https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/the-tic-service/tourette-syndrome-and-adhd/

Tourette Syndrome and ADHD

Around half of all young people with Tourette syndrome (TS) also have a condition called Attention-Deficit Hyperactivity Disorder (ADHD). This page describes ADHD, the effects it might have on everyday life, and ways to manage these effects.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a condition where a child or young person has trouble paying attention, is much more energetic than other kids their age, and can't control certain impulses. In everyday life, these children might be called "challenging" or "out of control," and their parents might feel judged by others because it's hard to manage their children's behaviour. However, ADHD affects the brain, and impulsive and challenging behaviour is part of the condition.

How is ADHD diagnosed?

There are internationally agreed standards used to diagnose ADHD. Assessment is made through observing a child and hearing about their behaviour since they were a young child. Often clinicians will also use questionnaires completed by parents, teachers and the younger person to help with diagnoses.

How does it affect others?

Some people with ADHD are very energetic and this means that, for both the child and their family, life can sometimes feel exhausting. Parents often say that they feel tired just from doing the usual day to day activities of life. Going to the shop or attending social events can be more challenging with a child that is always active and ‘on the go’. Siblings can sometimes find it hard if lots of attention is given to their brother or sister. They may also feel embarrassed if they or other people don’t understand their siblings’ behaviour. It is helpful to talk about these challenges and try to find ways to support the whole family.

Ways of coping

The most important thing is to remember that your child is not behaving badly on purpose. The parts in their brain that normally tells them to slow down and be careful works differently in people with ADHD. They cannot easily help behaving the way they do.
Getting help from your family doctor or specialist will make a big difference. There are many ways of treating ADHD, which often have a big effect.
Talk to someone if it all feels too much. This is true for all family members as there may be times when it feels harder to cope.

How can ADHD be treated?

Medicines

One option for treatment is medication. There is one type of medicine called methylphenidate (brand name: Ritalin) that can be effective in helping children with ADHD focus better. There are other medicines that also work well. You can find more information about this on our medicine information page. We recommend discussing ADHD medication with your child’s medical doctor, it can be very effective for children with tics.

Organisation

Having a set routine can make a difference to how a child or young person with ADHD copes with everyday life. Clear boundaries should be set so that everyone knows what behaviour is expected. Any instructions to your child must be clear and detailed. For example, say ‘put the toys in the box, and the books on the shelf, please’ rather than ‘tidy your room please.’ Also, try to focus on telling your child what to do, rather than what not to do. For example, say ‘please kick the ball in the yard’ rather than ‘stop kicking the ball inside’. Reward systems, like a chart, can be very helpful.

Therapy

There are different types of therapies. You may benefit from meeting with a clinician to discuss different approaches for your child. Positive parenting interventions to develop relationships and boundaries in primary school aged children have the strongest evidence. Family therapy involves the whole family and tries to find helpful ways of dealing with problems at home. If your child needs help for depression, anxiety or other related problems, they might benefit from cognitive behavioural therapy (CBT). CBT deals with the way a child or young person is thinking and how they react to these thoughts.

Learning support

Children and young people with ADHD may struggle at school due to their symptoms and may feel ‘left behind’ by their classmates. Arranging additional learning support from school, through an Individual Education Plan, can make a huge difference. It is best to discuss this with the class teacher or Special Education Needs Co-ordinator (SENCo).

Some children with ADHD may have additional learning difficulties that can be talked about with the SEN-co at school. These might be adjustment to where your child sits in the classroom, access to movement breaks or use of a timer to help complete tasks. If there are significant concerns about learning it may be possible to refer your child to an educational psychologist.

Where to get help?

The first discussion should be with your family doctor (GP). They can refer you to a specialist, if needed, for diagnosis and treatment. Your GP can also give you advice about treatments available in your local area, such as parenting groups. There are many support organisations for people with ADHD too.

If you have a specific question or concern, talk to a member of the TS team. The following organisations may also be able to offer support and advice:

ADDISS (The National Attention Deficit Disorder Information and Support Service)

Hyperactive Children’s Support Group

Support groups (AADD-UK)

Tic and ADHD explanation card

This is a short explanation card that you can use to help explain Tourette syndrome, tics, and your ADHD. Feel free to personalise this card and carry copies around with you!

You can find an editable version here.