Identification and treatment of individuals with attention-deficit/hyperactivity disorder and substance use disorder: An expert consensus statement

Table 4 Developmentally appropriate healthcare dimensions and examples of implementing them into practice

Dimensions of DAH	In practice
Biopsychosocial development and holistic care	Assess wider aspects of young person’s life using approaches such as HEEADSSS tool (Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety)
	Consider stage young person is at in their development rather than chronological age
Acknowledgement of young people as a distinct group	Opportunity for young person to be seen independently (for some or all of the consultation)
	Flexible access to service (e.g., outside school/college hours)
	Dedicated clinics and space (e.g., age-banded clinics, appropriately sized seating, magazines/posters of relevance and interest)
	Consideration of different ways young person can contact the service (e.g., digital technologies rather than letters/phone calls)
	Explain confidentiality and rights; display confidentiality policy in waiting room
Adjustment of care as the young person develops	Communication to be adjusted in line with cognitive development
	Appointment letters addressed directly to young person in addition to parents/caregivers, when needed; language used is clear
	Use of simple self-assessment tools which may feel less awkward for young person
	Record contact details for both young person and parents/caregivers
Empowerment of the young person by embedding health education and promotion	Psychoeducation provided to young person and parents/caregivers
	Shifting emphasis and supporting family to move from shared-care to self-management as the young person gets older
	Check out with young person how they would like parents/caregivers to be involved
	Involve parents/caregivers in treatment decisions in ways that have been agreed with young person
	Sign-posting young person to local services, as appropriate
	Discuss with young person their confidence and independence in making appointments, managing medication, etc.
Working across teams and organizations	Workforce training in developmentally appropriate healthcare, including strength-based approaches such as solution-focused and motivational interviewing
	Adult service included in transitioning planning prior to transfer (e.g., multi-disciplinary team meetings with adult and child teams present, adult services copied into correspondence)
	Transition planning to start early (aged 13-14)
	Opportunity for young person to visit adult service prior to transfer; provide information leaflet about service to be transferred to
	Young people issues are considered in service policies and guidelines; consistency of policies in child and adult services
	Young people’s participation at all levels of delivery

DAH: Developmentally appropriate healthcare.