condition can have a negative impact on a child's academic progress.

Speak to your child's teachers or their school's special educational needs co-ordinator (SENCO) about any extra support your child may need

Adults with ADHD

If you are an adult living with ADHD, you may find the following advice useful.

Make lists

Keep diaries

Stick up reminders and set aside some time to plan what you need to do if you find it hard to stay organised

Let off steam by exercising regularly

Find ways to help you relax, such as listening to music or learning relaxation techniques

If you have a job, speak to your employer about your condition, and discuss anything they can do to help you work better

Talk to your doctor about your suitability to drive, as you will need to tell the Driver and Vehicle Licensing Agency (DVLA) if your ADHD affects your driving

Contact or join a local or national support group. These organisations can put you in touch with other people in a similar situation, and they can be a good source of support, information and advice.

Starting School Topic

DEALING WITH TEARS

Going to school for the first time is exciting, but it can also be pretty scarey, for the child and for the grownups!  Teachers agree that helping small children settle happily into school is the most delightful, rewarding part of their job. Have confidence that the teacher will welcome and treasure your child and understand what a big step they are taking when they start school.  Look at these few simple tips, chances are you’ll already be doing a lot of these things and your child will take to school like a duck to water!

Make sure that you have all the equipment and clothing required well ahead of time to avoid a last minute panic. If you panic so will your child!Let your child enjoy the fun of getting a new school bag, pencils and so on. If possible avoid any major changes at home in the weeks around the start of school, so that your child has a secure base. Its not a good week to begin your own new high flying career!If your child has special needs or health issues talk to the school about these before the start of the term. Don’t worry, they will have the right experience to cope.Make sure you know when and where your child should go on the first morning, Act naturally, don’t overdo promises that school will be fun or warn about how different[or difficult] it will be. Just talk pleasantly and sensibly about ‘going to school’ and remember that its a normal part of  childhood- everyone does it!Give your child a simple description of what to expect, for example outline how the day will be organised, ending with ‘and then you come home.’   Remind them that the teacher is there to help them or answer any questions they might have, Remind yourself that teachers understand that starting school is a big step for small children and will be experienced and skilled at helping your child to settle in. Provide healthy but familar food if you send snacks or lunch to school with your child. Find out about any rules the school may have about the food children may bring (for example many schools do not allow peanuts  in any form)

FIRST FEW WEEKS

Be prepared for your child to be very tired for the first few weeks, there is a lot to learn and take in at school. So I advise early bedtimes and normal routine while they are settling in. If your child does cry when you leave them, follow the school rules on what to do. Some schools will allow parents to stay for a little while before they have to leave, other schools will expect parents to leave as soon as school starts, even if their child is upset. My advice is to show your child that you are confident that they will be fine very soon. Children  generally cry because they are upset at separating from their parent, not because they don’t like being at school. So remind your child that you will see them soon and remind yourself that separating is not going to be any easier whether you do it now or in half an hour’s time!Some children don’t settle at school well because they think they are missing out on better things at home. My advice is to keep a low profile on what you have done with younger brothers and sisters at home and save extra special treats for all the family to enjoy.

FREE SCHOOL MEALS

Every child in reception, year 1 and year 2 in state-funded schools will receive a free school lunch from September 2014, Deputy Prime Minister Nick Clegg has announced. The government will fund schools in England to provide every child in reception, year 1 and year 2 with a hot, nutritious meal at lunch time. The aim is to improve academic attainment and save families money – over the course of a year the average family spends £437 on school lunches per child. Universal free school meals for primary school pupils were a key recommendation in a recent review of school food produced independently for the Department for Education. The review found that, in pilots where all children have been given a free school dinner, students were academically months ahead of their peers elsewhere and more likely to eat vegetables at lunchtime instead of less healthy food like crisps. At the same time, the government will extend free school meals to disadvantaged students in further education and sixth form colleges.

What to put in your childs lunchbox?

Theres loads of choices to go for with Wraps, Bagels, Rolls Sandwhiches, Crackers, pita breads

You can have a chicken roll or a ham sandwhich or a cheese bagel or cheese on crackers or a tuna wrap

Please remember not to put peanut butter or nutella in your childs choice as other children may have nut allergies.

You can also put in a yogurt or a piece of fruit like a banana or a packet of raisens.

Some schools dont let you put in crips fpr your child as the seem to be 'unhealthy' for them so as a substitute you could put in some rice crackers orsome bread sticks or some babybells or some cocktail sausages.

For juice it is best to give them sugar free juice or fresh orange or apple juice

Breaktime Snacks

When your little ones first start school some schools let you have breaktime snacks so here are some options if your not sure what to do

You could give them:

 a little pot of dry cereal

Some cucumber and carrot sticks

a cereal bar

a packet of raisins

fruit eg. an orange or a banana or an apple

Some schools have a snack bar for them at school if they wish to buy something, my sons school charges 20p a snack and 20p for a sugar free juice drink.

Starting school means the start of a huge list for School supplies! School supplies vary depending on how old your child is buy Here are some of the items you may require when starting school:

Uniform

school bag

pencil case

pens

pencils

scissors

glue stick

rubber

crayons

pencil sharpener

Ruler

Compass

notebook

folders

Assistance with school uniform is available if you claim any of the following:

Income Support

Income based job seekers allowance

Income related Employment and support allowance

Child tax and your income is less than £16,010

If you are 16-16 years olfd and receive any benefits for yourself 

The clothing allowance is made once per school year, and payment is made directly to the applicant for the sum of £50 for every eligible child in primary or secondary school. For claims received after December, the sum of £25 is paid for every eligible child.

To apply you can dowmload an application pack from your local council's website

AUTISM

Autism Spectrum Disorder 

Autism spectrum disorder (ASD) is a condition that affects social interaction, communication, interests and behaviour. It includes Asperger syndrome and childhood autism.

The main features of ASD typically start to develop in childhood.

In the UK, it's estimated that about one in every 100 people has ASD. There is no 'cure' for ASD, but a wide range of treatments including education and behaviour support can help people with the condition.

CAUSES

The exact cause of ASD is unknown, but it is thought that several complex genetic and environmental factors are involved. In some cases, an underlying condition may contribute to ASD.

In the past, some people believed that the MMR (mumps, measles and rubella) vaccine caused ASD, but this has been investigated extensively in a number of major studies around the world, involving millions of children, and researchers have found no evidence of a link between MMR and ASD.

Risk Factors

Factors thought to increase the risk of developing ASD, known as ‘risk factors’, can usually be divided into five main categories:

Genetic factors – certain genetic mutations may make a child more likely to develop ASD.

Environmental factors – during pregnancy, a child may be exposed to certain environmental factors that could increase the risk of developing ASD.

Psychological factors – people with ASD may think in certain ways that contribute towards their symptoms.

Neurological factors – specific problems with the development of the brain and nervous system could contribute to the symptoms of ASD.

Other health conditions – certain health conditions associated with higher rates of ASD

SIGNS & SYMPTOMS

ASD can cause a wide range of symptoms, and there are many different ways those symptoms can be grouped.

Signs of ASD in Pre-School Children

*Spoken Language*

Delayed speech development (eg - not speaking at least 10 different words by the age of two) or not speaking at all

Frequent repetition of set words and phrases

Speech that sounds very monotonous or flat

Preferring to communicate using single words, despite being able to speak in sentences

*Responding to Others*

Not responding to their name being called, despite having normal hearing

Rejecting cuddles initiated by a parent or carer (although they may initiate cuddles themselves)

Reacting unusually negatively when asked to do something by someone else

*Interacting with Others*

Not being aware of other people’s personal space, or being unusually intolerant of people entering their own personal space

Little interest in interacting with other people, including children of a similar age

Not enjoying situations that most children their age like, such as birthday parties

Preferring to play alone, rather than asking others to play with them

Rarely using gestures (such as pointing) or facial expressions when communicating

Avoiding eye contact 

Having repetitive movements such as flapping their hands, rocking back and forth or flicking their fingers

Playing with toys in a repetitive and unimaginative way, such as lining blocks up in order of size or colour, rather than using them to build something

Preferring to have a familiar routine, and getting extremely upset if there are changes to their normal routine

Having a strong like or dislike of certain foods, based on the texture or colour of the food as much as the taste

Signs and Symptoms of ASD in School-Age Children

Preferring to avoid using spoken language

speech that sounds very monotonous or flat

Speaking in pre-learned phrases, rather than putting together individual words to form new sentences

Seeming to talk ‘at’ people, rather than sharing a two-way conversation

Taking people’s speech literally and being unable to understand sarcasm, metaphors or figures of speech

Reacting unusually negatively when asked to do something by someone else

Not being aware of other people’s personal space, or being unusually intolerant of people entering their own personal space

Little interest in interacting with other people, including children of a similar age, or having few close friends despite attempts to form friendships

Not understanding how people normally interact socially, such as greeting people or wishing them farewell

Being unable to adapt the tone and content of their speech to different social situations, for example speaking very formally at a party and then speaking to total strangers in a familiar way

Not enjoying situations and activities that most children their age like

Rarely using gestures or facial expressions when communicating

Avoiding eye contact

Having repetitive movements such as flapping their fingers, rocking back and forth or flicking their fingers

Playing in a repetitive and unimaginative way, often preferring to play with objects rather than people

Developing a highly specific interest in a particular subject or activity

Preferring to have a familiar routine, and getting extremely upset if there are changes to their normal routine

Having a strong like or dislike of certain foods, based on the texture or colour of the food as much as the taste

ASD can cause a wide range of symptoms, which are often grouped into two main categories:

Problems with social interaction and communication, including problems understanding and being aware of other people's emotions and feelings. It can also include delayed language development and an inability to start conversations or take part in them properly.

Restricted and repetitive patterns of thought, interests and physical behaviours, including making repetitive physical movements, such as hand tapping or twisting, and becoming upset if these set routines are disrupted.

Children, young people and adults with ASD are often also affected by other mental health conditions such as attention deficit hyperactivity disorder (ADHD), anxiety or depression.

About half of those with ASD also have varying levels of learning difficulties. However, with appropriate support many people can be helped to become independent.

DIAGNOSIS

Autism features can often be recognised in children before the age of two or three years. However for many, the signs will often only become more noticeable as they get older.

See your GP or health visitor if you notice any of the symptoms of ASD, or if you’re concerned about your child’s development. It can also be helpful to discuss your concerns with your child’s nursery or school.

Parents usually notice the symptoms of ASD when their child is around two or three years old.

In some instances, mild cases may not be detected until adulthood.

Diagnosing ASD in Children

The health professionals that can help with diagnosis could be:

A psychologist – a health professional with a psychology degree, plus further training and qualifications in psychology

A psychiatrist – a medically qualified doctor with further training in psychiatry

A paediatrician – a doctor who specialises in treating children

A speech and language therapist – a specialist in recognising and treating communication problems

Some local health authorities now use multidisciplinary teams. These are made up of a combination of professionals who work together to make an assessment.

Assessment

There are no individual tests to confirm a diagnosis of ASD, a diagnosis is instead based on the range of features your child is showing. The type of assessment carried out often depends on things such as access to additional information (for example nursery or school records) and the skills of the professional or team seeing your child.

AFTER DIAGNOSIS

Parents may react in different ways when ASD has been confirmed. Some parents feel relieved because they now understand the reasons behind their child's behaviour and can begin to treat them. Other parents feel an immense sense of shock and disbelief, as they are naturally worried about what the diagnosis means for their child's future.

However, the diagnosis offers an insight into your child's individuality and personality. In turn, it gives you a chance to guide their development and growth.

When a child is diagnosed with ASD, many parents are keen to find out as much as they can about the condition.

TREATMENT 

There is currently no 'cure' for ASD. However, a range of specialist education and behavioural programmes can be effective in helping children with ASD.

There are many different types of help for ASD and it can be hard to judge which one will work best for your child as each person with ASD is affected differently.

Some types of help can involve hours of intensive work, and this is not always possible for many families because of the practical, emotional and financial commitments necessary

Some methods used to help ASD are:

Social-communication programmes

Your child may be offered a type of programme called a 'social-communication intervention'. This aims to help them communicate and interact with people and make social situations easier. Depending on your child's age, these programmes may take place at school, or with a parent, carer or teacher.

Applied behaviour analysis (ABA)

Applied behaviour analysis (ABA) involves breaking down skills (such as communication and cognitive skills) into small tasks and teaching those tasks in a highly structured way, as well as rewarding and reinforcing positive behaviour while discouraging inappropriate behaviour.

ABA sessions are normally carried out at home, although some programmes can be integrated into schools or nurseries.

An ABA programme usually begins with simple tasks that become more complex over time, which can help your child's development by gradually improving their skills.

TEACCH

TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) is a type of educational intervention that places great emphasis on structured learning by using visual prompts. This is because research has found that children with ASD often respond better to information that is presented visually.

TEACCH is often delivered at special day centres, but you can also have training so you can continue the intervention activities at home.

Parent Education and Training

The parents of a child with ASD play a crucial role in supporting their child and helping them improve their skills.

If your child is diagnosed with ASD, it can be useful to find out as much as you can about life with the condition.

Communication Advice For Parents, Family & Friends

Communication is a particular challenge for children with ASD. Helping your child communicate can lead to reduced anxiety and improved behaviour.

You may find the following tips useful when communicating and interacting with the child:

Use the child’s name so they know you are addressing them

Keep background noise to a minimum

Keep language simple

Speak slowly and clearly with pauses between words

Accompany what you say with simple gestures

Allow extra time for the child to process what you have said

Improving Communication Skills

As well as the social-communication help mentioned above, a number of other treatments may be offered to specifically help overcome communication difficulties your child may have. 

These include:

Speech and Language Therapy

Speech and language therapy (SLT) is a type of skills training designed to improve your child's language skills. This can improve their ability to interact with others socially.

The therapist uses a number of techniques, such as visual aids, stories and toys to improve communication skills. 

Picture Exchange Communication System (PECS)

Some children with ASD find picture symbols helpful in allowing them to communicate more effectively, which is why an approach called the Picture Exchange Communication System (PECS) is sometimes carried out by trained specialists to help children with the condition.

PECS teaches children to communicate with adults by giving them cards with pictures on them. Over time, the child is taught progressively more difficult skills, such as using pictures to make whole sentences. This approach aims to eventually help children learn to initiate communication with others without prompting.

Makaton

Makaton is a communication programme that involves using signs and symbols in support of spoken language to help people with ASD communicate with others.

The signs used in Makaton are based on British Sign Language and each sign has a corresponding symbol. These symbols are simple drawings that can often be used independently of the signs. These signs or symbols can be used with speech to help provide extra clues as to what someone is saying.

Over time, as their speech and language skills develop, many people with ASD will stop using the signs or symbols naturally at their own pace and start to rely more on their speech to communicate.

Makaton can be helpful in improving basic communication in some people with ASD, as well as helping to improve social interaction and the ability to build relationships.

Psychological Therapy

If your child has ASD and a mental health problem (such as anxiety), or if their behaviour is causing problems, a psychological treatment may be offered.

Psychological treatments, such as cognitive behavioural therapy (CBT), involve meeting with a therapist to talk about feelings and thoughts and how these affect behaviour and wellbeing.

If a treatment like CBT is offered, the professionals involved in the treatment should also be aware of any changes that need to be made to the treatment because of the ASD. This might include more written or visual information (for example, worksheets and images), and using plain English.

Medication

No medication is available to treat the core symptoms of ASD, but medication may be able to treat some of the related symptoms or conditions, such as:

Problems sleeping – which may be treated with a medication such as melatonin

Depression – which may be treated with a type of medication called a selective serotonin reuptake inhibitor (SSRI)

Epilepsy – which may be treated with a type of medication called an anticonvulsant

Attention deficit hyperactivity disorder (ADHD) – which may be treated with a medication such as methylphenidate

aggressive and challenging behaviour, such as tantrums or self-harming – which may be treated with a type of medication called an antipsychotic if the behaviour is severe, or if psychological treatments (see above) have not helped

However, these medications can have significant side effects and are usually only prescribed by a doctor specialising in the condition being treated. If medication is offered, your child will usually have a check-up after a few weeks to see if it is helping.

DEPRESSION

WHAT IS DEPRESSION?

Depression is a mood disorder that is characterised by a low mood and possible other symptoms. It is an illness that can develop quickly or slowly and is usually caused by changes in body chemisty or life events. Depression is more than just feeling unhappy for a few days. Those with Depression have constant low moods that can last years it's not something that you can just stop feeling.

Causes of Depression

There is not one cause of Depression. Depression can start due to anything. Depression can start because of life events such as Abuse, Conflict, Death, Major events, birth of a baby or due to medication, illness or possibly a family history of Depression.. Past physical, sexual, or emotional abuse can cause depression later in life. What happens in the brain to cause depression is not fully understood. Evidence suggests it may be related to changes in the levels or activity of certain chemicals – particularly serotonin, norepinephrine and dopamine – which are the three main chemicals related to mood and motivation that carry messages within the brain

Signs of Depression

Depression varys from person to person each person will have different signs of depression. There are common signs to look out for these are:

⦁ Feeling helpless or hopeless

⦁ loss of interest in daily activites

⦁ weight or appetite changes

⦁ sleep changes

⦁ anger or irritablity

⦁ loss of energy

⦁ self-loathing

⦁ Recklessness

⦁ problems concentrating

⦁ unexplained aches and pains

⦁ Feeling suicidal 

It is important that if you notice any of these signs to seek medical attention.

Types of Depression

There are 9 different types of depression. These are

⦁ Major Depression - Also known and Clinical: Depression  in which sadness and disinterest in once enjoyed activities interfere with how you function every day

⦁ Dysthymia Depression - Dysthymia is a type of depression that causes a low mood over a long period of time — perhaps for a year or more

⦁ Postpartum Depression - PostPartum Depression is characterized by feelings of extreme sadness, fatigue, loneliness, hopelessness, suicidal thoughts, fears about hurting the baby, and feelings of disconnect from the child. It can occur anywhere from weeks to months after 

⦁ Seasonal affectice disorder - . Though many people find themselves in winter funks, SAD is characterized by symptoms of anxiety, increased irritability, daytime fatigue, and weight gain. This form of depression typically occurs in winter climates, likely due to the lessening of natural sunlight

⦁ Atypical Depression - one of the most common types of depression. Unlike other types of depression, people with atypical depression can be briefly cheered up by positive events, but they overreact to negative events

⦁ Psychotic Depression a mental state characterized by false beliefs, known as delusions, or false sights or sounds, known as hallucinations — doesn't typically get associated with depression however 20% of those with depression have episodes of psychotic depression.

⦁ Bipolar Disorder - If your periods of extreme lows are followed by periods of extreme highs, you could have Bipolar Disorder. Symptoms include feelings energetic or irratble, quick speaking, easily distracted , delusions of hallucinations.

⦁ Premenstrual dysphoric disorder - a type of depression that affects women during the second half of their menstrual cycles. Symptoms include depression, anxiety, and mood swings

⦁ Situational Depression - Situational depression is about three times more common than major depression, and medications are rarely needed : Symptoms of situational depression may include excessive sadness, worry, or nervousness, and if they don't go away, they may become warning signs of major depression.

Treatment part 1:

Treatment for depression usually involves a combination of medicines, talking therapies and self help.

Treatment options

The kind of treatment that your doctor recommends will be based on the type of depression you have. Below is a short description of the types of treatment your doctor may recommend.

Mild depression

Wait and see - 

If you're diagnosed with mild depression, your depression may improve by itself. In this case, you'll simply be seen again by your GP after two weeks to monitor your progress. This is known as watchful waiting.

Exercise - 

Exercise has been proven to help depression, and is one of the main treatments if you have mild depression. Your GP may refer you to a qualified fitness trainer for an exercise scheme or you can find out more about starting exercise here. Read more about exercise for depression.

Self help groups - 

Talking through your feelings can be helpful. It can be either to a friend or relative, or you can ask your GP to suggest a local self-help group. Find out more about depression support groups. Your GP may also recommend self-help books and online cognitive behavioural therapy (CBT).

Treatment part 2:

Moderate to severe depression

Antidepressants - Antidepressants are tablets that treat the symptoms of depression. There are almost 30 different kinds of antidepressant. They have to be prescribed by a doctor, usually for depression that is moderate or severe.

Combination therapy - 

Your GP may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. A combination of an antidepressant and CBT usually works better than having just one of these treatments.

Mental health teams - If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medication. 

Read more detailed information about these and other treatments below.

Talking treatments 

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Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) helps you understand your thoughts and behaviour and how they affect you.

CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present.

It teaches you how to overcome negative thoughts, for example being able to challenge hopeless feelings.

CBT is available on the NHS for people with depression or any other mental health problem that it has been shown to help.

You normally have a short course of sessions, usually six to eight sessions, over 10-12 weeks on a one-to-one basis with a counsellor trained in CBT. In some cases, you may be offered group CBT.

Online CBT

Computerised CBT is a form of CBT that works through a computer screen, rather than face to face with a therapist.

It's delivered in a series of weekly sessions and should be supported by a healthcare professional. For instance, it's usually prescribed by your GP and you may have to use the surgery computer to access the programme.

Ask your GP for more information or read more about online CBT and the courses available here.

Interpersonal therapy (IPT)

IPT focuses on your relationships with other people and on problems you may be having in your relationships, such as difficulties with communication or coping with bereavement.

There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed.

Counselling

Counselling is a form of therapy that helps you think about the problems you are experiencing in your life to find new ways of dealing with them. Counsellors support you in finding solutions to problems, but do not tell you what to do.

Counselling on the NHS usually consists of six to 12 hour-long sessions. You talk in confidence to a counsellor. The counsellor supports you and offers practical advice.

Counselling is ideal for people who are basically healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or the onset of a serious illness.

Getting help:

Your first port of call should be your GP, who can refer you for NHS talking treatments for depression available locally.

In some parts of the country, you also have the option of self-referral. This means that if you prefer not to talk to your GP you can go directly to a professional therapist.

Skin Conditions

Acne

Acne is a common skin condition that affects most people at some point. It causes spots to develop on the skin, usually on the face, back and chest. The spots can range from surface blackheads and whiteheads – which are often mild – to deep, inflamed, pus-filled pustules and cysts, which can be severe and long-lasting and lead to scarring.

Keeping your skin clean is important, but will not prevent new spots developing. Wash the affected area twice a day with a mild soap or cleanser, but do not scrub the skin too hard to avoid irritating it. If your skin is dry, use a moisturiser (emollient). Most of these are now tested so they don't cause spots (non-comedogenic).

If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription. See your GP if you cannot control your acne with over-the-counter medication or if it is causing you distress and making you feel unhappy.Also see your GP if you develop nodules or cysts, as they will need to be treated properly to avoid scarring.  

Acne is very common in teenagers and younger adults. About 80% of people between the ages of 11 and 30 will be affected by acne. It is most common between the ages of 14 and 17 in girls, and boys between 16 and 19. Most people have acne on and off for several years before their symptoms start to improve as they get older. Acne often disappears when a person is in their mid-twenties. In some cases, acne can continue into adult life. About 5% of women and 1% of men have acne over the age of 25.

It affects the grease-producing glands next to the hair follicles in the skin. Certain hormones cause these glands to produce larger amounts of oil (abnormal sebum). This abnormal sebum changes the activity of a usually harmless skin bacterium called P. acnes, which becomes more aggressive and causes inflammation and pus. There is no evidence that diet, poor hygiene or sexual activity play a role in acne.

Ringworm

Ringworm is a common and highly infectious skin infection that causes a ring-like red rash on the skin.

The rash can appear almost anywhere on the body, with the scalp, feet and groin being common sites. The condition, medically known as "tinea", isn't serious and is usually easily treated using creams sold by the pharmacy. However, ringworm is highly contagious and easily spread among people.nebDespite its name, it doesn't have anything to do with worms. It's an infection of the skin caused by a fungus.

You need to see your GP if you or your child have ringworm of the scalp. This type of ringworm is treated with antifungal tablets only available on prescription. Other types of ringworm are generally treated with antifungal cream from the pharmacy and you don't need to see a doctor unless the infection persists. However, pharmacists often prefer children to see a GP to confirm a diagnosis.

Ringworm is passed between people through direct skin contact and by sharing objects such as towels, hairbrushes and bedding. Pets such as dogs and cats can have ringworm, which they can pass on to people they come into contact with.

Ringworm is common. It's estimated that 10-20% of people will have a fungal skin infection at some point during their lifetime. People of all ages can be affected by ringworm, but children are particularly susceptible to it.

It's really important, where possible, to prevent spreading the infection. You should avoid sharing towels, bedding or clothes with anyone diagnosed with ringworm. If you think your pet has ringworm, take it to the vet. If your pet is treated quickly, you will be less likely to catch the infection from it. If your child has ringworm, they do not need to stay off school. However, you should inform the school your child has the condition. In addition to treatment, your child should maintain a good level of personal hygiene to prevent the infection spreading.

Psoriasis. 

Psoriasis is a condition on the skin that causes red, flaky, crusty patches of skin covered with silvery scales. 

These patches normally appear on your elbows, knees, scalp and lower back but can appear anywhere on your body. 

Most people are only affected in small patches. 

In some cases, the patches can be itchy or very sore.

Psoriasis only affects around 2% of people in the UK. 

It can start at any age, but most often develops in adults under 35 years old. 

For some people, it is just a minor irritation, for others it has a major impact on their quality of life. Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger. 

Knowing your triggers may help you to avoid a flare-up. 

Common triggers include:

an injury to your skin such as a cut, scrape, insect bite or sunburn 

drinking excessive amounts of alcohol

smoking

stress

hormonal changes, particularly in women (for example during puberty and the menopause)

certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines 

ACE inhibitors (used to treat high blood pressure)

beta blockers (used to treat congestive heart failure)

throat infections 

other immune disorders, such as HIV.

Psoriasis is not contagious so it cannot be spread from person to person. There is no cure for psoriasis, but treatment will usually help keep the condition under control.

Most people with psoriasis can be treated by their GP. 

Your GP may refer you to a skin specialist (dermatologist) and their team in a hospital if your symptoms are particularly severe or did not respond well to other treatments. 

Your doctor will probably start with a mild treatment, such as topical creams (which are applied to the skin), and then move on to stronger treatments if necessary.

A wide range of treatments are available for psoriasis, but identifying which treatment is most effective can be difficult. 

Talk to your doctor if you feel a treatment is not working or you have uncomfortable side effects.

Treatments fall into three categories:

topical - creams and ointments that are applied to your skin

phototherapy - your skin is exposed to certain types of ultraviolet light

systemic - oral and injected medications that work throughout the entire body 

Often, different types of treatment are used in combination.Your treatment for psoriasis may need to be reviewed regularly. Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping. There are several different types of psoriasis. Many people have only one form of psoriasis at a time, although two different types can occur together. One type may change into another type or may become more severe.

There are many different types of psoriasis including; plaque psoriasis, scalp psoriasis and nail psoriasis.

Eczema. 

It mainly affects children, but can continue into adulthood.

Eczema is a condition that causes the skin to become itchy, red, dry and cracked. 

It is a long-term, or chronic, condition.

Eczema commonly occurs in areas with folds of skin, such as:

behind the knees

the inside of the elbows

on the side of the neck

around the eyes and ears

Eczema can vary in severity and most people are only mildly affected. 

Severe symptoms include cracked, sore and bleeding skin.

People with eczema usually have periods when symptoms are less noticeable, as well as flare-ups when symptoms become more severe, needing additional treatment. Symptoms include itchy, dry and red skin that may be broken or cracked.

Eczema can occur in small patches all over the body and is most common:

in infants – on the face and scalp, and on the arms and legs

in adults and children – on the hands or around joints on the arms and legs, such as the inside of the elbows or the backs of the knees

The symptoms of eczema vary according to how severely you or your child are affected by the condition.

People with mild eczema normally have only small areas of dry skin that are occasionally itchy. In more severe cases, eczema can cause widespread dry skin, constant itching and oozing fluid. 

Scratching can disrupt your sleep and make your skin bleed. It can also make itching worse, and a cycle of itching and regular scratching may develop. In children, this can lead to sleepless nights and difficulty concentrating at school. During a flare-up symptoms become worse and you or your child may need stronger treatment when this happens. 

During a flare-up, your skin may be:

extremely itchy, red, hot, dry and scaly

wet, weeping and swollen

infected with bacteria. There is no single cause of eczema. It probably has a mixture of inherited and environmental causes that act together at different times.

You may be born with an increased likelihood of developing eczema, which you inherit from your parents. 

Some of the most common allergens that can cause eczema include:

house dust mites

pet fur

pollen

Eczema can sometimes be caused by food allergens, especially before the age of one. Foods that typically cause allergic reactions include:

cows milk

eggs

nuts

soya

wheat

Some studies of children and young people with atopic eczema found that one-third to nearly two-thirds also had a food allergy.

Allergies do not always play a role. There are many other things likely to bring out eczema, including:  

cold weather

dampness

harsh soaps

washing too much

rough clothing 

Although there is no cure for eczema, treatments can ease the symptoms.Children with eczema normally find their symptoms naturally improve over time.

Medications used to treat eczema most commonly include:

emollients – used all the time for dry skin

topical corticosteroids – used to reduce swelling and redness during flare-ups

Your GP will prescribe emollients for dry skin and the weakest effective topical corticosteroid. 

Different strengths are needed for different parts of the body.

As long as the eczema is not infected, certain dressings or bandages – known as dry wraps, wet wraps and occlusive dressings – may also be applied by a healthcare professional.

They work by reducing itchiness, preventing scratching and helping to stop the skin from drying out.

Other medicines used to ease the symptoms of eczema include:

antihistamines

oral corticosteroids

antibiotics

topical immunosuppresants

IMPETIGO

Impetigo is a common and highly contagious skin infection that causes sores and blisters. It's not usually serious and often improves within a week of treatment.

There are two types of impetigo:

non-bullous impetigo, which typically affects the skin around the nose and mouth, causing sores to develop that quickly burst to leave a yellow-brown crust

bullous impetigo, which typically affects the central part of the body between the waist and neck, causing fluid-filled blisters to develop that burst after a few days to leave a yellow crust

Both types of impetigo may leave behind some red marks when the crusts have cleared up, but these will usually improve over the following days or weeks.

Speak to your GP if you think you or your child may have symptoms of impetigo.

Impetigo is not usually serious, but it can sometimes have similar symptoms to more serious conditions such as cellulitis (an infection of the deeper layers of skin) so it's important to get a correct diagnosis.

Your GP can also prescribe treatment to help clear up the infection more quickly than if it was left untreated.

Impetigo is caused by bacteria infecting the outer layers of skin.

The bacteria can infect the skin in two main ways:

through a break in otherwise healthy skin, such as a cut, insect bite or other injury

through skin damaged by another underlying skin condition, such as scabies or eczema.

The infection can be spread easily through close contact, such as through direct physical contact, or by sharing towels or flannels. Impetigo can affect people at any age but children more often than adults. Every year in the UK, around one in every 35 children up to four years of age and around one in every 60 children between four and 15 years of age will develop impetigo.

Non-bullous impetigo is the most common type of impetigo, accounting for more than 70% of cases. Bullous impetigo is most common in babies, although it can affect older children and adults too.

How impetigo is treated

Impetigo usually gets better without treatment in around two to three weeks, but treatment is often recommended because it can reduce the length of the illness to around seven to 10 days and can lower the risk of the infection being spread.

The main treatments prescribed are antibiotic creams or antibiotic tablets. These usually have to be used for around a week.

During treatment, it's important to take precautions to minimise the risk of impetigo spreading to other people or other areas of the body, such as by:

not touching the sores whenever possible

washing your hands regularly 

not sharing flannels, sheets or towels

staying away from work, school, nursery or playgroup until the sores have dried up or treatment has been continuing for at least 48 hours 

Most people are no longer contagious after 48 hours of treatment or once their sores have dried and healed.

Potential complications

Impetigo is rarely serious, but in some cases the infection can spread to other areas of the body and cause problems such as cellulitis and scarlet fever.

In very rare cases, impetigo may lead to some scarring, particularly if you scratch at the blisters, crusts or sores.

VITILIGO

Vitiligo is a long-term condition that causes pale, white patches to develop on the skin due to lack of a chemical called melanin.

Vitiligo can affect any area of your skin, but most commonly occurs on skin exposed to the sun, such as your face, neck and hands.

The condition varies from person to person. Some people only get a few small, white patches that progress no further. Other people get bigger white patches that join up across large areas of their skin.

There is no way of predicting how much of your skin will be affected. The white patches are usually permanent.

Why does vitiligo occur?

Vitiligo occurs due to a lack of melanin in the affected areas of skin. Melanin gives your skin its colour and protects it from the sun. It is not exactly clear what causes this lack of melanin, but it has been linked to problems with the immune system and nerve endings in the skin. Certain things can increase your chances of developing vitiligo, such as a family history of the condition or having another autoimmune problem, like an overactive thyroid gland. Vitiligo is not caused by an infection and you cannot catch it from contact with someone who has it. In the UK, about 1 in 100 people develop vitiligo. It usually starts to appear at around 20 years of age, although it can occur at any age. Women and men are equally likely to be affected. 

Diagnosis

Vitiligo can usually be identified by a GP after a physical examination. You may also be asked questions about your family's medical history and if the problem is affecting your confidence. In some cases, an ultraviolet lamp, may be shone on your skin to examine it in more detail and rule out other skin conditions. You may also be checked for symptoms of other autoimmune conditions, such as diabetes. Sometimes, blood tests are taken to check how well your thyroid gland is functioning.

How is vitiligo treated?

The white patches caused by vitiligo are usually permanent, although there are treatment options to improve the appearance of your skin.

If the patches are relatively small, skin camouflage cream may be used to cover them up.

In general, combination treatments, such as phototherapy (treatment with light) and medication, give the best results.

In some cases, treatment may restore pigment to your patches but the effect does not usually last. Unfortunately, there is nothing that can stop the condition from spreading.

Complications

Vitiligo can sometimes cause other problems. Due to a lack of melanin, your skin will be more vulnerable to the effects of the sun. If it is not protected with a strong sun cream, then sunburn is likely.  Vitiligo may also lead to a lack of pigmentation in your eyes and a partial loss of hearing. Problems with confidence and self-esteem are common in people with vitiligo, particularly if the condition affects areas of frequently exposed skin. Support groups can often help by putting you in contact with other people who have vitiligo. Your GP may suggest a group in your area. Charities such as The Vitiligo Society may be able to help.