Oct 10

ADHD diagnosis and EHCPs: your questions answered

Parents often ask whether to seek an ADHD diagnosis and whether to apply for an EHCP. These are the questions I hear most often in my clinic.

“I’m not sure if I should get my child formally diagnosed with ADHD.”

This is a very personal decision.

There is no right or wrong choice.

As a clinician, I am pro-diagnosis because a diagnosis helps you and your child understand how their brain works.

For example: struggling with homework shifts from “being lazy” to “finding it hard to start tasks.” This reframing allows you to support your child with the right tools and strategies.

I like to think as getting a diagnosis for ADHD or Autism as the same, if not a little more expensive and complicated, as getting an eye test for your child. You would want to know and actually you would need to know if your child is having trouble seeing the board at school.

If you didn’t find out and get them tested you may not know they are struggling and missing out on learning, it may well cause them to be anxious about school too, they may get in trouble for “not concentrating”.

Knowing that your child is short or long sighted means that they can get the tools to help them. That may mean glasses, that may mean the teacher allows them to sit at the front of the class. Whatever adaptations are made helps them thrive in their environment .

“I’m worried about the label of ADHD. Will people think differently about my child?”

This is a common concern. My first question back is: “What label do they have now?”

Often parents tell me their child has already been called “lazy,” “disruptive,” “disorganised” or “unmotivated.” Those labels do not help your child, and they risk being internalised.

An ADHD diagnosis provides a constructive explanation, not a judgement. It opens up understanding, helps reduce stigma, and makes it easier for others to support your child. As awareness grows, so does acceptance.

“What does a diagnosis actually do?”

A diagnosis can:
  • Help with understanding your child and the “why” behind their behaviours
  • Help your child understand themselves. My child knew their brain was a little different to their friend. An ADHD diagnosis has help them understand their challenges.
  • Make schools take your concerns more seriously.
  • Unlock support such as tailored learning strategies.
  • Open the door to medication if tht for your child.

A child with ADHD will on average receive 20,000 more negative comments than their peers before the age of 12.

Comments such as “ why can’t’ you just ….” “ stop doing that” etc are damaging to a child’s self-esteem but when these are replaced with understanding that it is ADHD support is more likely to be give over criticism.

It is not a golden ticket. Support varies widely across the country. But it does create a framework for you to advocate for your child.

“When is the right time to seek a diagnosis?”

Earlier is often better, because:
  • Children diagnosed later may already have internalised negative labels.
  • They may struggle with self-esteem if their difficulties have gone unrecognised.
  • Relationships have already been damaged 
  • Habits have been formed
  • They may already be behind in school work or learning
  • Friendships may be damaged
  • Years may be lost where strategies to help them may not have been put in place.

However, there are important points to consider:
  1. Are behaviours part of a developmental stage or due to a change in environment e.g. a new academic year at school- note any patterns to behaviour as this will help decide if a diagnosis is needed. 
  2. For an ADHD diagnosis, symptoms must start before age 12, last at least six months, and appear in at least two settings (home and school).
  3. Symptoms must affect daily functioning, such as learning, family life or friendships.
  4. Going for a diagnosis too early can sometimes mean difficulties are missed, especially if your child masks at school.
  5. Waiting too long is also risky. Referral times are long, and the impact on learning and wellbeing can grow without support. I cannot tell you the number of calls I get in May when the exam season starts from worried parents when they suddenly realise that their concerns years ago were very valid and their child is struggling and it’s time to sit big exams.

“What if we don’t want a diagnosis, or we’re still waiting?”

  • Its ok to not want a diagnosis and with wait times being so long currently for a diagnosis, it falls on us as parents to advocate for our children, put measures in place or ask other for too. If you think they are struggling no harm will be done if you support them as if they have ADHD:
  • Talk with your child about where they struggle.  Then you need to put on your “neurodiversity glasses” to understand their behaviours differently and put scaffolding in place to support them. It maybe that the lunch hall is too noise and it dysregulates them so that concentration in class after lunch is impossible, this could be fixed relatively easily with the support of school.
  • Work with teachers or club leaders to make small, reasonable adjustments (for example, movement breaks, visual schedules, or a quiet space at lunchtime).

    Most people want to help—especially if you ask for small, practical changes

“What's the process to get a diagnosis ?”

There are two ways you can go about getting an ADHD diagnosis for your child in the UK:

1. NHS referral
  • Start by speaking to your GP.
  • Your GP may refer you to CAMHS (Child and Adolescent Mental Health Services), a consultant paediatrician, or a psychiatrist.
  • Waiting times vary across the country and can be very long sometimes up to three years.
  • In some areas, you may have the right to choose, which means you can ask your GP to refer to a different provider with shorter waits.
  • A diagnosis can be made by a paediatrician, a psychiatrist, or a clinical psychologist. Only paediatricians and psychiatrists can prescribe medication.

2. Private referral
  • A private assessment is usually quicker, with waiting times between three and six months.
  • You may see a paediatrician, psychiatrist, or clinical psychologist but again only paediatricians and psychiatrists typically prescribe medication.
  • A private diagnosis can cost between £1,000 and £2,000, with the average between £1,400 and £1,600.
  • Some schools and NHS professionals may be cautious about accepting a private diagnosis.

“What does the assessment involve?”

A thorough ADHD assessment usually takes three to four hours and includes:
  • Questionnaires from school and caregivers
  • An interview with parents or carers
  • An interview with the child
  • Sometimes a computer-based attention test

Quick, 40-minute assessments are not standard and may not provide a reliable result.

Key differences between NHS and private routes

Speed: Private assessments are usually much faster to administrate.

Medication: NHS and private paediatricians/psychiatrists can prescribe medication; psychologists usually cannot.
If you have a private diagnosis , then any medicines will be prescribed privately and you will need to pay for this yourself. Some GPs’ although the number is reducing, will agree to a “shared care agreement” with your private doctor and take on the responsibility of prescribing so that the NHS pays.
However the dosage will need to be stable for at least 3 months and any changes will need to happen through the prescribing doctor not the GP. Shared care agreements can vary massively around the country. Our GP will not do this.

Ongoing support: Getting advice or medication changes can be easier privately, while NHS contact often depends on set appointments.

Cost: Private assessments are expensive but may feel necessary if NHS waiting times are too long.

“What is an EHCP?”

An Education, Health and Care Plan (EHCP) is a legally binding document created by your local authority. It sets out what support your child needs and requires the school to provide it so that they can access learning.

“Why are EHCPs in the news so much?”

Because demand is outpacing supply.

The school system is designed for “round pegs in round holes.” Many neurodiverse children don’t fit that mold.

Families are turning to EHCPs to secure support, but:
  • Requests have risen sharply.
  • Councils are overwhelmed.

Many families have to go to tribunal to fight for a plan, which is costly for everyone involved.
In truth, small, inclusive classroom changes, benefiting around 90% of learners, would reduce the need for so many EHCPs.

“Is it worth applying for an EHCP?”

For some families, yes. Especially if:
  • Your child is a school refuser.
  • Mainstream provision isn’t working
  • The adjustments needed are significant , like 1 to 1 support.
  • Alternative education is needed.

But be aware:
  • Getting an EHCP is often a long and stressful process. If honest it feels like the local authorities rely on parents being exhausted and therefore giving up .
  • Even with a plan, schools sometimes struggle to meet all the outlined needs.
  • Many families wait over a year before support is in place.
  • EHCP’s are not the GOLDEN TICKET ! The finances and resources are often not there to support the stated adaptations in the documents .
  • Be prepared to go to tribunal ! The EHCP process is a fight.

The final word(s)

A diagnosis and an EHCP are tools, they do not in themselves make challenges disappear. They can open doors to understanding and support, but they don’t guarantee everything will change overnight.

Meanwhile, small, everyday adjustments at home and in school can make a huge difference to your child’s confidence and wellbeing. I see it all the time, parents are where the power is.

 Be your child’s advocate, put on your neurodiverse glasses and see the world through their eyes to gain understanding, wear a curiosity hat to ask “why”. Why is there this behaviour, why are they struggling, then ask, ask for small adjustments, ask your child what they need so that they have the scaffolding around them to thrive.

To find out more about these small adjustments and understand the tools you can use to help your child, EHCP or not, try the taster of our twigged Toolkit for ADHD for free today.
gee eltringham

The founder

I started twigged out of both personal urgency and professional insight.
As The Toolkit Therapist and parent to a neurodivergent child, I experienced first hand the overwhelm and isolation families often face after a diagnosis.
Frustrated by the lack of practical, empathetic support, I set out to create what I couldn’t find: simple, evidence-based tools that make everyday life easier.
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