NICE Guidelines

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. NICE quality standards are designed to encourage measurable quality improvements within a particular area of health or care and are derived from the best available evidence. The standards are developed independently by NICE in collaboration with health and social care professionals, their partners, and service users. Quality standards are relevant to a variety of different audiences including commissioners of health and social care, staff working in primary care and local authorities, social care provider organisations, public health staff, people working in hospitals or in the community, and the users of services and their carers.

The NICE Guidelines for ADHD is contained in a 600+ document that makes various recommendations for both parents and clinicians. A 56-page summary of the NICE Guidelines for ADHD can be downloaded here.

Amongst other things it is recommended that parent-training/education programmes should be the first-line treatment for parents or carers of pre-school children or school-age children and young people with ADHD and moderate impairment:

 

 

 

 

 

 

 

 

The Guidelines also state:

"When using group treatment (Cognitive Behavioural Therapy and/or social skills training) for the child or young person in conjunction with a parent-training/education programme, particular emphasis should be given to targeting a range of areas, including social skills with peers, problem solving, self-control, listening skills and dealing with and expressing feelings. Active learning strategies should be used, and rewards given for achieving key elements of learning."
(From 2003 to 2006 ADHD North West included a programme covering the areas listed above for the young people whose parents/carers were attending our specialist ADHD parenting programme. It is unfortunate that this successful programme had to be discontinued due to loss of funding.)

 

In respect of drug therapy the Guidelines recommends:

FOR CHILDREN AND YOUNG PEOPLE:  "Drug treatment is not indicated as the first-line treatment for all school-age children and young people with ADHD. It should be reserved for those with severe symptoms and impairment or for those with moderate levels of impairment who have refused non-drug interventions, or whose symptoms have not responded sufficiently to parent-training/education programmes or group psychological treatment."

FOR ADULTS: "Drug treatment is the first-line treatment for adults with ADHD with either moderate or severe levels of impairment unless the person would prefer a psychological approach. Methylphenidate is the first-line drug. If methylphenidate is ineffective or unacceptable, atomoxetine or dexamfetamine can be tried. If there is residual impairment despite some benefit from drug treatment, or there is no response to drug treatment, Cognitive Behavioural Therapy (CBT) may be considered. Psychological interventions without medication may be effective for some adults with moderate impairment, but there are insufficient data to support this recommendation."

The Guidelines also includes comprehensive sections on assessment procedures, post diagnosis advice and treatment therapies, the use of drugs, and the transition of young people into adult services, as well as a specific section relating adults.

 

 

 

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