A paediatric ADHD assessment is more structured than many parents expect. It is not a single test, and it is not a one-hour consultation. NICE NG87 sets out what a good UK assessment looks like, and this article walks through the practical content: who carries out the assessment, what happens during it, what to bring as a parent, and what happens afterwards.
Who does the assessment
NICE NG87 specifies that ADHD assessment in children must be carried out by a healthcare professional with training and experience in the diagnosis and management of ADHD [1]. In the UK, this is usually:
- A community paediatrician with specific ADHD training
- A consultant child and adolescent psychiatrist (CAMHS)
- A specialist nurse or specialist practitioner working under a consultant
- A clinician at a CQC-registered private service that meets the same standard
The qualifications matter because a properly conducted ADHD assessment is more than a screening questionnaire. The clinician needs to take a developmental history, gather information from multiple settings, consider differential diagnoses, and make a clinical decision that holds up against scrutiny.
NeuroFX provides private ADHD assessment for children aged 6 and upwards with the same NICE-aligned clinical standard as NHS assessment. The assessment is delivered by clinicians with specific paediatric ADHD training.
What the assessment covers
A NICE-aligned paediatric ADHD assessment covers several elements, usually across one or more appointments [1, 3]:
Clinical interview
The core of the assessment. The clinician takes a detailed history covering:
- Current symptoms and difficulties
- Developmental history from pregnancy and birth through preschool and into school
- Educational history including school reports, SEN involvement and academic progress
- Family history of ADHD, autism, mental health conditions and learning difficulties
- Co-occurring conditions (sleep, anxiety, mood, autism, learning difficulty, tics)
- Social history including family structure, recent life events, and the child's social and emotional functioning
The interview is conducted with the parent or parents, and depending on the child's age and developmental stage, with the child as well. Older children and adolescents are usually interviewed separately from the parent for part of the appointment.
Rating scales
Standardised rating scales completed by parent and teacher provide quantitative information about the symptoms across settings. The most commonly used in UK paediatric ADHD assessment are the Conners 3 [4] and the Strengths and Difficulties Questionnaire (SDQ) [5]. The teacher version is essential because school is the environment where ADHD difficulties most clearly show up.
Rating scales are not diagnostic on their own. They support the clinical interview, not replace it.
Observation and direct assessment
The clinician may observe the child during the assessment, noting attention, activity level, impulsivity, and how the child engages with structured tasks. This is descriptive observation rather than a formal test.
Consideration of differential diagnoses
ADHD features overlap with several other conditions. The assessment considers:
- Anxiety disorders and depression
- Autism and autistic traits
- Specific learning difficulties (dyslexia, dyspraxia)
- Sleep disorders
- Sensory processing differences
- Hearing or vision difficulties
- Trauma history
- Other neurological conditions
Where the picture suggests another condition is also present, the assessment may extend, or a separate referral may be needed. Combined ADHD and autism assessment in Bedford is available where both are clearly in the picture from the start.
Physical health considerations
Baseline measurements are taken if medication is likely to be discussed: height, weight, blood pressure and heart rate. A cardiac history (in the child and the family) is reviewed.
What to bring
A good assessment depends on the information you bring. Useful materials [1, 3]:
- All available school reports, particularly from the early years and from any year where concerns were raised
- Any previous reports from educational psychology, speech and language therapy, occupational therapy, or other professionals
- Records of any SEN involvement, including a copy of the EHCP if one is in place
- Hospital letters or GP records related to development, mental health, or any physical condition
- Family medical history, particularly ADHD, autism, mental health conditions, and any cardiac history
- Notes from your own observations: what the difficulties look like at home, at school, and in other settings
- The completed parent rating scales if these were sent in advance
- A timeline of how the difficulties have developed across the child's life
If you can, ask the school to complete the teacher rating scales before the assessment. School cooperation makes the picture more complete.
How long it takes
A paediatric ADHD assessment is usually delivered across one or two appointments, with a total clinical contact time of around two to three hours [1]. Some services deliver everything in a single longer session; others split it. Rating scales are completed before or between sessions.
NHS waiting times in many areas have been long; private assessment is typically faster. The actual assessment itself does not differ substantially in length between NHS and private routes; the difference is mainly in how soon it can happen and how the follow-up is structured.
What happens at the end
The clinician explains the conclusion at the end of the assessment, usually in a feedback discussion with the parents (and the child or young person, age-appropriately). The conclusion is one of:
ADHD confirmed
The clinician explains the diagnosis, the type of presentation (predominantly inattentive, predominantly hyperactive-impulsive, or combined), and the implications. A written report follows, which is the document that supports school adjustments, EHCP applications and any onward referrals.
ADHD not confirmed but other difficulties identified
Sometimes the picture is real difficulty but does not meet ADHD criteria. The clinician explains what the picture is more likely to reflect and what next steps make sense.
Diagnosis deferred pending more information
Where the picture is unclear, the clinician may want school observation, additional rating scales, or a separate assessment for autism, learning difficulty or another condition before reaching a conclusion.
A written report is provided in all cases, usually within a few weeks. The report covers the assessment findings, the diagnosis or conclusion, and the recommendations.
What happens after diagnosis
If ADHD is confirmed, the next conversation typically covers:
- Psychoeducation for the child, the parents and the school
- School adjustments and SEN support
- Whether medication is appropriate; the ADHD medication and prescribing with NeuroFX pathway covers this conversation in detail, with a dedicated paediatric medication decision article in this library
- Family-level support and any onward referrals
The diagnosis is the start of a process, not the end of one.
What this means in practice
- A NICE-aligned paediatric ADHD assessment involves a clinical interview, parent and teacher rating scales, consideration of differential diagnoses, and baseline physical measurements where medication may follow.
- The assessment is more structured than many parents expect, and depends on the information you bring.
- The most useful single contribution from parents is a complete set of school reports, ideally going back to the early years.
- The assessment ends with a feedback discussion and is followed by a written report within a few weeks.
- The diagnosis is the start of a support process, not the end of one.
When to speak to a professional
Speak to your GP if you want to start the NHS paediatric ADHD assessment pathway. Speak to the school SENCo as a parallel conversation; school cooperation strengthens the assessment. NeuroFX offers private ADHD assessment for adults and children aged 6 and upwards where the NHS wait is not workable. Seek urgent help via 111, 999 or A&E for any acute mental health crisis or safety concern.
Sources
- NICE. Attention deficit hyperactivity disorder: diagnosis and management. NG87. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng87
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: American Psychiatric Association Publishing; 2022.
- Royal College of Psychiatrists. ADHD in children and young people. https://www.rcpsych.ac.uk/
- Conners CK. Conners 3rd Edition (Conners 3). Multi-Health Systems. https://storefront.mhs.com/
- Goodman R. The Strengths and Difficulties Questionnaire (SDQ). https://www.sdqinfo.org/
