ADHD Assessment and Ongoing Care for Children and Adolescents

An ADHD assessment at Hunter Children's Clinics looks at your child from several angles rather than relying on any single test. Depending on your child's age and presentation, an assessment may include:

• a detailed clinical interview with you and, where appropriate, your child;
• standardised rating scales completed by parents or carers;
• input from school, with your consent, so we understand how your child is going in the classroom and playground;
• cognitive testing where it is clinically indicated; and
• consideration of other factors that can look like, or occur alongside, ADHD.

Gathering information from more than one setting helps us build an accurate picture and make sound recommendations, whether or not a diagnosis of ADHD is made.

Depending on your child's requirements and your wishes as a parent, an ADHD assessment at Hunter Children's Clinics can follow one of several pathways:

• Paediatrician led. A paediatrician conducts the assessment and, where a diagnosis is made, oversees ongoing management.
• Nurse practitioner led, with paediatrician oversight. A nurse practitioner conducts the assessment under the supervision of a paediatrician, with input from our social work team as part of the pathway. You can read more about this model on our Hunter ADHD Nurse Practitioner Pathway page.
• Psychology based assessment. The psychology team conducts the assessment, which can include cognitive testing and detailed psychometric measures. You can read more on our psychology services page.

The most suitable pathway is discussed with you, taking into account your child's presentation, what the assessment needs to answer, and your preferences.

Where a diagnosis of ADHD is made, your paediatrician will discuss the full range of support options with you. Management is individualised and may include strategies for home and school, and, where appropriate, medication. If medication is recommended, your paediatrician will explain the options, monitor your child's response, and adjust the plan over time at review appointments.

Medications such as stimulants are prescribed on authority scripts. Any change to a medication dose needs to be discussed in an appointment rather than by email or phone message, so that your child's care remains safe and well monitored.

Ongoing ADHD care depends on regular review. Authority scripts are only valid for 6 months, and pharmacies cannot dispense on a script once more than 6 months have passed since it was issued, even if repeats remain. For this reason it is the family's responsibility to book a follow-up appointment well in advance of a script expiring, ideally at least one month ahead, so that care continues without interruption.

Many review appointments can be conducted by telehealth where clinically appropriate, which can make ongoing care more convenient for families who live further afield. The full details of how we handle prescriptions are set out in the questions below.

Hunter Children's Clinics works in partnership with general practitioners to support children with ADHD close to home. Under a shared care arrangement, a paediatrician remains involved in your child's care while your GP takes part in ongoing management. If you are a GP seeking information about referring into this model, please see our ADHD shared care information for referrers.

You may also be interested in our autism assessment and psychology services, as attention and learning difficulties often overlap.

How you arrange an assessment depends on the pathway. To be seen by a paediatrician or nurse practitioner, a valid GP referral is required before a new patient appointment can be booked, and a referral is also needed for a Medicare rebate on those consultations. A psychology-based ADHD assessment does not require a GP referral. When you are ready, please call Hunter Children's Clinics on 02 4072 1877 to arrange an appointment. You can find more detail about referrals, fees and Medicare on our fees and referrals page.

Do I need a GP referral for an ADHD assessment?

It depends on the pathway. A psychology-based ADHD assessment does not require a GP referral. To be seen by a paediatrician or nurse practitioner, a valid GP referral is required before a new patient appointment can be booked, and a referral is also required for a Medicare rebate on those consultations. A referral typically lasts 12 months, so it is the family's responsibility to keep track of expiry dates.

Who diagnoses and manages ADHD at Hunter Children's Clinics?

Depending on your child's requirements and your wishes, assessment can be paediatrician led, nurse practitioner led with paediatrician oversight and social work input, or psychology based. Where a diagnosis is made and medication is appropriate, medication management is overseen by a paediatrician and reviewed at follow-up appointments.

How do repeat prescriptions and authority scripts work?

Please request any necessary repeat prescriptions during your scheduled consultation. Scripts are usually issued with enough repeats to last until your next appointment. Scripts for medications such as stimulants are authority scripts, and the repeats will be held by your pharmacy. This means that you need to give the script to the pharmacy you intend to continue to go to for the rest of the repeats. Authority scripts are only valid for 6 months. Pharmacies will not issue medication on a script, even if there are repeats left, if more than 6 months have passed since the date of issue. It is the family's responsibility to ensure that a follow-up appointment is booked well in advance of a script expiring (one month) to ensure continuity of care.

Scripts are not usually issued without an appointment. If you cannot attend or miss an appointment, have rescheduled, but will run out of medication before this time, then a single script without any repeats can be issued to tie over until the next appointment. This may attract a script fee of $40. If you lose an authority script before giving it to your pharmacy, you will need to give us a statutory declaration stating that you have lost the script, prior to any further scripts being issued. This will attract a script fee of $40. We will endeavour to process off-session requests as timely as possible; however, please remember that our doctors are busy with clinical care and may not be able to attend to requests immediately. Because of the high volume of clinical duties, please allow up to 3 weeks for these requests to be finalised. If you feel that a medication dose needs to be altered, this needs to be discussed in an appointment. You will need to call us and schedule either a face-to-face or telephone consult to discuss the dose alteration prior to any new scripts being issued. To read more about our prescriptions policy, please read our Family Partnership Handbook.

How often will my child need a review?

Children on medication need regular review so that their response can be monitored and their plan adjusted. Because authority scripts are valid for 6 months, we recommend booking a follow-up well before a script expires, ideally at least one month ahead, to ensure continuity of care. Many reviews can be done by telehealth where clinically appropriate.

Can ADHD reviews be done by telehealth?

Yes, many review appointments can be conducted by telehealth where it is clinically appropriate. Some appointments still need to be face to face, and your paediatrician will advise what is suitable for your child.