Overview
Following an assessment and diagnosis, our Neurodevelopmental Service is committed to supporting children, young people, and their families as they navigate next steps. Whether a diagnosis of ADHD, Autism, or neither is made, our goal is to ensure families feel informed, empowered, and connected to the right services.
This section explains what treatment options may be available and provides guidance on how to access post-diagnostic support locally and regionally. diagnostic support locally and regionally.
What to Expect After a Diagnosis
Understanding Your Child’s Needs
Your clinical team will explain the assessment findings, the behaviours observed, and the factors contributing to your child’s needs. Families are encouraged to bring a relative, friend, or staff member from school for additional support during feedback appointments.
If No Diagnosis Is Given
If your child does not meet the diagnostic criteria for ADHD or Autism, you will still receive guidance to help you understand their needs and access appropriate support services.
ADHD Treatment Options
Types of ADHD medication
There are two types of ADHD medication. Both types of medication will reduce hyperactivity and impulsivity. They will also help your child to concentrate.
Each person’s body is different. This means that some medications will be better for your child than others. It’s very common to try different medications at different doses to find which one is best for your child.
Stimulants are generally recommended as the first choice for children and young people with ADHD. Non-stimulant medication is recommended if the stimulants do not work, cause significant side effects or are not suitable for your child or young person.
Medication Supply Updates
For the most up to date information on ADHD medication availability, please refer to the NHS Cheshire and Merseyside prescribing update: Update on ADHD Medication Shortage – NHS Cheshire and Merseyside.
Electronic Prescription Service (EPS)
From 1st October 2025, Alder Hey will be using EPS to process prescriptions. Click the button below to find out more.
More informationAutism Post-Diagnostic Support
Families receiving an Autism (ASD) diagnosis will be connected to a range of specialist support services.
Support Groups & Parenting Programmes
Information on Autism support groups is available through our existing Post-Diagnostic Support page. Many programmes allow self referral, including ADDvanced Solutions Community Network and Riding the Rapids parent training programme.
Sleep
You can find all of the latest information about training courses related to sleep, and book your place, on the Liverpool CAMHS website.
Local Area Information
Knowsley-specific resources and services are incorporated into our post diagnostic support pathways to ensure families can access relevant, local provision.
Celebrating Strengths & Moving Forward
Regardless of diagnostic outcome, we recognise the importance of embracing each child or young person as a unique individual. Families are supported to recognise and celebrate strengths, interests, and personal qualities as part of their ongoing journey.
How We Support You Next
You will receive a tailored post diagnosis outcome report including:
- Details of local and regional support services
- Guidance for schools and educational settings
- Information about therapy options, community groups, and workshops
- Resources to help you understand neurodivergence and develop strategies at home
Our team is here to help you find the right ongoing support for your child or young person.
Support for Professionals
The following link outlines the statutory commissioned offer from Health and Local Authority of services and support available for children, young people and their families in Liverpool at different stages of their journey:
- early help/pre-diagnosis
- during the assessment and diagnosis stage; and
- post-diagnosis
Pathological Demand Avoidance (PDA)
The following position statement has been co-produced between Alder Hey
Childrens NHS Foundation Trust, Education (Liverpool and Sefton) and Parent Carer
Forums (Liverpool & Sefton) to ensure a shared understanding of Pathological
Demand Avoidance (PDA) and how best to support children and young people with
this profile and their families. We work together to ensure every parent/carer in
Liverpool and Sefton feels that their voice, their views and their experiences matter
and contribute towards developing and improving services to positively impact upon the lives of children and young people with SEND.
What is Pathological Demand Avoidance (PDA)?
Demand avoidance is a common response to anxiety in children with and without
Autism Spectrum conditions. In contrast, Pathological demand avoidance (PDA) is
not common and is characterised by a continued and pervasive extreme resistance
to everyday demands through strategies of social manipulation that originate from an anxiety-driven need to be in control.
The PDA profile of Autism can sometimes be difficult to identify and it’s not
uncommon for it to be missed, misunderstood or misdiagnosed, which may lead to
poor outcomes for children and young people.
PDA was first described as a separate clinical entity by Elizabeth Newson and
colleagues in Nottingham and almost all published research regarding PDA comes
from this group. There is ongoing debate but most professionals believe that children described as having PDA fall within the autistic spectrum (ASD). Children and young people with ASD and a demand avoidant profile may respond to different strategies particularly in educational settings.
PDA does not appear as a separate diagnostic condition in nationally and
internationally recognised diagnostic manuals such as DSM-5 or ICD-10. As there
are no formal ‘diagnostic criteria’ for identifying a PDA profile of autism, Alder Hey
does not make this a separate diagnosis. However, for a child or young person who
has been assessed as being on the autism spectrum and presents with a demand
avoidant profile, this will be recognised and described within the child or young
person’s assessment report as “ASD with a PDA profile”.
Alder Hey will only consider recognising PDA as a profile within a diagnosis of ASD,
therefore the assessments and information gathered as part of the diagnostic
process must result in a diagnosis of ASD before PDA can be considered and
recognised. Where there is no diagnosis of ASD, PDA will not be considered.
However, if PDA strategies are found to be helpful for the child or young person then we would suggest they are employed by parents/carers/school even when a
diagnosis has not been reached, as ultimately it is the interventions and support
based on the needs of the child or young person that are essential rather than
focusing on further assessments and diagnosis.
What might a PDA profile look like?
Children and young people with a PDA profile may use a number of strategies in
response to demands, including delay tactics, distraction, shouting, falling to the
ground, saying body parts don’t work, negotiating, escape, manipulation, aggressive or dangerous behaviour.
Behaviours that may be typical (but are not always) seen are:
- Resistance to / avoidance of everyday demands e.g. getting up, getting dressed, eating a meal or washing.
- Using ‘social’ strategies as part of the avoidance e.g. not just saying no, withdrawing, shutting down or running away, distraction, making excuses, physical incapacitation, withdrawing into fantasy, procrastination, controlling, reducing meaningful conversation or masking.
- Sociable, yet lacking depth of understanding
- Excessive mood swings e.g. difficulties with emotional regulation, rapid mood swings, impulsiveness and unpredictability.
- Comfortable in fantasy/imaginative play e.g. this can sometimes be to an extreme extent with other personas being adopted for a prolonged period of time.
- Displays of obsessive behaviour, often focused on other people
Some of these behaviours are a form of ‘panic attack’, often referred to as ‘fight,
flight or freeze’ responses.
How do we support children and young people with PDA?
Children and young people with this profile do not generally respond to the traditional approaches recommended for autism and also tend not to respond to conventional parenting, teaching or support approaches.
Often the child or young person responds better to a more flexible and non-confrontational set of personalised approaches. The most important thing is to gain a strong understanding of the presentation of the individual and to use approaches
which are going to be most effective for them.
Schools can gain further information and support from https://www.pdasociety.org.uk/working-with-pda-menu/info-for-education-professionals/
Resources
- https://www.pdasociety.org.uk/
- https://www.autism.org.uk/
http://www.seftonpcf.org/
www.livpac.org.uk- https://www.theisabellatrust.org/
https://www.liverpoolcamhs.com/- Liverpool SEND Local Offer
- Sefton SEND Local Offer
- Education support
Sefton CVS
Referrals
If you would like to refer your child for a PDA assessment, please e-mail [email protected]