Diagnosis pathways for ADHD in Children

Step 1

Step 1

If you are concerned that your child may have ADHD speak to your GP or your child’s school. The conversation should be around any difficulties your child is facing and whether there may be an underlying cause for them that would warrant further assessment. There are many causes of difficulties in a child’s development and the question of ADHD will be considered as part of the whole picture.

Information around ADHD signs and symptoms can be found our our About ADHD page.

Step 2

Step 2 (Option 1) NHS Referral – Local

Your child’s GP or school can make an NHS referral for your child to have a developmental assessment (Note: Some areas have rules on referral including needing both School and GP agreement to refer. Please talk to your local GP and/or school to confirm the local rules).

Depending on their age and your local borough the referral may be to the local Developmental Paediatric team or to the Child and Adolescent Mental Health Service (CAMHS). Your child should be referred to the appropriate service within the borough you live in. If your GP is making the referral, it is often useful for your child’s school to also send in information to support the referral.

Step 2 (Option 2) – NHS Referral – Right to Choose

If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This important legal right also includes your choices for your child as well. This means that, for instance, should you decide the waiting time for your ADHD assessment is too long, then you can choose alternative providers.

You can learn more about right to choose on our Right To Choose page

Step 2 (Option 3) Referral to a Private Provider

Long waiting lists and lack of accessibility of Right to Choose throughout the UK means private diagnosis and treatment is a serious consideration for many, despite the financial cost often being a significant sacrifice.  As a charity we are lobbying for the NHS ADHD provision to be properly resourced so it can be timely and effective and that people  then don’t feel private is necessary for them.

A Private Assessment is directly equivalent to an NHS Assessment and should have equal weight with any school; however, it does not automatically entitle you or your child to access NHS resources – including GP care or NHS Prescriptions. Although some NHS GPS will use their discretion on these matters. Private Assessments can be expensive. For a guide to prices you can see a number of providers listed in the ADHD UK Marketplace.

This is something that you can speak to your GP about in more detail. You also have the option to self-refer – most private assessment providers do not require a GP or School referral for a Private Assessment.

If your GP says there is no ADHD service in your area:

England, Wales and Northern Ireland follow the NICE guidelines on ADHD, which gives a right to the provision of an ADHD service. That means if there is no local provision then your local NHS has an obligation to fund you to receive the service elsewhere. You can access that funding through the Individual Funding Request process and can learn more about that here.

Scotland has a different guidance system (SIGN). You can learn more about that here.

If you are in England and you want to know more or your GP refuses to allow Right to Choose

We have created a specific page on Right to Choose and have a support letter you can download. To access it please click here.

If your School or GP refuses to provide a referral you can consider:

(i) Getting a second GP opinion. You can do this formally or informally. Formally by putting in a request to your GP practice. Informally by booking a new GP appointment and requesting a different doctor. If you choose the informal route it is imperative that you tell your second GP of your previous discussion.

(ii) If you have very few options with your own GP service, for instance it is a single GP or very small practice, then you may consider changing GP. The NHS find a GP service is here. There is now an option for an predominately online based NHS GP service. You can learn about that here.

(iii) If you have the funds you can get a private assessment. We are unable to provide recommendations for individual clinicians; however, we do recommend that you ensure your clinician is a recognised member of the General Medical Council  You can search the register here.

Step 3

Step 3 – Intial Assessment

Once the referral is accepted your child will have an initial assessment either by a doctor, either a developmental paediatrician or a child psychiatrist. The assessment will usually involve looking at all aspects of your child’s development and in particular any areas that they struggle with. It usually lasts between 60 and 90 minutes and will involve questions for yourself and age appropriate questions for your child. In some cases it may also involve a play based developmental assessment for your child.

The aim of the assessment is to establish whether there is a likely underlying developmental cause for any difficulties your child has. If the clinician assessing your child feels that a diagnosis of ADHD may explain their difficulties they will likely give you a specific questionnaire to take away to complete which assesses this in more detail. A questionnaire will also need to be completed by your child’s school. In some areas /some clinics this questionnaire may have been sent prior to your clinic appointment. (In that case Steps 3 and 4 may be combined into a single appointment).

Step 4

Step 4 – Results Appointment

Once these diagnostic questionnaires and initial assessment have been completed your child will be given a follow-up appointment to discuss the results. Usually with this information the clinician will be able to tell you if your child meets the criteria for a diagnosis of ADHD or not. The clinician should then explain to you exactly what this means.

Step 5

Step 5 – Next Steps Following a diagnosis of ADHD

If your child is given a diagnosis of ADHD it is likely that your clinician will discuss management strategies and changes that can be made at home and school to support your child. Many families find that having the diagnosis in itself can be very helpful in understanding their child’s difficulties better and how to better support them. Older children often also find the diagnostic process helpful in understanding their own difficulties.

Some children with ADHD may go on to require medication. If this is being considered for your child, your clinician will discuss this with you.

See our resources area here for further support.