ADHD assessment for children: a guide for parents and carers

Parents often notice that a child struggles to sit still, wait their turn, follow instructions, finish tasks or manage emotions in ways that seem beyond their age. Teachers may report disruption, incomplete work or difficulty with friendships. Because many children are active and inattentive at times, assessment asks whether behaviour is more severe, longer lasting and more impairing than expected for the child's age and stage.

The GP, school special educational needs coordinator or health visitor may start the process. Referral is generally to community paediatrics or child and adolescent mental health services. In England, Right to Choose may apply to some mental-health pathways, and families can also arrange private assessment. A thorough assessment includes a developmental history, a clinical interview with parents, observation or talking with the child, and reports from school.

• Attention, hyperactivity and impulsivity, and how they compare with peers.

• Age of onset and persistence over time.

• Impact on learning, friendships, family life and safety.

• Other explanations, such as hearing or vision problems, sleep problems, anxiety, trauma, language difficulties or autism.

• Family history of ADHD or related conditions.

• Physical health, growth and any medicines.

Standardised rating scales completed by parents and teachers help show how behaviour varies between settings. A school report describing classroom behaviour, learning and support already provided is very valuable. If you are planning a private assessment, the provider may ask for school contact, and you should check what they need before the appointment.

If ADHD is diagnosed, the plan generally begins with information for the family and school, parent training programmes, classroom strategies and support with sleep and routines. Medication may be considered for school-age children with moderate to severe symptoms or when other measures are not enough, with careful monitoring of growth, heart rate, blood pressure, appetite and sleep. Reviews continue over time.

Children with ADHD often benefit from clear routines, immediate feedback, short tasks, regular movement and positive attention. Parent groups can reduce isolation. If your child has an Education, Health and Care plan or special educational needs support in school, ask how these can include ADHD-related needs.

Parents commonly want to know how long the process will take, whether their child will be seen alone, what the school will be asked to complete and what happens if the team decides that ADHD is not the explanation. Ask these at the start. It also helps to bring a short written timeline of your concerns, with examples from different settings and ages, and any previous reports from health visitors or nursery staff. Keeping a few weeks of notes on sleep, mood and mealtimes can show patterns that are hard to remember in a short appointment.