Private ADHD assessment has grown quickly, and quality varies more than price does. Here is what a thorough one involves, and what the shortcuts look like.
Information from more than one setting is not optional
ADHD is defined partly by difficulties appearing in more than one setting. An assessment based only on what parents report cannot establish that, however careful the questioning.
So school or college input is essential, usually through standardised questionnaires completed by someone who teaches the child. A service that does not ask for it is not doing the assessment properly — and its conclusion is not one a school or NHS service will find persuasive.
Ask before booking: do you require information from school, and what happens if we cannot get it?
A questionnaire is a starting point, not a diagnosis
Rating scales are genuinely useful. They are also a measure of how observers perceive a child, which is information about the observers as well as the child.
They should be one input into a clinical interview covering developmental history, how difficulties show up day to day, and what else might explain them. A “diagnosis” produced by scoring forms without that conversation is not worth what you paid.
What must be considered before ADHD is settled on
- Sleep. In children, tiredness usually looks like overactivity rather than sleepiness.
- Hearing. A child who mishears instructions looks like one who ignores them.
- Anxiety and low mood. Both impair concentration.
- An unrecognised learning difficulty. A child who cannot read the worksheet will find something else to do.
- Autism. The two co-occur often, and inattention can be the presenting feature.
- What changed recently. Difficulties that started this term point at something that happened this term.
If none of these came up, the assessment was too narrow.
The medication question, and shared care
This is where private assessment gets complicated in the UK, and where you should ask before paying.
If medication is recommended, someone must prescribe and monitor it. Many families hope their GP will take this over under a shared care agreement. GPs are not obliged to enter shared care, and many practices decline it for privately initiated treatment. Policies vary by area and by practice.
Ask the provider directly: who prescribes, who monitors, what happens if our GP declines shared care, and what does continuing privately cost per year? A clinic that answers vaguely is leaving you to discover the answer later.
Will the NHS and school accept the diagnosis?
Schools generally engage with a well-evidenced report because it helps them. Local authorities assess needs rather than diagnoses.
NHS services vary: some accept a private diagnosis into their pathway, others reassess before offering NHS-funded treatment. Nobody can promise you otherwise.
Questions worth asking
- Do you require school information, and what if we cannot obtain it?
- Who conducts the assessment, and what is their registration?
- What else will you consider besides ADHD?
- If medication is recommended, who prescribes and monitors it?
- What if our GP declines shared care?
- What follow-up is included?
Where we fit
We assess at our Ickenham clinic in West London. ADHD covers the clinical background, how we assess our process, and how we work with schools the part after the report.
This article is general information about how assessment works in the UK. It is not a diagnosis, not advice about your individual child, and not advice about medication.