The Australian ADHD Clinical Practice Guideline explained

In 2022, Australia published its first national clinical practice guideline for ADHD. The Australian ADHD guideline sets out how ADHD should be identified, diagnosed and treated across the lifespan.

It is a long, technical document written mainly for clinicians. This article explains what it is, how it was developed, and the key points that matter for people with ADHD, parents and carers. Knowing what the guideline says can help you ask good questions about your own care.

What the guideline is

The full name is the Australian Evidence-Based Clinical Practice Guideline for Attention Deficit Hyperactivity Disorder. It was developed by the Australasian ADHD Professionals Association (AADPA).

According to AADPA, the guideline was launched in October 2022 and approved by the National Health and Medical Research Council (NHMRC). NHMRC approval means the guideline met national standards for how health guidelines are developed. It is also endorsed by several professional bodies, including the Australian Psychological Society and the Royal Australian and New Zealand College of Psychiatrists.

The guideline gives advice on identifying, diagnosing and treating ADHD in young children (5 years and under), children, teenagers and adults.

How it was developed

A 2023 paper describing the guideline explains the process. A group of 23 people developed it. They included clinicians, researchers, people with lived experience of ADHD, carers, and Aboriginal and Torres Strait Islander psychologists.

The group worked through 50 priority questions. They updated evidence reviews from the UK’s NICE ADHD guideline and carried out new reviews for Australia. AADPA reports that more than 700 public consultation comments were also considered.

How to read the recommendations

The guideline contains more than 100 clinical recommendations. The 2023 paper notes that only 12 were based directly on systematic reviews of research. Most of the rest are based on expert consensus where research was limited.

The wording matters. The paper explains that “should” means the group judged the benefits to be greater than the harms. “Could” means the evidence was more limited or the balance was less clear.

What it says about diagnosis

該 guideline notes that ADHD occurs in about 6 to 10% of Australian children and adolescents, and 2 to 6% of adults. It sets out clear expectations for assessment.

• Who assesses. Clinicians should be registered, trained in diagnosis using the DSM or ICD (the main diagnostic manuals), and experienced in ADHD assessment or supervised by someone who is.
• What is included. A full clinical and psychosocial assessment, including strengths, reports from other people, and a medical check to exclude other causes.
• More than one setting. Information should come from more than one setting and more than one person.
• Not rating scales alone. Questionnaires are useful additions, but a diagnosis should not rest on them alone.
• Young children. A paediatrician or child psychiatrist with expertise in young children should assess children aged 5 and under.

The guideline also says ADHD commonly occurs alongside other conditions. A diagnosis of ADHD should prompt the clinician to consider what else might be present.

What it says about treatment

AADPA’s treatment summary describes a multimodal approach. This means combining medication and non-medication options, unless there is a good reason to use only one.

Non-medication supports

• Everyone with ADHD should be offered guidance on lifestyle factors such as sleep, exercise and diet.
• Parent and family training should be offered to families of children with ADHD, including children under 5.
• Cognitive behavioural interventions could be offered to children aged 5 to 12, and should be offered to teenagers and adults.
• ADHD coaching could be considered as part of a support plan for teenagers and adults.

藥物

• Stimulant medicines (methylphenidate, dexamfetamine or lisdexamfetamine) are the first-line medication option for children, teenagers and adults.
• Non-stimulant medicines are options when stimulants are not suitable or not effective.
• For children aged 5 and under, medication should be used cautiously and monitored closely.
• Decisions should be shared between the clinician and the person, or their family.

The guideline does not decide who can legally prescribe. Each state and territory sets its own prescribing rules, and several are changing. Our article on GP referrals and ADHD assessments explains more.

Groups the guideline highlights

The guideline draws attention to people who are often missed or poorly served:

• Girls and women. Clinicians should be aware that ADHD may be under-recognised in girls and women. They are less likely to be referred and more likely to be given a different diagnosis, such as anxiety or depression.
• Aboriginal and Torres Strait Islander peoples. The 2023 paper notes the need for culturally appropriate screening and assessment, and says standard questionnaires may not be valid for these communities.
• Adults. ADHD can be diagnosed and treated at any age. The guideline makes specific recommendations for adults, including cognitive behavioural interventions and medication.

It also calls for primary care and public mental health services to provide ADHD care across the lifespan, and for more ADHD training in health courses.

What it means for you

You can use the guideline to understand what good care looks like. For example, you might ask a clinician:

• Will you gather information from other people who know me or my child?
• How will you check for other conditions?
• What non-medication options do you recommend alongside, or instead of, medication?
• How and when will we review whether the treatment plan is working?
• What supports might help at home, school or work?

These questions are not a test of your clinician. They simply help you take an active part in decisions about your care.

Limits to keep in mind

A guideline describes good practice in general. It cannot tell you exactly what will suit you or your child. Your clinician should apply it to your situation, your preferences and your other health needs.

Because most recommendations are based on expert consensus, some advice may change as new research comes in. The guideline itself includes a chapter on research priorities, which shows where more evidence is still needed.

The guideline also covers support at key transitions, such as moving from child to adult health services. If you or your teenager is approaching that stage, it is worth planning ahead with your treating team.

AADPA has also published a free Consumer Companion. It explains the guideline in plain language and was written by a person with lived experience of ADHD.

Invictus Health 能提供哪些協助

Our psychologists and neuropsychologists offer ADHD 評估 for children and adults, and you can self-refer. For children with wider learning or developmental questions, see paediatric neuropsychology.

For adults after a diagnosis, some of our psychologists and counsellors work with adults with ADHD and autism. You can use our 尋找治療師 page to choose someone who suits you. Fees are on our 費用與退款 頁面。.

This article is general information only. Please speak with a qualified health professional about your own situation.