ADHD in Children: Understanding and Supporting Your Child

ADHD is among the most common neurodevelopmental conditions in childhood, affecting approximately 5–7% of children globally. For parents, a diagnosis can arrive as both a relief and an upheaval — relief because behaviour that seemed inexplicable now has a name, and upheaval because the path forward is unclear. Understanding how ADHD actually presents in children, what the assessment process involves, and which interventions have solid evidence behind them is the foundation of effective support.

How ADHD Presents in Children

The DSM-5 recognises three presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined. In younger children, hyperactive-impulsive symptoms are most visible — the child who cannot stay seated, calls out in class, or grabs things impulsively. As children mature, physical hyperactivity often reduces and inattentive symptoms become more prominent: losing belongings, failing to complete tasks, difficulty sustaining attention on anything that is not immediately rewarding. Symptoms must cause functional impairment in at least two settings, such as home and school, for a diagnosis to be made.

Girls are significantly underdiagnosed. Their ADHD more often presents as inattentive or internally hyperactive — daydreaming, disorganisation, and emotional dysregulation — rather than the disruptive behaviour that prompts teacher referrals. Many girls are not identified until adolescence or adulthood, by which point years of struggling without support have taken a significant toll on self-esteem.

Getting an Assessment

A proper ADHD assessment for a child should involve clinical interview with both the child and parents, standardised rating scales completed by parents and teachers, review of developmental history, and ruling out other explanations for the symptoms. In the UK, referrals typically go through the GP to a paediatrician or CAMHS (Child and Adolescent Mental Health Services). Wait times can be long; a validated ADHD screening questionnaire completed beforehand can help structure the referral and document the pattern of symptoms clearly.

Comorbidities to Know About

ADHD rarely travels alone. Around 50% of children with ADHD also have a learning difficulty such as dyslexia or dyscalculia. Anxiety disorders affect around 30%. Oppositional defiant disorder (ODD) is present in up to 50% of hyperactive-impulsive presentations. Autism spectrum disorder co-occurs in roughly 20–30% of cases. Each comorbidity needs its own consideration in the support plan; treating ADHD alone without addressing anxiety, for example, may leave a child still struggling significantly despite medication.

Evidence-Based Interventions

For children under six, NICE guidelines recommend behavioural parent training as the first-line treatment, with medication reserved for moderate-to-severe cases where behavioural approaches have not been sufficient. Stimulant medications (methylphenidate, lisdexamfetamine) have the strongest evidence base for school-age children and are effective in approximately 70–80% of cases. Non-stimulant options such as atomoxetine are used where stimulants are not tolerated or where comorbid anxiety is prominent. Medication works best alongside environmental adjustments: consistent routines, clear and brief instructions, movement breaks, and reduced distractions. Collaboration with the school to put a support plan in place is often as important as any clinical intervention.

Dr. Adeel Sarwar, PhD, is a mental health professional specialising in a broad spectrum of psychological conditions such as depression, anxiety, ADHD, eating disorders, and obsessive-compulsive disorder (OCD). Armed with years of experience and extensive training in evidence-based therapeutic practices, Dr. Sarwar is deeply committed to delivering empathetic and highly effective treatment.