An assessment that separates ADHD from the things it is mistaken for — a bright child who is bored, an untested learning difficulty, anxiety, poor sleep, or a hearing problem. Each of those looks like inattention in a classroom, and each needs something different.
By the time most parents book an appointment, the child has already been told what the problem is — by a class teacher, a relative, or a neighbour with an opinion. Careless. Lazy. Not trying. Needs a firmer hand. None of these is a diagnosis, but a child hears them for years and eventually agrees.
ADHD is diagnosed on a pattern, not on a bad term at school. The symptoms must have been present before age twelve, must show up in at least two settings rather than one, and must be interfering with how the child actually functions. A child who concentrates for six hours on a game and not six minutes on homework is not excluded by that — ADHD affects sustained attention on whatever the brain does not find rewarding, which is most of school.
Almost always some version of one of these three.
He is bright, everybody says so. He just will not sit.
Parent of a nine-year-oldThe school has called me in four times this term.
Parent of a seven-year-oldShe is no trouble in class. She just does not finish anything.
Parent of a twelve-year-oldADHD is not rare — somewhere around one school child in twenty meets criteria. What is common is that it goes unrecognised for years, and the two reasons for that are predictable.
A child who is inattentive but not disruptive gives the school nothing to call home about. The report card says 'could do better' for nine years. This presentation is substantially more common in girls, which is a large part of why girls are diagnosed later and less often.
An intelligent child compensates through primary school on memory and quickness alone. It surfaces in class seven to nine, when the volume of content finally exceeds what can be absorbed without a system for sitting down and working. Parents read the drop as adolescence or bad company.
Not a scare, just what the follow-up studies show for children who are never assessed.
Two appointments rather than one, because school input takes about a week to come back and the diagnosis cannot responsibly be made without it. Rating scales on their own do not diagnose ADHD — they measure how much a behaviour is bothering whoever filled in the form.
Pregnancy and early milestones, when the difficulty was first noticed, what has already been tried, and what the report cards actually said in each class. Old report cards are considerably more useful than the most recent one.
A standardised teacher questionnaire sent to the class teacher. The diagnostic criteria require symptoms in two settings, and a parent's account alone cannot establish that. Schools almost always fill these in, and usually within a week.
Hearing and vision first, because an undetected hearing loss presents exactly as inattention. Then screening for a specific learning disorder, anxiety, disturbed sleep and, where indicated, thyroid function. Around two-thirds of children with ADHD have a second condition alongside it, and treating only the ADHD leaves most of the problem standing.
Under six, medication is not first-line anywhere in the world — behavioural parent training is, and it works. From six upward the evidence supports medication and behavioural work together rather than either on its own. Parent training is not a comment on your parenting; it is a specific set of techniques for a child whose brain does not respond to ordinary consequences delivered at ordinary intervals.
The constraint is legal rather than clinical. Methylphenidate, the stimulant most used for ADHD in India, is a controlled substance, and the Telemedicine Practice Guidelines 2020 do not permit it to be prescribed over a video consultation. Atomoxetine, a non-stimulant, can be prescribed online and is a reasonable first choice for a good number of children. Where a stimulant is the right drug, she arranges a physical clinic visit on a case-by-case basis, or refers to a psychiatrist in her network in your own city, so that the prescription is lawful and can be refilled where you live.
The most useful thing you can bring is the report cards from classes one to four, including the teacher's remarks column. ADHD has to have been present before age twelve, and a remark written when your child was seven is better evidence than anything either of us can reconstruct from memory now.
Covers the first appointment. The second, once the school questionnaire has come back, is charged as a follow-up. A parent must attend; whether the child joins for all or part of it depends on age.
Yes. The assessment is a developmental history, school reports and standardised rating scales, and all three work over video — in some ways better, because the child is at home rather than in an unfamiliar room. What cannot be done online is prescribing a stimulant. Diagnosis, behavioural treatment and non-stimulant medication can all be handled remotely.
For the first appointment a parent alone is often more useful, particularly for a teenager who will not speak freely with a parent listening. Younger children are seen for part of the session. For adolescents, time alone with the doctor is standard practice, and what is said in it stays confidential except where there is a safety concern.
Not on its own. ADHD is not named among the twenty-one specified disabilities in the schedule of the Rights of Persons with Disabilities Act 2016, while specific learning disorder and autism spectrum disorder are — and certification for ADHD alone is inconsistent between states and boards. A good number of children with ADHD also meet criteria for a specific learning disorder, and that is the route to a disability certificate and to CBSE or ICSE concessions. If the assessment points that way, you will be told plainly what the next step is and which separate assessment it needs.
No, and nothing is shared with anyone without your written consent. In practice, schools that know tend to be more helpful than schools that are guessing, and a short letter setting out accommodations — seating at the front, extra time, instructions given one at a time — often changes more day to day than a dose adjustment does.
Reviewed at least once a year, usually with a planned break during a long holiday to see what is still needed when it is stopped. Some children come off it in adolescence; some continue into adult life. The decision is made on how the child functions without the drug, not on how many years they have been taking it.
Often recognised once the child is
Anxiety, behaviour, school refusal
Where both are being considered
Call Tele-MANAS 14416 — free, 24 hours. If someone is in immediate danger, call 112.