There has exponential rise in children and adults seeking treatment for ADHD in high income countries across the globe. In Australia, approximately one in 20 children are diagnosed and receiving treatment for ADHD- often with little regard for the environment in which they are living and the adversities which they have experienced. Inattention, impulsivity and disorganisation are transdiagnostic problems- they occur in depression, anxiety and in response to trauma. The Australian Child Maltreatment Study showed that 62% of Australians experience one or more forms of maltreatment in childhood.

This presentation outlines issues around the diagnosis and optimal management of ADHD and considers the role of trauma, adversity and other factors that may be causal of or worsen executive dysfunction. The appropriate standard of care for children being assessed and treated for attentional problems with be outlined. The challenges of supporting children with both executive dysfunction and childhood trauma will be discussed and strategies provided to support the best outcome for neurodiverse children who have experienced adversity.