Conference Presentation – Evolving Landscapes in Mental Health


Inside Out Occupation Therapy Group director, Kathleen Langford is proud to have presented in a joint symposium team led by Dr Wai Chen (Child and Adolescent Psychiatrist, Kings College, London) at this recent conference.

The joint symposium was entitled Novel Topics in ADHD and in the Spectrum Phenotypes of ADHD-Autism and of ADHD-Emotional Lability Presentations with Kathleen’s specific presentation titled “How Important and Relevant is Occupational Dysfunction in Complex ADHD Representations?” An abstract is been provided below.

It was fantastic to have the opportunity to present at the Australian and New Zealand Royal College of Psychiatrists Congress for 2014, which was held at the Exhibition Centre in Perth. It was a full-house for this symposium, and a captive audience. Kathleen spoke about the relevance of Occupational Therapy for this cohort of children, and discussed the ways in which Occupational Therapy assessment informs the broader diagnostic process, formulation and treatment planning for these children.

Kathleen was approached by numerous Paediatricians and Child and Adolescent Psychiatrists following this assessment, who were very interested in learning more about Occupational Therapy, and how to access services for their current clients.

How Important and Relevant is Occupational Dysfunction in Complex ADHD Representations?

Children’s occupations are broadly grouped into their student, leisure and self-care roles. Successful functioning within these roles relies on the integration of numerous skills and abilities (performance components). Occupational dysfunctions are often over-looked in routine ADHD assessments. The Complex ADHD Service (CADHS) is a statewide Tier 4 clinic for children with severe impairments related to complex ADHD. This study examines the prevalence of performance component deficits and associated occupational dysfunction amongst CAHDS referrals.

Method: Audit review of consecutive case records undergoing assessments in CAHDS was carried out.  The prevalence of subtypes were recorded and computed.

Findings: 64 consecutive cases of Complex ADHD children assessed in CAHDS were examined.  The average age was 11, ranging from 3.5 to 16.5; 84% were boys.  100% of CADHS referrals were found to have 2 or more occupational related deficits, while 73% had 6 or more deficits (defined as scoring below 17th centile).  In the break-down of subtypes, the most prevalent problem (91%) was sensory integration difficulties, 70% were sensory seekers, 80% had handwriting difficulties, 67% had planning and organizational deficits, 60% had auditory processing problems, 55% had gross motor difficulties, 51% had balance deficits, 71% had visual perceptual skill variability and 45% had an ocular motor irregularity.  Parents, referrers and schools of assessed children rated these findings highly relevant and important in the assessment outcome.

 Conclusion: Children with complex ADHD are very likely to have significant impairments in their occupational performance. Accurate identification and feedback of these findings to parents, educational personnel and referrers forms a major contribution in the service provided by CADHS.