Children's Attention Deficit Hyperactive Disorder (ADHD) assessment service

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects how children and young people manage attention, activity levels, and impulses.

ADHD can include:

• Inattention – difficulty concentrating, being disorganised or forgetful, struggling to finish tasks
• Hyperactivity – finding it hard to sit still, fidgeting, seeming constantly “on the go”
• Impulsivity – acting or speaking without thinking, interrupting others, difficulty waiting

For a diagnosis of ADHD, these difficulties must:

• Have been present for at least 6 months
• Occur in more than one setting (for example home and school)
• Cause significant impact on learning, behaviour, or social life

Many children show some of these behaviours at times. ADHD is considered when difficulties are persistent, developmentally inappropriate, and affect every day functioning. Strengths, interests, and abilities are always an important part of understanding a child, not just their difficulties.

What should I do if I’m worried?

If you are concerned your child may have ADHD, there are important steps you can take before considering a referral.

1. Access early support and information

In line with national guidance, parents and carers should be offered access to parent education or support for ADHD-like behaviours without waiting for a diagnosis.

This may include ADHD-focused programs or other evidence-based parenting support, such as the Solihull Approach or equivalent local services.

These programs can help you:

• Better understand attention, activity, and emotional regulation difficulties
• Learn practical strategies to support your child at home
• Decide whether further assessment may be needed

2. Talk to your child’s school

Share concerns with your child’s teacher, SENCO, or school nurse.

School staff can help put appropriate support in place and monitor how your child manages in the classroom.

3. Put support strategies in place

Support strategies should be tried at home and school, such as:

• Clear routines and structure
• Visual supports
• Behaviour or learning strategies

Many children show improvement when the right support is in place.

4. Monitor progress over time

It is important to observe and record:

• What strategies have been used
• What has helped
• What difficulties remain

Before an ADHD assessment referral

Before referring a child for an ADHD assessment, we usually expect evidence that:

• Support strategies have been used consistently for at least 10 weeks
• School-based support has been in place for at least one school term
• The impact and outcomes of these strategies have been recorded

This information helps ensure that any assessment is appropriate, thorough, and in line with national clinical guidance.

When can a referral be considered?

A referral to the Herefordshire and Worcestershire ADHD pathway may be considered if:

• The child is aged 5½ to 17½ years
• ADHD-like difficulties have been present for 6 months or more
• Difficulties occur across more than one setting
• There is clear impact on education and/or social functioning
• Information is available from home and school (or another setting)
• Support strategies have been tried and have not been sufficient on their own

If a child shows ADHD-like behaviours but can manage education and social life without significant impairment, they may not meet criteria for a diagnosis, although support may still be appropriate.

Private ADHD assessments

If your child has had a private ADHD assessment, and you are seeking NHS involvement, we require:

• A full copy of the assessment report, including all raw data from assessment tools (not just summary scores or conclusions)
• Completion of the Herefordshire and Worcestershire Community Paediatrics ADHD Referral Form by parents/carers and the child’s school or education setting

Private assessments are reviewed using the same clinical standards as NHS assessments to ensure care is safe, evidence-based, and in line with NICE guidance.

The NHS is not automatically able to accept or continue care without this information.