Telehealth ADHD Assessment Western Sydney - Dr. Preena Uppal
Led by General Paediatrics and Paediatric Neurology specialist Dr Preena Uppal, Sunshine Kids Clinic delivers a complete spectrum of paediatric services, from routine check-ups to specialised care, designed to support your child’s overall health and development.
We provide comprehensive support for newborns, children with developmental delays, behavioural challenges, autism, and Attention Deficit Hyperactivity Disorder, along with expert paediatric neurology services. Our hybrid care model includes both Telehealth ADHD Assessment Western Sydney and in-person consultations to provide the most timely and comprehensive support for your family.
We strive to ensure a positive and welcoming experience for families and remain dedicated to sharing valuable educational resources through our website.
What is ADHD?
Overview of ADHD Symptoms
Recognising the signs of Attention Deficit Hyperactivity Disorder is not always straightforward. Many behaviours associated with ADHD can appear in anyone occasionally. However, children and adults with ADHD, sometimes referred to as Attention Deficit Disorder, experience these challenges more frequently and more intensely than others of the same age.
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ADHD Symptoms at Different Ages
Common areas of difficulty for both children and adults include:​
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Maintaining focus
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Controlling impulses
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Regulating emotions
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Remembering information
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Beginning or completing tasks​
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Some individuals with ADHD are also hyperactive, meaning they feel a constant need to move or stay physically active.
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Symptoms can present differently depending on age. Reviewing typical signs across developmental stages and discussing any concerns with a Child ADHD Specialist Western Sydney can help determine the most appropriate next steps.
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ADHD Symptoms in Preschool to Grade 2
Children in early primary years may:
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Struggle to follow simple instructions, such as “put on your backpack.”
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Leave their seat, fidget, or talk during quiet times, including story sessions or while watching television.
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Rush through tasks without paying attention to detail, such as writing words or pouring cereal into a bowl.
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Take items without permission, like picking up something from a teacher’s desk or grabbing sweets in a shop.
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Forget recently learned information, such as basic maths facts.
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Become overly upset or angry about small incidents, like spilling a drink or missing a catch.
ADHD Symptoms in Grades 3 to 7
Older primary school children may:
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Procrastinate on assignments, such as delaying essay writing.
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Complete schoolwork hastily.
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Submit untidy work containing careless errors.
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Work slowly and struggle to finish tasks within a reasonable timeframe.
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Seek attention by being disruptive or acting silly in class.
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Feel restless during activities they find uninteresting, such as certain excursions.
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Speak or act without considering the consequences.
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Have difficulty following multi-step instructions
ADHD Symptoms in Teens and Adults
Adolescents and adults may:
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Find it difficult to prioritise tasks and ensure essential responsibilities are completed.
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Forget to record assignments or monitor deadlines.
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Frequently “zone out,” needing to reread information or ask others to repeat themselves.
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Lose focus on tasks that do not hold their interest.
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Experience challenges in forming and maintaining friendships.
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Engage in risky behaviour without fully considering potential outcomes.
Non-Medication Options for Treating ADHD
ADHD - Supporting Children at School and at Home
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Attention Deficit Hyperactivity Disorder (ADHD) can influence a child’s academic progress, social development, and overall family life. Supporting a child with ADHD may involve behaviour strategies, structured approaches at home and in the classroom, and, in some cases, professional counselling.
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Strategies for School and Homework
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Verbal Instructions
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Keep directions short, simple, and specific.
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Use the child’s name or gently touch their shoulder to gain eye contact before sharing important information.
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Ask the child to repeat the instructions to confirm understanding.
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Provide reminders, supervision, and encouragement to help them stay on task.
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Written Tasks
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Emphasise key information using symbols such as asterisks, capital letters, or bold text.
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Reduce copying from the board by providing printed handouts instead.
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Classroom Environment
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Maintain a tidy and organised workspace.
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Seat the child near the front of the classroom.
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Arrange seating thoughtfully to limit distractions, placing the child near positive role models where possible.
Additional Learning Approaches
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Offer one-to-one instruction whenever possible.
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Pair the child with a supportive class buddy to reinforce directions.
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Include hands-on activities to increase engagement.
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Schedule demanding tasks during the child’s peak concentration times, often in the morning.
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Provide a checklist to outline tasks clearly.
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Limit the number of choices to avoid overwhelming the child.
Managing Over-Activity and Fatigue
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Include regular short breaks, such as five minutes after every thirty minutes of work.
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Alternate academic tasks with brief physical movement, such as structured errands.
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Keep simple, low-pressure activities available for short breaks from demanding tasks.
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Allow the use of a quiet, non-disruptive fidget tool at the desk if helpful.
Maintaining Structure
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Children with ADHD often find routine changes challenging and benefit from predictability.
Helpful strategies include:
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Establishing a consistent daily routine and keeping classroom activities organised.
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Giving advance notice of transitions, with reminders as needed.
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Displaying daily schedules and classroom rules clearly, such as attaching a flowchart inside a desk or notebook.
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Informing the child ahead of time about any changes whenever possible.
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Supporting Self-Esteem
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Set realistic goals and encourage participation in activities where success is likely.
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Recognise achievements verbally and through written praise such as notes or certificates.
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Highlight strengths in written work by marking the best sections.
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Value effort, even if the outcome is not perfect.
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Review daily accomplishments together before the end of the school day.
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Address learning challenges promptly to rebuild confidence.
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Developing Social Skills
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Encourage interaction in small groups rather than large ones.
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Reinforce positive behaviours such as sharing and cooperation.
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Teach appropriate responses to conflict, such as walking away or speaking to a teacher.
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Support participation in supervised group activities like Scouts or sports clubs.
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Discuss how actions affect both themselves and others.
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Use visual reminders such as “Stop, Think, Do” to promote thoughtful behaviour.
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Strengthening Home - School Communication
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Use a daily communication book between home and school to share both positive behaviours and concerns.
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Teachers should regularly share encouraging feedback with parents, ideally in the child’s presence.
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Homework Tips
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Create a calm, organised, and clutter-free study space.
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Establish a consistent daily homework schedule.
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Strategies for Home
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It can be easy to focus on difficult behaviours, especially when they feel overwhelming. However, behaviour at home often improves with consistent rewards for positive actions and appropriate consequences for negative ones.
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Implement a positive behaviour system, such as reward charts for younger children or token systems for older ones. Refresh rewards regularly to maintain motivation.
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Establish clear, written family rules that outline rewards for following them and consequences for breaking them. Apply these rules consistently.
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Notice and praise helpful, respectful, and kind behaviour. Be specific about what you appreciate. Consistency among caregivers is essential.
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Ignore minor attention-seeking behaviours where appropriate, and respond positively when communication is respectful.
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Apply logical consequences, such as completing homework before screen time.
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Keep consequences immediate and manageable, ensuring they are realistic and short-term.
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Schedule regular one-on-one time with your child doing activities they enjoy, reinforcing love and connection.
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Key Points to Remember
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Frequently recognise and reward positive behaviour and achievements.
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Address learning difficulties early to rebuild confidence.
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Provide a quiet, organised homework environment.
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Discuss the impact of actions with the child.
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Use a positive behaviour system at home.
Overlook minor negative behaviours and apply clear, immediate consequences for more serious ones.
Medication Options for Treating ADHD
Attention Deficit Hyperactivity Disorder (ADHD)
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Attention deficit hyperactivity disorder, commonly known as ADHD, is a long-term condition that affects a child’s ability to concentrate and regulate impulses. It can influence academic performance, relationships with peers, and overall family life.
In Australia, it is estimated that around one in 20 children are affected by ADHD, with boys diagnosed more often than girls.
The precise cause of ADHD is not yet fully understood. However, it often runs in families, suggesting a genetic link. Importantly, ADHD is not the result of ineffective parenting.
With appropriate support at home and in school, and medication when required, children with ADHD can thrive and achieve positive outcomes in life.
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Signs and Symptoms of ADHD
The key features of ADHD generally fall into three areas:
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Inattention - difficulty staying focused, frequently forgetting instructions, and leaving tasks unfinished.
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Impulsivity - acting without considering consequences, interrupting others, struggling to manage emotions, and being prone to accidents.
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Hyperactivity - excessive restlessness, constant movement, and difficulty remaining still.
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Some children experience ADHD without significant hyperactivity. These children may primarily struggle with focus, attention, forgetfulness, and being easily distracted. This presentation is often referred to as inattentive ADHD.
It is important to note that all young children can be inattentive or impulsive at times. However, ADHD is diagnosed only when these behaviours are persistent and significantly affect daily functioning. If symptoms are interfering with your child’s wellbeing, an ADHD Assessment Western Sydney is recommended.
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When to Seek Medical Advice
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ADHD must be diagnosed by a qualified and experienced health professional. If you are concerned about your child, consult your General Practitioner first. They can refer you to a paediatrician or child psychologist for a comprehensive evaluation.
There is no single test that confirms ADHD. Diagnosis is based on detailed information gathered from parents, teachers, and sometimes other professionals such as speech pathologists. It is essential to rule out other conditions that may produce similar symptoms and require different treatment.
Many children with ADHD also experience additional challenges, including learning difficulties, sleep disturbances, or anxiety. These concerns should be assessed and managed alongside ADHD.
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Treatment Options for ADHD
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Supporting a child with ADHD often involves a combination of approaches. Positive parenting strategies, structured routines, classroom adjustments, social skills development, and counselling can be highly beneficial.
If these strategies do not sufficiently reduce the impact of symptoms, medication may be considered.
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Stimulant Medication
Stimulant medications have been the primary treatment for ADHD symptoms since the 1970s and remain the most effective option. Approximately one to two per cent of Australian children are prescribed these medications.
Stimulants work by targeting areas of the brain responsible for attention and alertness. Around 80 per cent of children with ADHD experience significant improvement in focus, impulse control, and hyperactivity.
The two most commonly prescribed stimulants in Australia are methylphenidate and dexamphetamine. They function similarly and share comparable side effects. These medications are available in short-acting forms (lasting three to four hours) and long-acting forms (lasting six to 12 hours).
In Australia, stimulant medications are strictly regulated and can be prescribed by paediatricians, child psychiatrists, neurologists, and in certain circumstances, General Practitioners.
These medications are among the most extensively researched treatments for children and are not addictive when used at prescribed doses. Some children take them only on school days and do not experience withdrawal symptoms on weekends.
Non-stimulant medications, such as atomoxetine, clonidine, and guanfacine, are also available and may be appropriate for children who cannot tolerate stimulants.
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Possible Side Effects
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Reduced appetite, particularly at lunchtime, is the most common side effect and may influence weight gain. Other less common effects include:
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Stomach pain
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Headaches or dizziness
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Difficulty falling asleep
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Increased irritability or emotional sensitivity
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Some children experience no side effects. When side effects occur, they can often be managed by adjusting the dosage or timing. If necessary, stimulants can be stopped immediately without tapering, and withdrawal symptoms are not expected.
Stimulants may slightly affect growth in height for some children, so regular monitoring is recommended. They may also cause a small rise in heart rate and blood pressure, which is generally not problematic in children with healthy hearts. Pre-treatment testing may be required if there is a known heart condition or relevant family history.
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Ongoing Monitoring
Children taking stimulant medication should have regular follow-up appointments. Reviews are more frequent during the early stages of treatment and at least every six months thereafter. Height, weight, heart rate, and blood pressure should be routinely checked.
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Fish Oil and Other Approaches
Certain non-medication strategies, including fish oil supplements, may offer mild benefits for some children. While restrictive diets are typically not helpful, maintaining balanced nutrition is important.
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Key Points to Remember
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ADHD involves persistent inattention, impulsivity, and sometimes hyperactivity.
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Not all children displaying these behaviours have ADHD.
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Diagnosis requires a comprehensive assessment by a qualified professional.
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Behavioural strategies, school support, and counselling are effective components of management.
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Stimulant medication remains the most effective treatment for ADHD symptoms.
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Many children with ADHD also experience additional challenges, such as learning difficulties, anxiety, or sleep issues, which should be addressed alongside ADHD.
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Is ADHD Medication Right for My Child?
Whether you are considering ADHD medication for your child or your child is already taking it, there is a great deal to understand. How do various ADHD medications function? Are side effects likely to occur?
Having clear information can help ensure your child gains the greatest possible benefit from treatment. This guide is designed to support you in making well-informed decisions while exploring or managing ADHD medication.
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Types of ADHD Medication
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There are several categories of medication used to treat ADHD, and they do not all work in the same way. In consultation with the prescribing professional specialising in ADHD and Behavioural Assessment Western Sydney, your child may need to try more than one option before identifying the most suitable one.
Many parents have concerns such as:
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My partner and I frequently disagree on how to manage our son’s ADHD. How can we reach a shared understanding?
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We have not yet told our child about his diagnosis, although he senses that something is different. How should we approach this conversation?
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I sometimes lose my temper and raise my voice when my child with ADHD misbehaves. How can I remain calm in challenging moments?
It is helpful to understand the different ADHD medications your child’s prescriber may recommend.
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ADHD Medication Side Effects
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Side effects are a common concern for parents. Some may worry, for instance, that medication could increase their child’s anxiety. While side effects such as sleep disturbances or irritability can occur, adjusting the dosage or changing the timing of medication often helps manage these issues effectively.
Gaining accurate information about potential side effects can help you feel more confident in supporting your child’s treatment.
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Who Prescribes ADHD Medication for Children
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Various healthcare professionals are qualified to prescribe ADHD medication. In addition to prescribing, they monitor your child’s response to ensure the medication type, dosage, and schedule are appropriate and effective.
Understanding the roles of a Child ADHD Specialist Western Sydney can help you navigate your child’s treatment with greater clarity.
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ADHD Drug Holidays and Medication Adjustments
There may be occasions when the prescriber recommends modifying your child’s medication. Adjustments might be necessary if the current dosage or timing leads to side effects or does not provide sufficient benefit. In some cases, a “drug holiday” may be suggested during school holidays or weekends.
Learning when and why medication adjustments are needed can help you support your child’s ongoing care.
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ADHD Medication Misuse
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As children grow older, they may encounter peer pressure to share or sell their medication. Some may misuse it in an attempt to enhance focus during demanding periods, such as examinations. In rare instances, this misuse can develop into abuse.
Being aware of these risks enables parents to have open conversations and guide their children toward safe and responsible use of medication, as recommended by an expert offering ADHD and Behavioural Assessment Western Sydney.
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Autism Spectrum Disorder
What is Autism?
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Autism can be difficult to define clearly.
Autism is a neurodevelopmental condition that influences how a person’s brain grows and operates. It is estimated that around 1 in 40* individuals are on the autism spectrum. Autism can be identified in people of any age, cultural background, or socio-economic group.
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Social interactions
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Many Autistic people may feel uneasy in busy, crowded, or socially complex environments. They might find it easier to connect with others through online platforms such as chat, gaming, or video.
Understanding social cues and interpreting how non-Autistic people think can sometimes be challenging. Emotional regulation may also require extra effort, and some Autistic individuals prefer spending time alone rather than with peers, both during childhood and later in life. These factors can make forming and sustaining friendships more difficult.
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Sensory awareness
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Heightened sensory sensitivity is common among many Autistic people. This can mean increased sensitivity to sounds, smells, tastes, textures, and physical contact. As a result, they may:
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Feel overwhelmed or distressed by loud noises, bright lights, certain fabrics, or close physical contact such as haircuts.
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Attempt to reduce discomfort by covering their ears or seeking out quiet spaces.
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Engage in repetitive movements, such as hand flapping or pacing, particularly when feeling stressed or excited.
Seek calming sensory input, such as touching specific textures, smelling objects, or moving fingers in front of their eyes.
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Communication preferences
Autistic individuals may communicate in a very direct and honest manner, which can sometimes be perceived as blunt. Small talk may not hold much appeal, and understanding sarcasm or humour can be difficult. Reading non-verbal cues, including facial expressions and gestures, may also present challenges.
Because of differences in information processing, some Autistic people may need additional time to understand spoken language. They may also repeat certain words or phrases, which can sometimes appear unusual or unrelated to the immediate context.
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Strengths and interests
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While strengths vary from person to person, many Autistic individuals excel in logical or visual thinking, remembering detailed information, noticing fine details, and working with technology.
A strong and focused interest in specific topics or activities is another common trait. This deep engagement often allows them to develop extensive knowledge and expertise in their chosen areas.
On a personal level, many Autistic people demonstrate qualities such as honesty, loyalty, dependability, persistence, fairness, and kindness.
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Language and terminology
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Aspect recognises the right of individuals to choose the language that best reflects their identity and experiences. In its content, Aspect may use either identity-first language (for example, “Autistic person”) or person-first language (for example, “person on the autism spectrum”), depending on individual preference.
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Autistic person
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Informed by the views of the Autistic community and international research, Aspect generally adopts respectful, strengths-based, identity-first language, such as “Autistic person”.
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Autism Spectrum Disorder (ASD)
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Autism Spectrum Disorder (ASD) is the clinical term used by health professionals to describe the range of neurodevelopmental differences that influence how an Autistic person thinks, communicates, and experiences the world. The term “spectrum” highlights the wide variation in experiences, recognising that each individual has unique strengths, challenges, and support needs.
Although ASD remains the formal diagnostic term, Aspect prefers not to use it in everyday language, as the word “disorder” can imply that something is wrong or needs to be fixed.
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Autism Diagnosis for Children: A Guide
Key Points
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An autism diagnosis can involve one or several professionals and different types of assessments.
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Health professionals assess a child’s strengths, differences and challenges.
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The diagnostic process includes two standard components: a comprehensive needs assessment and a diagnostic evaluation.
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While waiting for a formal diagnosis, it is advisable for children to begin therapies and supports.
Autism Diagnosis: What to Expect
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An autism diagnosis is based on:
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Observing how your child plays and interacts with others, focusing on current development.
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Interviewing you or using questionnaires to gather information about your child’s behaviour and interactions.
Reviewing your child’s developmental history, including past milestones and patterns.
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The National guideline for the assessment and diagnosis of autism in Australia recommends that the process include:
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A comprehensive needs assessment
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A diagnostic evaluation
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Comprehensive Needs Assessment
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A comprehensive needs assessment has two components:
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Assessment of functioning
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Medical evaluation
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Assessment of Functioning
This part evaluates your child’s characteristics, strengths and abilities in areas such as daily living skills, communication and thinking. It also considers your child’s everyday environment, including who they live with and whether they attend child care or school, to better understand their support needs.
This assessment may be conducted by a GP or paediatrician, or by an allied health professional such as a psychologist, speech pathologist or occupational therapist.
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Medical Evaluation
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The medical evaluation is typically carried out by a GP, paediatrician or psychiatrist. It involves a physical examination, a review of medical history, and possibly additional tests to determine whether a medical condition may explain your child’s characteristics or behaviour.
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Diagnostic Evaluation
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If the comprehensive needs assessment indicates that your child may be autistic, a diagnostic evaluation is recommended to confirm whether autism best explains your child’s characteristics and behaviour.
During this stage, professionals may meet with you and your child several times to:
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Assess strengths, differences and challenges in areas such as thinking, learning and communication
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Ask detailed questions
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Review findings from the comprehensive needs assessment
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There are two main approaches to diagnostic evaluation:
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Lead practitioner diagnostic evaluation
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Consensus team diagnostic evaluation
The most appropriate approach depends on your child’s needs and the clarity of the available information.
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Lead Practitioner Diagnostic Evaluation
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This approach is suitable when autism characteristics are clear and alternative explanations are unlikely.
A specialist medical practitioner, such as a paediatrician or psychiatrist, or a specialist psychologist, leads the process and makes the final decision. They may consult other professionals if required.
If the practitioner is unable to make a confident diagnosis, the case may be referred to a consensus team.
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Consensus Team Diagnostic Evaluation
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This approach is recommended when signs of autism are less clear or when other conditions, such as language disorders or anxiety, may explain the behaviours. A multidisciplinary team conducts this assessment.
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Tests and Tools Used in Autism Diagnosis
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Professionals use various tools during both comprehensive needs assessments and diagnostic evaluations.
One key reference is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). It uses the term autism spectrum disorder and outlines the criteria required for diagnosis.
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Screening Tools
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Screening tools help determine whether a child shows enough signs of autism to proceed to a full assessment. Australian screening tools include:
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ASDetect
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Autism Detection in Early Childhood (ADEC), 2nd edition
Social Attention and Communication Surveillance - Revised (SACS-R)
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Diagnostic Tools
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Detailed diagnostic tools may include:
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Autism Diagnostic Interview - Revised (ADI-R)
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Autism Diagnostic Observation Schedule - Second Edition (ADOS-2)
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Preparing for an Autism Assessment
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You can prepare by writing down your observations and concerns, including:
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Specific behaviours
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Your child’s age when you first noticed them
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How long the behaviours have been occurring
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For example:
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Your child does not respond to their name despite repeated attempts over several months.
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Your child lines up toys in a particular way and becomes distressed if the arrangement is disturbed.
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Your child becomes upset when routines change, such as taking a different route to child care.
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It is also helpful to include any concerns raised by your child’s early childhood service or school.
Depending on age and communication abilities, you can prepare your child by explaining what will happen during the assessment. You may also use pictures or social stories to help them understand what to expect.
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Understanding Autistic Behaviour
Positive behaviour approaches for your autistic child
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​Your autistic child is more likely to show positive behaviour when they feel calm and secure. Developing skills, creating supportive environments, and offering clear instructions and choices can also make a meaningful difference.
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Building confidence in your autistic child
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Confidence can be strengthened by recognising and encouraging your child’s strengths, interests, and talents. Tools such as strengths cards and personalised books can support this process.
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Responding to challenging behaviour in your autistic child
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When your autistic child displays challenging behaviour, focusing on encouraging positive actions is often the most effective response. Clear rules and consistent consequences may also be helpful.
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Supporting your autistic child through change
Adjustments to routines, surroundings, or plans can feel overwhelming for autistic children. Visual schedules, social stories, and other practical strategies can assist them in managing change more comfortably.
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Understanding special interests, routines, and rituals
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Special interests, routines, and rituals often help autistic children and teenagers manage stress. These interests can also contribute positively to learning and overall development.
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Sensory sensitivities in autistic children
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Your autistic child may be highly sensitive or less sensitive to stimuli such as sound, light, clothing textures, or temperature. Simple adjustments can be made to improve their comfort and wellbeing.
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Recognising, understanding, and managing emotions
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Autistic children and teenagers may require additional support to identify, understand, and regulate their emotions. Everyday teaching opportunities, emotion cards, and tools such as emotional ladders can be beneficial.
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Masking in neurodivergent children and teenagers
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Masking refers to altering behaviour in order to blend in with others. For neurodivergent children and teenagers, masking can impact both mental and physical health, as well as overall wellbeing.​
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Understanding Common Autistic Behaviour Challenges
Managing Aggressive Behaviour in Autistic Children
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Autistic children and teenagers may sometimes display aggressive actions or self-injurious behaviour. Remaining calm allows for a more effective response. Understanding the reasons behind the behaviour is equally essential.
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Preparing Autistic Children for Medical and Other Appointments
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Visits to dentists, doctors, or even hairdressers can feel overwhelming for autistic children and adolescents. Careful preparation, including the use of social stories and visual supports, can make these experiences smoother and less stressful.
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Understanding Meltdowns in Autistic Children and Teenagers
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Meltdowns occur when autistic children and teenagers become extremely overwhelmed. Preventing or managing meltdowns requires guidance and support to help them regulate intense emotions.
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Supporting Your Autistic Child if They Experience Bullying
Bullying may present through physical, behavioural, emotional, or online indicators. If an autistic child is being bullied, collaborating closely with the school is often the most effective approach.
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Responding to Stimming in Autistic Children
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Stimming involves repeated movements or sounds. For many autistic children and teenagers, it serves as a way to regulate emotions, manage stress, and maintain self-control.
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Addressing Wandering or Running Away in Autistic Children
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Wandering is common among autistic children and adolescents. Identifying the underlying reasons is important. Measures such as installing safety gates, teaching personal safety skills, using identification bracelets, and utilising tracking technology can improve safety.
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Our Western Sydney Paediatrician Serving:
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Penrith
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Blacktown
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Parramatta
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Westmead
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Prospect
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Seven Hills
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Quakers Hill
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Marsden Park