In reply to Hon. SANDRA KANCK (28 May).
  The Hon. DIANA LAIDLAW: The Minister for Human Services has provided the following information:
 1. A response was provided by the Attorney-General to the Hon. Ian Gilfillan MLC in this House on 26 May 1998. The response was in some detail and it is not necessary to repeat all of the detail at this time. As indicated previously, the Government is aware of the NHMRC report and the need for an interagency response. The work of an interagency group looking at the recommendations has not been completed, although the NHMRC report is an expert report which should be considered carefully by all agencies in responding to this serious problem.
 2. In line with the recommendations that a multi-model approach should be used, the Child and Adolescent Mental Health Service teams in South Australia do work in a multi-model manner. All participants know that pharmaceuticals are only one component of a treatment program necessary to minimise the effects of this disorder.
 A consistent approach to management of referred patients has been negotiated between the Northern and Southern Child and Adolescent Mental Health Service teams to ensure appropriate management is available across the State. Some variations will occur in country offices due to the different mix of staff available and the need to negotiate appointment times with families. Ap-pointments are usually available within two weeks, although provision is made where it is considered that a child/young person is judged to be a danger to themselves or to other people. In such cases, an urgent appointment can be arranged.
 3. The Child and Adolescent Mental Health Services give priority to those families who are socially or economically disad-vantaged and refer patients to other agen-cies where it is seen that their services will not meet all the child's needs. These include educational facilities.
 4. Extensive debate in the literature and in the community occurs as a response to the difficulty in establishing appropriate criteria by which the diagnosis of ADHD can be made. Opin-ions vary and, while it is acknowledged there are a significant number of children affected by this disorder, the actual number varies from country to country. It is said to be as high as 5 per cent in the United States, although it is considered to be much lower in Australia, perhaps of the order of 1.5 per cent of children. This reflects a wide variation in the behaviour of children in whom ADHD may be considered. It is, therefore, likely that some misdi-agnosis may occur and needs to be guarded against, both at the upper end of the behavioural problem and at the lower end.
 The matter of inappropriate prescribing is always of concern. However, at this time, it is not believed there is widespread inap-propriate prescribing, although this matter needs constant review and is of concern both to the Medical Board of South Australia and to the Public and Environmental Health Division of the South Australian Health Commission (Department of Human Services). There are as many proponents for increased prescribing as there are for decreased prescribing, with varying levels of scientific research support, and this makes it difficult to make definitive value statements concerning these matters. However, it is important that we continue to keep these issues under scrutiny.