As you may be aware there is a national supply disruption of some types of ADHD medication. Please see the published patient safety alert for detailed information.

CAS-ViewAlert (mhra.gov.uk)

The disruption is due to a combination of manufacturing issues and increased global demand. Supply of the above products are not expected to be restored until various times between October and December 2023. Other strengths are not expected to be able to support excessive increased demand. This may have an impact upon a number of the young people in your care. The following information will help you support young people and their families while they wait for the medication disruption to be resolved. We would ask that schools:

  • Identify children and young people within their care who may be affected by changes to their ADHD medication.
  • For schools who administer ADHD medication, the advice would be to share the medication supply parents have at home and have a system in place to take and handover the medication at the end of the school day. Due to the current shortages, it will not be possible to provide a separate supply for school and another supply for home.
  • Ensure contingency plans are put in place for children with EP/EHCP/health care plans to help manage ADHD and related behaviours if they are off ADHD medication for more than ONE week.
  • Ensure reasonable adjustments are made to accommodate continued access to learning for children with ADHD as per the Kent Mainstream Core Standards, Medway Ordinarily Available Provision in Mainstream Schools, and the Equalities Act 2010

Our specialist children’s ADHD providers have provided some useful information below:

Strategies for Schools
The information below may help develop strategies to support your staff and children at this time. However, please remember that there is not a ‘one size fits all solution’ and that all neurodiverse children and young people will have varied and differing support needs at different points in their life. Strategies implemented should be personalised to the individual child or young person.

Please educate staff and students at school about neurodiversity using neuro-affirmative language and approaches.

Students with ADHD may require reasonable adjustments to support them to be able to access the school environment (please discuss and liaise with parents and the young person about this).

The ADHD Foundation has collated a comprehensive set of resources tailored towards supporting children and young people with ADHD. We’d like to draw particular attention to their Teaching and Managing Students with ADHD resource.

Additionally, please see the following advice:

To support access to learning

  • activities may need to be chunked down into smaller, more achievable sections
  • activities may need to be presented visually or in an alternative format (e.g. task management boards, visual timetables; etc).
  • do not change seating arrangements without warning
  • scaffold your child’s learning opportunities around topics of interest and motivating factors to support engagement in learning.

To support at unstructured times

  • provide a safe place where they can go to eat or relax
  • relaxed lunchbox rules for children with restricted diets and identified safe foods
  • providing special interest groups/ clubs (not social skills groups) where they can meet with other children and young people with similar interests e.g. Pokémon club/ music club; etc.

To support understanding of new situations

  • use Social StoriesTM to share accurate social information in a patient and reassuring manner that is easily understood by the child. The goal of a Social Story™ is never to change the child’s behaviour but is there to support them to understand what usually happens in certain events
  • Comic Strip ConversationsTM are simple visual representations of conversations that can be used to show:
    • National disruption of medication supplies to treat attention deficit hyperactivity disorder (ADHD) – advice for schools 3
    • things that are actually said in a conversation • how people might be feeling
    • what people’s intentions or thoughts might be
  • five Point Scales are used to help children visually explore how they might be feeling in different situations. A five-point scale should be individualised to each child and is used to help them identify how they are feeling in situations.

To accommodate sensory differences

  • relaxed uniform regulations
  • movement breaks timetabled into the school day
  • allowing use of fidget toys
  • providing the young person with a ‘timeout’ or ‘break’ card they can use when they need a break.
  • use of ear defenders or noise cancelling headphones (with or without music playing)

Advice for Meltdowns
A meltdown is an intense response to an overwhelming situation. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control. A young person may have a meltdown if they feel overwhelmed. A meltdown is not a choice and children are not in control of their behaviour during a meltdown. A meltdown is not the same as a tantrum. It is not bad or naughty behaviour.

Preventing sensory meltdowns before they start:
While certainly not all meltdowns can be prevented, there are things you can do to reduce the intensity and frequency of them.

  • Make sure that the young person is always well hydrated by keeping a water bottle filled and reminding them to drink from it often.
  • provide healthy snacks often throughout the day.
  • keep an event log to identify potential triggers.
  • allow access to noise cancelling headphones or ear defenders in class and for places that might be an issue.

They may benefit from implementing deep pressure activities throughout the day (every 2 hours). This could be helping move furniture, handing out water bottles/recourses, carrying folders to another class or wearing a weighted ruck sack.

How to respond to a meltdown

  • Control your own response – remember that the young person is having a neurological response. You cannot help a child calm down if you are not calm yourself.
  • Talk as little as possible. Once they are having a fight, flight, freeze response, their ability to access the part of the brain that processes language is essentially shut down. What works best is to say the same thing repetitively in a very calm, soft voice such as “let’s breathe”. National disruption of medication supplies to treat attention deficit hyperactivity disorder (ADHD) – advice for schools 4
  • Remove the young person from the environment to a place with very little sensory stimuli.
  • If possible, provide a sensory area for them to go to with calming music, a soft or weighted blanket, noise cancelling headphones, chew, fidgets, a vibrating palm massager, and low lighting.
  • Use a calm down kit. Be sure to have practised while they are calm so that the items and techniques will be familiar.
  • Help them focus on regulating their breathing. Blowing bubbles, blowing a pinwheel or placing their hand on their stomach to feel it rise and fall are good techniques to try.

You can find further guidance on implementing robust and targeted support packages, and the responsibilities of partners working with children with ADHD here:

Signposting for children and young people, and their families
Children, young people and their families may be feeling overwhelmed and uncertain at this time. If families are concerned, please signpost them to:

  • their healthcare provider (note that the medicine shortages are national so alternatives may not be prescribed)
  • the NHS Kent and Medway patient information line- A non-clinical phoneline for further information on the disruption: 01634 335095 option 3 then option 3, ADHD Medicine Shortages.
  • the Kent Resilience Hub’s parent and carer resources
  • Moodspark children and young people’s website
  • The ADHD Foundation’s resources page (filter for ‘parents and carers’ or ‘children and young people’)
  • SENDIAS

Advice on medication
We recognise that this is a worrying situation, but a temporary pause in medication is not physically harmful despite it being impactful in other ways. Patients on guanfacine should NOT stop suddenly (due to rebound hypertension) and will need to seek medical advice from specialists for alternatives.

ADHD FAQs