I'm not a clinician; I'm a parent who has been through this process with Jude. This guide draws on publicly available information from NICE (National Institute for Health and Care Excellence), NHS England, ADHD UK, and NHS Trust guidance. It is a starting point only. The process can vary meaningfully depending on where you live and which pathway your child is referred to. Please always speak to your GP, SENCO, or the relevant NHS team about your child's specific situation. This is not medical advice.
Getting an ADHD assessment for your child often starts with a feeling you can't quite name. Something about the way your child moves through the world: the constant motion, the lost belongings, the meltdowns over homework, the gap between how bright they clearly are and how hard everyday things seem. Then comes the uncertainty: is this ADHD? Is it something else? Is it just my parenting? How do I even start?
Jude was assessed when he was seven. I found the process confusing at first, partly because I didn't understand what ADHD looks like in a child (it's often not what you expect), and partly because no one gave me a clear picture of what was going to happen. This guide is what I wish someone had given me before we started. If you're also wondering about an autism assessment, that follows a similar but distinct process covered in a separate guide.
What ADHD looks like in children
It is worth saying this first, because the public image of ADHD (a boy who can't stop running around and interrupting) is only one version of a much wider picture. ADHD presents in three main ways, according to the DSM-5 criteria used in UK diagnoses: predominantly inattentive, predominantly hyperactive-impulsive, and combined type. Many children, particularly girls, present primarily as inattentive and are frequently missed precisely because they are not disruptive.
Common signs that parents describe include: difficulty sustaining attention on tasks that require effort, losing things constantly, seeming not to listen even when spoken to directly, forgetting instructions partway through, difficulty waiting turns, impulsive decisions without thinking through consequences, a very short fuse when frustrated, difficulty shifting attention away from preferred activities, and struggles with time (what occupational therapists call time blindness). None of these on their own is diagnostic. The assessment looks at the full picture, how long the difficulties have been present, whether they show up in more than one setting, and the degree to which they affect daily functioning.
Step 1: Starting the referral
The most common starting point is your GP. You don't need a diagnosis or a report from school to make the initial appointment. You need to describe your concerns clearly, with specific examples, and ask for a referral for an ADHD assessment.
1
Book a GP appointment (a longer one if possible)
Ask for a double appointment if your surgery offers them. Bring a written list of specific behaviours you've noticed, with examples. Concrete, observed instances are more useful than general descriptions. Note how long you've been seeing these patterns, and whether they show up at school as well as at home.
2
Gather school input before the appointment if you can
Ask your child's teacher or SENCO to write a brief summary of what they observe in class. ADHD must be present in more than one setting to meet the diagnostic criteria, so school observations are important. Having these written down before the GP appointment can strengthen the case for referral.
3
The GP refers to the local community paediatric or neurodevelopmental team
In most areas, ADHD referrals for children go to a community paediatric team, a specialist neurodevelopmental service, or (in some areas) CAMHS (Child and Adolescent Mental Health Services). The pathway varies by region. Once the referral is accepted, your child goes on a waiting list.
4
The school SENCO can also refer in many areas
If your GP is reluctant to refer, the school SENCO can often make a referral independently, or provide supporting information that helps move a GP referral forward. It is worth having both conversations in parallel.
Sarah's experience
"The most useful thing I did before Jude's GP appointment was keep a two-week diary. Specific incidents, not summaries. 'Tuesday: took 45 minutes to put his shoes on, cried, ran out of time for breakfast.' Things like that. It felt obsessive at the time. In hindsight it was exactly what the clinicians needed to understand what we were dealing with."
What if the GP refuses?
It happens, and it can be deeply frustrating. If your GP declines to refer, ask them to explain their reasoning on clinical grounds and what evidence they would need to reconsider. You can request a second opinion from another GP at the same practice.
ADHD UK (adhduk.co.uk) has comprehensive guidance on your rights in this situation, including template letters for requesting a referral under Right to Choose. The organisation is parent-founded and actively advocates for families who are being turned away.
Under-recognition in girls and in children who mask: NICE explicitly notes that ADHD is under-recognised in girls and in children who manage to appear compliant in structured settings. If your daughter is described as a daydreamer, disorganised, or emotionally dysregulated, these can all be presentations of the inattentive type. The assessment process is the same regardless, but it is worth naming this if you feel your child's difficulties are being dismissed.
Right to Choose: how it works for ADHD
In England, if your GP agrees that an ADHD assessment is clinically appropriate, you have a legal right under the NHS Choice Framework to choose which NHS-contracted provider carries out that assessment. This is known as Right to Choose. It applies to children as well as adults, though not all Right to Choose providers offer assessments for children, so it is worth checking age eligibility before asking your GP to refer.
What it means in practice
You can ask to be referred to any NHS-contracted provider, not just your local team. Some providers offer shorter waits. ADHD UK maintains a current list of providers and their approximate waiting times at adhduk.co.uk.
Still NHS-funded
A Right to Choose assessment is NHS-funded throughout. Any medication that follows is prescribed on an NHS prescription at the standard prescription cost, or free if your child qualifies.
ICB funding restrictions
Some local Integrated Care Boards (ICBs) have introduced temporary restrictions that affect when providers can book assessments. This is an active and changing situation. Check the ADHD UK website for the most current picture for your area.
One waiting list only
You can only be on one NHS waiting list for the same condition at any one time. If you switch to a Right to Choose provider, you must come off your existing waiting list first.
Right to Choose currently applies in England only. It does not apply in Scotland, Wales, or Northern Ireland, where different local arrangements exist.
What the ADHD assessment involves
An ADHD assessment is not a single appointment. It is a structured process that brings together information from multiple sources: you, your child's school, and the assessing clinicians. The tools and format vary between services, but the core components are broadly consistent with NICE guidelines.
Phase 1
Pre-assessment questionnaires
Before any clinical appointments, most services send out questionnaires. You will be asked about your child's developmental history: pregnancy and birth, early milestones, how they played, how they manage friendships, sleep, behaviour at home, and the specific difficulties that prompted the referral. These are detailed and can take some time. Take them seriously — they form the foundation of the assessment.
Phase 2
The Conners questionnaires
The Conners rating scales are among the most widely used standardised questionnaires for ADHD assessment in children. Separate versions are sent to parents and to teachers, and older children (usually from age 8) may complete a self-report form as well. Each form asks about specific behaviours across areas such as inattention, hyperactivity, impulsivity, emotional regulation, and academic performance. Responses are rated on a 0 to 3 scale (not true at all to very often true). The completed forms are scored and compared against population norms to identify where a child's profile sits relative to their age group. The Conners system is designed as a multi-informant tool precisely because ADHD presentations often differ between home and school, and that variation is itself useful diagnostic information.
Phase 3
The clinical appointment
This is where a clinician — usually a specialist community paediatrician, child psychiatrist, or specialist nurse — meets with you and your child. There will typically be a session with you alone (or you and your partner) to discuss the developmental history in more depth, and a session with your child. The clinician will review all the pre-assessment information alongside what they observe directly. The clinical interview covers the same ground as the questionnaires but in more depth, and gives the clinician a chance to ask follow-up questions, observe your child's behaviour and attention directly, and rule out other explanations for the difficulties.
Phase 4 — some services
The QbTest
Not all services use the QbTest, but it is increasingly common. It is a computerised continuous performance test designed to provide objective data on attention, activity level, and impulse control. Your child sits at a screen and responds to a repetitive visual task for around 15 to 20 minutes. A small motion-tracking device attached to their headband records physical movement at the same time. NICE recognises the QbTest as an option to support the diagnostic process in children. It is not a standalone test (a positive or negative result does not confirm or rule out ADHD on its own), but it adds an objective layer of information alongside the questionnaires and clinical observations. Many children find it engaging. Others find the repetitiveness frustrating, which is itself informative.
Phase 5
The outcome
Once all the information is gathered, the clinician reaches a diagnostic conclusion and discusses it with you in a feedback appointment. They will explain the reasoning, what the assessment found, and what happens next. A written report typically follows within a few weeks. If ADHD is diagnosed, the report will usually include recommendations for school support and, where appropriate, a discussion of whether medication should be considered as part of a broader treatment plan.
ADHD diagnosis uses the DSM-5 criteria. For a diagnosis of ADHD, symptoms must be present in at least two settings (usually home and school), must have been present before the age of 12, must cause significant impairment in daily functioning, and must not be better explained by another condition. The assessment process is designed to check all of these systematically, not just to count symptoms.
A note on AuDHD
ADHD and autism frequently occur together. Research suggests that between 30% and 50% of autistic children also have clinically significant ADHD, and roughly 20% of children with ADHD also meet criteria for autism, according to research published by Autistica. The term AuDHD has emerged within the neurodivergent community to describe this co-occurrence. It is not a separate formal diagnosis, but both conditions can be diagnosed concurrently. This has only been possible since the DSM-5 in 2013, when the exclusion criterion that had prevented dual diagnosis was removed.
If you think your child may have both, say so at the start of the process. Many assessing services will screen for both as part of the same pathway, or will refer for an autism assessment if ADHD is confirmed and autism seems likely. Our companion guide to getting an autism assessment covers that process separately, including the different tools involved.
How long does it take?
NICE recommends that children should receive a first appointment within 13 weeks of referral. Many local NHS services are not meeting this target. In some areas, waits for community paediatric ADHD assessment exceed 18 months. The Children's Commissioner's 2024 report on neurodevelopmental waiting times found that children were waiting over a year for a community paediatrician appointment on average, and sometimes significantly longer.
Right to Choose providers sometimes offer faster access, though this varies by ICB and changes over time. ADHD UK's website keeps the most current information on waiting times across Right to Choose providers, updated monthly.
While you wait: a referral in the system does not have to mean a standstill at school. The SENCO can put SEN Support in place based on observed need, without waiting for a diagnosis. Ask for a meeting. Visual timers for task transitions, fidget tools for focus, movement breaks, and wobble cushions are examples of adjustments many families find helpful in the waiting period and beyond.
Private assessment: the key things to know
Some families choose a private ADHD assessment to avoid a long wait. Private assessments in the UK typically cost between £800 and £2,000 for a child, though prices vary considerably by provider and by the complexity of the assessment. A reputable private assessment should follow NICE guidelines, use standardised rating scales such as the Conners, include a developmental history interview, gather school information, and produce a comprehensive written report.
One important consideration: even after a private diagnosis, ADHD medication for a child must be initiated by a specialist, and your GP will need to agree to a shared care arrangement before taking over repeat prescriptions. Some GPs are reluctant to accept prescribing responsibilities based on a private diagnosis. It is worth asking your GP about this before proceeding with a private assessment, to understand what will happen if the assessment results in a diagnosis and medication is recommended.
A private report can also be used to support an EHCP application and a DLA claim, though local authorities are not automatically obligated to act on private reports without their own assessment. In practice, a thorough private report from a qualified clinician carries significant weight.
After the diagnosis: what comes next
The diagnostic report
Keep this document safely. You will need it for school SEN discussions, EHCP applications, DLA claims, and any future specialist referrals. Request a copy if it is not sent automatically.
School support
Share the report with the SENCO. Request a meeting to update the SEN support plan and discuss reasonable adjustments. These might include extended time for assessments, movement breaks, a structured homework planner, or seating arrangements that reduce distraction.
The medication conversation
If medication is recommended, this opens a separate conversation with the specialist. NICE guidelines are clear that medication is never the whole answer. Read our guide to ADHD medication for children, which covers all the options and what to expect from the prescribing process.
DLA
An ADHD diagnosis can support a DLA claim for your child. DLA is not means-tested and does not require a specific diagnosis, but the written evidence a diagnostic report provides is very helpful. Our DLA guide covers the process in full.
Useful resources
- ADHD UK — adhduk.co.uk The most comprehensive UK resource for ADHD information and parent advocacy. Their Right to Choose tracker is updated monthly with current wait times across providers. They also have template GP referral letters and guidance on what to do if you are refused a referral.
- NHS — nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd The NHS website sets out the referral process and assessment pathway clearly. A useful first read for understanding the standard NHS route.
- NICE Guideline NG87 — Attention deficit hyperactivity disorder: diagnosis and management The main UK clinical guideline that NHS services are expected to follow for children with ADHD. The patient information version is readable and worth looking at if you want to understand what standards the assessment should meet.
- Young Minds — youngminds.org.uk Good practical information for parents on what to do if you are concerned about your child's mental health and attention, and how to advocate within the school and NHS system. Their parent helpline is 0808 802 5544, Monday to Friday.
- Children's Commissioner — childrenscommissioner.gov.uk Their 2024 report on neurodevelopmental waiting times is the most thorough recent overview of how long children are waiting across England, and what the system gaps look like from a national perspective.
I'm a parent and not a professional, and the pathway described here reflects national NHS guidance. Your local service may work differently. Waiting times, referral routes, and Right to Choose availability all vary by area. ADHD UK's website (adhduk.co.uk) is the most reliable source for current, area-specific information.
Questions parents often ask
Can my child get support at school without a formal ADHD diagnosis?
Yes. Schools are required to make reasonable adjustments for any child who needs them, without waiting for a formal diagnosis. If your child is struggling with attention, impulse control, or behaviour, speak to the SENCO now. They can put SEN Support in place, which might include visual timetables, movement breaks, chunked tasks, or a quieter workspace. A diagnosis opens the door to an EHCP application and strengthens any DLA claim, but the school does not need to wait for it before helping your child.
How long does an ADHD assessment take from start to finish?
Waiting times vary considerably by area and pathway. The NICE guideline recommends a first appointment within 13 weeks of referral. In practice, local NHS services in some areas are seeing children wait 18 months or more. Right to Choose providers sometimes offer shorter waits, though this varies by ICB and by provider. ADHD UK (adhduk.co.uk) maintains an up-to-date tracker of current waiting times across Right to Choose providers, which is the most reliable source for current figures.
My GP refused to refer my child for an ADHD assessment. What can I do?
Ask the GP to explain on what clinical grounds they are refusing, and what evidence they would need to reconsider. You can request a second opinion from another GP at the same practice. You can also ask the school SENCO to provide written observations, which can strengthen the case for referral. If the GP continues to refuse, ADHD UK has guidance on your rights and on Right to Choose, including template letters for requesting a referral. A private assessment is also an option, though costs are significant.
What is AuDHD, and could my child have both ADHD and autism?
AuDHD is a term used in the neurodivergent community to describe someone who has both ADHD and autism. It is not a separate formal diagnosis, but both conditions can be officially diagnosed together, which has only been possible since the DSM-5 in 2013. Research suggests that between 30% and 50% of autistic children also have clinically significant ADHD, and roughly 20% of children with ADHD also meet criteria for autism. If you think your child may have both, mention this at the start of the assessment process. Many services will assess for both as part of the same pathway.
What is the QbTest and does my child have to do it?
The QbTest is a computerised continuous performance test that measures attention, activity level, and impulse control while a child performs a repetitive task, with physical movement tracked via a camera. It takes around 15 to 20 minutes. NICE recognises it as an option to support the diagnostic process for children. It is not a standalone test and not all NHS services use it. If your child is assessed by a service that includes the QbTest, they will be told what it involves beforehand.
Will my child need medication if they are diagnosed with ADHD?
No. Medication is one option within a broader treatment plan, not an automatic next step. NICE guidelines are clear that for children under 5, medication is not recommended as a first-line treatment at all. For children aged 5 and over, medication is considered only when ADHD symptoms continue to cause significant impairment despite environmental and behavioural strategies being in place. Many children are supported effectively through school adjustments, parent strategies, and behavioural support without medication. Our guide to ADHD medication for children covers the options in detail.
Related guides
Getting an Autism Assessment
The referral process, ADOS-2, developmental history interviews, and what to expect at the appointment.
ADHD Medication Explained
The medications used for children in the UK, how they work, and how prescribing works via the NHS.
SEN Support & EHCPs Explained
How the school support system works and what an EHCP application involves.
DLA for Children Explained
Disability Living Allowance for children under 16: who qualifies, current rates, and how to apply.