Childhood ADHD: How to Recognise the Signs
Childhood ADHD: How to Recognise the Signs, Seek a Diagnosis and Find Support in the UK
It is often misunderstood, misdiagnosed—or missed altogether—particularly in girls and quieter children. Early identification and support can make a significant difference to a child’s self-esteem, education, relationships, and long-term mental health. I know this, not just as a health professional—but personally. I wasn’t diagnosed with ADHD until adulthood. Looking back, the signs were there throughout childhood: the forgetfulness, the overwhelm, the way my mind would race in a hundred different directions when I was supposed to be sitting still and listening. But because I wasn’t disruptive and did well at school, it flew under the radar. Looking back when I had to sit in my own room to complete my A LEVEL’s, dropped out of the first university I attended due to crippling anxiety, it was pretty obvious. This experience has given me a deeper understanding of how ADHD can go unnoticed—especially in girls and in children who mask their struggles. It’s also why I’m so passionate about helping parents spot the signs early, navigate the diagnostic system, and feel empowered to advocate for their child. In this blog, I’ll take you through the key signs of ADHD, how to gather evidence, where to go for support in the UK, and what to expect from the diagnosis process. Whether you're at the very beginning of your journey or already suspect your child may have ADHD, this guide is for you.
What Is ADHD?
ADHD is a condition that affects behaviour, attention, and impulse control. It is typically divided into three presentations:
Inattentive type (often missed in girls): Difficulty focusing, forgetfulness, disorganisation.
Hyperactive-impulsive type: Constant movement, fidgeting, talking, acting without thinking.
Combined type: A mix of both inattentiveness and hyperactivity/impulsivity.
ADHD is not caused by poor parenting, too much screen time or sugar—it is a neurodevelopmental condition linked to differences in brain structure and function, often running in families.
Can ADHD Be Diagnosed in Children Under 5?
Yes, ADHD can be diagnosed in children under 5, but it is less common—and often more complex. That is because many typical toddler behaviours, such as being active, impulsive, and having short attention spans, overlap with ADHD symptoms. Therefore, healthcare professionals are cautious and tend to wait until behaviours are clearly persistent, excessive for age, and causing significant challenges across multiple settings. In the UK, the average age for an ADHD diagnosis is between 6 and 7 years old. This is often when children start school and the demands for attention, impulse control, and sitting still become more structured and measurable. Teachers are also trained to spot patterns and can offer helpful insights during the diagnostic process.
Why Is Diagnosis Rare Before Age 5?
Developmental variability: Young children develop at different rates, and what looks like ADHD at age 3 may be typical by age 5.
Observation across settings: It's harder to gather evidence from multiple environments before school starts.
Limited clinical pathways: Many CAMHS and community paediatric services do not routinely assess children under 5 for ADHD unless symptoms are extremely severe or are accompanied by other neurodevelopmental concerns.
That said, if a child under 5 shows significant signs of hyperactivity, inattention, or impulsivity that are far beyond what's expected for their age, it's important to speak to a GP or health visitor. In some cases, early referral to a community paediatrician may be appropriate—especially if the child is struggling to engage in early education, showing signs of emotional distress, or at risk of exclusion from the nursery.
How Do You Know If Your Child Might Have ADHD?
ADHD often becomes more noticeable once a child starts school, where demands on focus and self-regulation increase. Some common signs of ADHD include:
Inattentive symptoms:
Frequently losing things
Trouble organising tasks or following instructions
Easily distracted or forgetful
Appears not to listen, even when spoken to directly
Hyperactive-Impulsive symptoms:
Difficulty sitting still, even in calm environments
Talking excessively or interrupting others
Constantly “on the go” or unable to play quietly
Difficulty waiting their turn
Emotional and Social Clues:
Struggles with emotional regulation (frequent outbursts or tearfulness)
Finds it hard to make or keep friends due to impulsivity or lack of awareness of social cues
Experiences low self-esteem from repeated criticism or “getting it wrong”
If you recognise several of these signs consistently over time and across multiple settings (e.g. home and school), it may be worth seeking further assessment.
How to Seek a Diagnosis in the UK
Getting a diagnosis of ADHD in the UK typically involves these steps:
1. Talk to Your Child’s Teacher or SENCO
Gather their observations—are they seeing the same behaviours at school? Teachers may raise concerns first, or you can initiate the conversation. Schools can refer your child to a local neurodevelopmental pathway or paediatrician through your GP or a health visitor if under 5.
2. Visit Your GP
Your GP can refer your child to a community paediatrician (for younger children) or Child and Adolescent Mental Health Services (CAMHS). A referral usually requires school input and a completed questionnaire such as the SNAP-IV, Conners Rating Scale, or SDQ (Strengths and Difficulties Questionnaire).
3. What the Diagnostic Process Involves
A detailed developmental history
Reports from home and school
Questionnaires and observations
Sometimes, cognitive assessments (e.g., from an Educational Psychologist)
The process can take time—waitlists for CAMHS and paediatric services are often long, and delays are common. In some areas, private assessments are available, but always ensure they meet NICE guidelines and are conducted by registered professionals (e.g. GMC, HCPC, or BACP registered).
Gathering Evidence: What Helps?
To support a referral and diagnosis, keep a symptom diary and collect examples over time.
Here’s what you can do:
Write down specific behaviours and when they occur (e.g. difficulty sitting through dinner or meltdowns after school).
Keep school reports or teacher feedback, particularly if they mention talking, interrupting, not listening, poor attention, behaviour, or social difficulties.
Collect samples of work showing inconsistency or executive functioning difficulties.
You may also want to track:
Sleep patterns
Eating habits
Emotional regulation
Any co-occurring difficulties (e.g., sensory sensitivities, anxiety)
Where to Get Support in the UK
NHS and Local Services:
GP and CAMHS: Initial point of contact for referral.
School SENCO (Special Educational Needs Coordinator): Can support classroom adaptations and behaviour plans,and initiate an EHCP (Education, Health and Care Plan) if needed.
Community paediatricians: Often assess ADHD in younger children (under 7–8 years).
Charities and Organisations:
ADHD UK – www.adhduk.co.uk
ADDISS – www.addiss.co.uk
The ADHD Foundation – www.adhdfoundation.org.uk
Contact – Charity for families of children with disabilities, including ADHD (www.contact.org.uk)
Online Communities and Parent Support:
Local Facebook groups or SEND forums
Parenting courses for ADHD (e.g., Triple P ADHD, Incredible Years)
ADHD-specific coaching and therapy for older children or families
Final Thoughts
Early identification and understanding of ADHD can transform the way a child understands themself. Without support, children with ADHD are more vulnerable to anxiety, depression, academic difficulties, and low self-esteem. But with the right tools, accommodations, and encouragement, children with ADHD can thrive. If you suspect your child may have ADHD, trust your instincts, gather evidence, and start the conversation with the school or your GP. You are your child’s best advocate—and they don’t have to navigate this journey alone.
References
National Institute for Health and Care Excellence (NICE). (2018). Attention deficit hyperactivity disorder: diagnosis and management (NG87). Retrieved from https://www.nice.org.uk/guidance/ng87
NHS England. (2023). ADHD in children. Retrieved from https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/
Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018). ADHD in children and young people: prevalence, care pathways, and service provision. The Lancet Psychiatry, 5(2), 175–186. https://doi.org/10.1016/S2215-0366(17)30167-0
ADHD Foundation. (2023). Understanding ADHD: A guide for parents and carers. Retrieved from https://www.adhdfoundation.org.uk
Ford, T., et al. (2007). The British Child and Adolescent Mental Health Survey 2004: the prevalence of DSM-IV disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 46(4), 424-433. https://doi.org/10.1097/chi.0b013e3180306191
Russell, G., Rodgers, L. R., Ukoumunne, O. C., & Ford, T. (2014). Prevalence of parent-reported ASD and ADHD in the UK: findings from the Millennium Cohort Study. Journal of Autism and Developmental Disorders, 44(1), 31–40. https://doi.org/10.1007/s10803-013-1849-0
ADDISS (The National Attention Deficit Disorder Information and Support Service). (2023). Resources and Information for Parents. Retrieved from http://www.addiss.co.uk
Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135(4), e994-e1001. https://doi.org/10.1542/peds.2014-3482