Understanding ADHD in Children: Expert Strategies for Diagnosis and Support
By Dr Daniel Gordon • 28, Aug 2025
Restlessness, struggles with focus, emotional difficulties. For some children, these are just fleeting phases of growing up. For others, they point to something deeper: ADHD.
Few topics in child health spark as much debate. Are we overdiagnosing? Are key signs, especially in girls, being missed? Are we relying too much on medication?
This month on The Health Perspective I sat down with Dr Josh Harwood, a clinical psychologist specialising in children’s mental health, to talk about ADHD and neurodiversity. Our conversation cut through myths and fears to get to the heart of what really matters: helping children feel understood, supported, and able to thrive.
What follows is a reflection on that dialogue. A guide for parents trying to navigate one of the most talked-about challenges in child development today.
Is ADHD Overdiagnosed or Are We Just Catching Up?
One of the first questions I put to Josh was the one I hear most often from parents in clinic: is ADHD being overdiagnosed in children?
As a GP, I understand the worry. Parents look around and feel that suddenly everyone seems to be getting a diagnosis. They wonder whether normal childhood behaviours are being medicalised.
Josh’s answer was thoughtful.
“The number of diagnoses has gone up, sometimes five or ten times over the last decade. But that does not automatically mean we are overdiagnosing. It may mean families feel more comfortable seeking support, and professionals are getting better at recognising it.”
The real risk, he added, is when ADHD becomes a catch-all explanation for behaviours that may be better understood in other ways. Diagnosis should never be a quick checklist. It must be a careful process, looking at the child across multiple environments (home and school) and over time.
Why Early Support Makes a Difference
This is something I see often in practice. A child struggles to sit still or focus, and they quickly get labelled the naughty one or the lazy one. Over time, those labels can chip away at their self-esteem and shape how they see themselves.
Josh explained why early support matters so much.
“When children are young, their brains are highly plastic. With the right support, they can adapt and develop strategies. But if you delay until the teenage years or beyond, those patterns are harder to shift.”
Early help does not mean rushing to diagnosis. Sometimes it simply means ensuring teachers understand a child’s needs, or giving parents strategies to respond in ways that protect confidence as well as learning. The goal is not to put a label on a child, but to give them the support that allows them to thrive.
Diagnosis and Labels: What Parents Really Need to Know
Many parents worry about labels. They fear a diagnosis will lower expectations, or become an excuse for difficult behaviour.
Josh was clear that this is not the case.
“A diagnosis does not mean everything goes. It helps identify the areas a child finds difficult so you can provide scaffolding and let their natural strengths shine.”
The problem is not the label itself, but what happens next. Too often, families are given a diagnosis and then left to manage on their own. As I often say, this is a “diagnose and dump” approach, and it helps no one.
Josh explained why this is so unhelpful.
“The diagnosis is just the starting point. What really helps is a thorough assessment that builds a picture of a child’s strengths and struggles. From there, you can create a tailored support plan.”
Labels should never define a child. They are tools to open doors to understanding, support, and strategies. Progress comes from pairing the diagnosis with practical help at home, in school, and in the wider community.
ADHD in Girls: Why So Many Are Missed
Boys are often picked up quickly because of outward behaviours such as restlessness, impulsivity, or being disruptive in class. Girls, however, are far more likely to mask their difficulties. They may appear calm and capable at school, but the effort of holding it together can leave them exhausted or struggling at home.
Josh described these children as the ones who are “very bright and able, holding it together at school but maybe not at home.” These are often the young people who slip under the radar, and as a result they are at risk of missing the support they need.
ADHD in girls is too often not recognised until adolescence, when confidence problems, anxiety, or low mood begin to surface. The message for parents and teachers is simple: ADHD does not look the same in every child. Quiet does not always mean coping.
The Role of Schools and Environment
Schools are often where concerns about ADHD first arise. Teachers may be the first to notice that a child cannot sit still, loses focus easily, or struggles with impulsivity. But classrooms themselves can play a part. Large class sizes, exam pressure, and overstretched teachers can make behaviours far more visible.
Josh reminded us that the context is crucial:
“Sometimes what looks like ADHD is actually a child responding to a difficult environment. That is why we have to take the whole picture into account.”
For parents, this means working not only with clinicians but with schools too. Small adjustments such as extra movement breaks, quieter working spaces, or clear routines can make a big difference to how a child copes and learns.
ADHD Treatment: Medication, Therapy or Both?
Parents often come with strong views. Some want to avoid medication at all costs. Others see it as the only answer.
Josh acknowledged both perspectives. He explained that some parents say, “I really want to do everything in my power to avoid having to use medication, so set me up with parenting strategies, support in school, and ways to help my child directly.” Others, he said, have seen the difference stimulant medication can make and feel reassured when it is part of the plan.
The evidence is clear: medication can be very effective, but it works best when combined with therapy, parenting support, and school involvement. As I often tell families, there is no one-size-fits-all solution.
The most powerful results come from what I call a toolbox approach. That toolbox might include low-dose medication, practical strategies at home, tailored support at school, or psychological therapy.
The exact mix depends on the child and the family, but what matters is that it is flexible and personalised.
When Should a Child Be Assessed?
One of the most common anxieties I hear from parents is about age. I often meet families who have been told their two- or three-year-old needs an ADHD assessment.
Josh was very clear. Assessments before the age of five are rarely reliable, except in very obvious cases. He explained, “If you applied ADHD criteria to two-year-olds, you would end up diagnosing the majority of them, because impulsivity and high activity are normal at that stage of development.”
For most children, it is better to provide support and monitor progress, then reassess once they have had time to develop school-readiness skills.
Importantly, waiting does not mean doing nothing. As Josh put it, families can still benefit from parenting support, play therapy, or strategies to make daily life easier. Regular reviews give parents reassurance that progress is being tracked. If difficulties remain or intensify as the child reaches school age, then a formal assessment can be pursued at the right time.
Final Thoughts: ADHD Is a Difference, Not a Deficit
My one take-home message is this. I do not agree with the idea that ADHD is a deficit or a disorder, even though those words are built into the name. I am confident the terminology will change in the years ahead. Right now, I believe it puts many parents off seeking support because they worry their child will be labelled in a negative way.
ADHD Should Be Seen as a Difference
That difference can bring challenges, but it can also lead to incredible skills and talents. Children with ADHD can still be very able, creative and resilient. What matters is understanding how their brain is processing information, how they see the world, and how they feel in their body. With that understanding, we can give them targeted support to make the difficult parts of life easier while allowing the areas where they already thrive to become their superpowers.
This is why I always encourage parents to seek support as early as possible. That does not necessarily mean rushing into a full diagnosis. It can simply mean spending an hour with a specialist who understands these issues, to talk through whether an assessment or different strategies might help.
The label itself should never be the focus. It is just one part of the picture, and often not a perfect one. What matters is that children feel seen, understood, and supported, so they can grow into the strengths that make them who they are.
That is the real goal.
If this conversation resonates, I encourage you to watch the full interview with Dr Josh Harwood on my YouTube channel The Health Perspective. It may change the way you think about ADHD and what truly matters in raising confident and resilient children.
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