All parents of children with ADHD should be offered support and classes to help them deal with difficult behaviour, say new guidelines. Medicines should only be used in school-age children who have the most severe symptoms, and then always alongside support and training for parents.

What do we know already?

ADHD stands for attention deficit hyperactivity disorder. ADHD is a common behavioural problem. It affects about 3 in 100 children and young people in the UK, and about 2 in 100 adults.

There are three main symptoms of ADHD: inattention, hyperactivity and impulsivity. A child with ADHD might find it difficult to sit still, be forgetful and disorganised, and find it hard to follow instructions. These problems can cause serious difficulties, both at home, and at nursery, school or work. For example, a child with ADHD might be very disruptive in class, constantly wanting to move about and interrupting the teacher and other pupils.

If your GP or a teacher thinks your child might have ADHD, they should refer him or her to a specialist who has training in treating ADHD. This could be a paediatrician, psychiatrist or other specialist doctor.

To diagnose ADHD, doctors say that a child or adult must have two of the main symptoms (inattention or hyperactivity and impulsivity) or all three, and that these cause problems in at least two settings: for example, at home and at school. They might say someone has severe ADHD if they have all three symptoms and these cause more serious problems in at least two settings.

Doctors use talking treatments and medicines to treat ADHD. You’ve probably heard of Ritalin, which is one brand name for a drug called methylphenidate. But some doctors are worried that too many children are given medicines for ADHD. A group of experts has looked at the evidence of what treatments work for ADHD and produced guidelines for doctors.

What do the new guidelines say?

The new guidelines recommend different treatments depending on the age of the child or young person and the severity of their ADHD. The guidelines say:

* Parents of a pre-school child with ADHD should be offered support and positive parenting classes. Medicines should never be used.

* Parents of a school-age child with ADHD should be offered support and parenting classes. The child might also be offered psychological treatment in a group. This might be cognitive behaviour therapy (CBT) or another talking treatment that helps the child develop social skills, such as how to get on with peers, how to listen and how to solve problems. If the child’s symptoms are moderate and this treatment doesn’t help then they may be offered medicines (see below).

* School-age children and young people with severe ADHD might be offered medicines. Parents should also be offered parenting classes. Three medicines are used to treat ADHD: methylphenidate (brand names Ritalin, Concerta, Equasym), atomoxetine (Strattera) and dexamfetamine (Dexedrine). Which medicine your child is prescribed will depend on a number of things, such as whether they have any other symptoms and the side effects associated with the medicine.

Parents should have between 8 and 12 sessions of parenting classes. These might be for a group of parents or for individual couples.

It’s important to emphasise that taking part in parenting classes doesn’t mean that parents of children with ADHD are bad at parenting. Children with ADHD have behaviour problems that can be difficult to manage. And the aim of the classes is to teach parents ways of dealing with these challenging behaviours.

What about diet, supplements and exercise?

The guidelines say that it’s important for children with ADHD to have a healthy, balanced diet and regular exercise.

Parents are advised not to give their children supplements of omega-3 fish oils or to exclude foods from their diets, as there’s no evidence that either of these measures help symptoms.

What do the guidelines say about adults with ADHD?

By the time they’re 18, anyone who continues to have symptoms of ADHD should be cared for by adult services. Medicines are usually recommended for adults with moderate or severe ADHD. Adults should also be offered psychological treatments, such as CBT, to help them cope with problems at work and at in their everyday dealing with people.

Where do the guidelines come from?

The guidelines come from the National Institute for Health and Clinical Excellence (NICE), an independent body that advises the government about which treatments should be available on the NHS in England and Wales. When it looks at how a condition should be treated, it asks lots of experts and patients to give evidence. A group of doctors, patients and other people considers all the evidence and makes a decision about what to recommend.

What should I do now?

If your child has ADHD, you might like to read more about the new guidance. You can find a version for the public at


NICE clinical guideline 72. Attention deficit hyperactivity disorder. Diagnosis and management of ADHD in children, young people and adults. September 2008. Available online at* (…)

Source:, UK