Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network.

BACKGROUND: ADHD is neurodevelopmental disorder which persists into adulthood. Presently, therapeutic approaches are mainly pharmacological and psychological whilst the role, scope and approaches of occupational therapists have not been adequately described. RESULTS: In this consensus statement we propose that by assessing specific aspects of a person's occupation, occupational therapists can deploy their unique skills in providing specialist interventions for adults with ADHD. We also propose a framework with areas where occupational therapists can focus their assessments and give practice examples of specific interventions. CONCLUSIONS: Occupational therapists have much to offer in providing interventions for adults with ADHD. A unified and flexible approach when working with adults with ADHD is most appropriate and further research on occupational therapy interventions is needed.

Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women.

BACKGROUND: There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS: The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS: A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS: This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.

The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD.

The behavioural characteristics of ADHD do not exist in binary form (i.e. normal vs. abnormal); instead, they exist on a spectrum or continuum. This implies that some aspects of ADHD can be adaptive rather than impairing, or some adults may possess certain strengths or attributes that mediate and/or compensate for their ADHD-related deficits or impairments. More research is needed to clarify these observations. To explore and describe positive aspects of ADHD from the perspective of successful adults with ADHD. A phenomenological approach with open-ended interviews was used to collect data. The interviews were audio taped, transcribed verbatim and analysed using thematic content analysis. Six core themes (cognitive dynamism, courage, energy, humanity, resilience and transcendence) defined by 19 sub-themes were found. These themes were compared against attributes catalogued in the character strengths and virtues (CSV) handbook and classification for positive psychology. Two core themes (cognitive dynamism and energy) were not listed as virtues in the CSV, and neither were six sub-themes (divergent thinking, hyper-focus, nonconformist, adventurousness, self-acceptance and sublimation) listed as behavioural traits. We propose these constructs as positive aspects specific to ADHD, and the other constructs, as positive aspects relevant to people in general, with or without ADHD. This study offers insights into positive human qualities, attributes or aspects of ADHD that can support and sustain high functioning and flourishing in ADHD life. This study also addresses the question in the disability research about "how we might reconsider the behaviours associated with ADHD so that they are seen as valuable and worthy of conservation?".