How to Get Your Child Evaluated for ADHD: A Step-by-Step Guide

Once you have decided it is worth finding out, the next question is how. In the US there are two routes that run in parallel: a medical evaluation, which can lead to a diagnosis and treatment, and a school evaluation, which decides what support your child gets in the classroom. Here is how each one works, what to bring, and what happens afterwards — whatever the answer turns out to be.

Updated 2026-10-26.

Two routes, two different questions

• The medical route asks: does this child have ADHD, or something else, and what treatment would help? It is done by a pediatrician or a specialist and can result in a diagnosis.
• The school route asks: does this child need extra support to learn? It is done by the school district, is free, and can result in an IEP or a 504 plan. A school evaluation doesn’t give a medical diagnosis, and a diagnosis doesn’t automatically give school support.

You can start either first, or both at once. Each one is stronger with information from the other.

Before the appointment

1. Write down specific examples

Doctors work from what they are told, and a fifteen-minute appointment is short. For two or three weeks, keep notes: what happened, where, when, how long it lasted and what came just before. Include how long you have noticed these patterns — ADHD criteria require symptoms that have lasted at least six months — and what goes well, as well as what doesn’t.

2. Collect information from school or preschool

The clinician will want to know how your child manages outside home. Ask the teacher for a short written note on attention, activity level, following instructions and getting along with others, compared with the rest of the class. Bring recent school reports if you have them.

3. Gather the background

• Any concerns from pregnancy, birth or early development (speech, walking, toilet training).
• Sleep: what time, how long, snoring or restless sleep.
• Hearing and vision checks, and when they were done.
• Family history: ADHD runs strongly in families, so mention if a parent, sibling, aunt or uncle has it — or thinks they might.
• Big changes or stresses at home in the last year.

The medical route, step by step

Step 1: Start with your child’s pediatrician

Most children start with their regular doctor. Under the American Academy of Pediatrics (AAP) guideline, pediatricians and other primary care clinicians are expected to evaluate ADHD in children from age 4, and many diagnose and manage it themselves. Book a longer appointment if you can, and say when booking that it is about attention and behaviour.

If the picture is complicated — your child is very young, there are signs of other conditions, or the first approach doesn’t help — the pediatrician may refer you to a developmental-behavioural pediatrician, a child psychiatrist or a child psychologist.

Step 2: Rating scales from home and school

Expect questionnaires, usually one for you and one for your child’s teacher. A common example is the Vanderbilt Assessment Scale, which asks how often each ADHD symptom happens and how much it affects schoolwork and relationships. Getting the teacher’s form back quickly is often the slowest part, so ask early.

Step 3: The assessment itself

There is no blood test or brain scan for ADHD. The clinician will talk with you, observe and talk with your child, review the questionnaires and history, and check for other causes such as hearing, vision or sleep problems. The AAP guideline also asks clinicians to screen for conditions that often come with ADHD, such as anxiety, depression, learning difficulties and autism.

Your child may seem perfectly focused in the doctor’s office. That is common — a new place, one adult, full attention — and it is why the notes and teacher reports matter so much.

Step 4: The result

The outcome will be one of a few things: ADHD (described as mainly inattentive, mainly hyperactive-impulsive, or combined), something else that better explains the difficulties, ADHD plus something else, or "not enough to diagnose now, let’s review". Ask what the clinician saw, what they ruled out, and what would make them look again.

The school route, step by step

US public schools have a legal duty, under the Individuals with Disabilities Education Act (IDEA), to find and evaluate children who may need special education, at no cost to families. ADHD is listed in the federal regulations as an example under "Other Health Impairment", one of the categories that can qualify a child for support.

• Put the request in writing. Email or a letter to the principal or the district’s special education office, dated, saying you are requesting a full evaluation because of concerns about attention and behaviour, with a few specific examples. Keep a copy.
• Consent. The school will send a plan describing the assessments it proposes. Nothing starts until you give written consent.
• Timing. Under federal rules the evaluation must be completed within 60 days of your consent, unless your state sets its own timeline.
• If the school says no, it must explain why in writing, and you have the right to challenge the decision.
• The outcome can be an IEP (Individualized Education Program, for children who need specialised instruction) or a Section 504 plan (for accommodations such as extra time, movement breaks or a seat near the teacher), or neither.

For children under 3, the CDC notes that you can contact your state’s early intervention programme directly; from age 3, the local school district can evaluate even if your child isn’t in school yet.

After the evaluation

If your child is diagnosed

Treatment depends on age. For 4- and 5-year-olds, the AAP recommends behavioural approaches first — parent training in behaviour management and, where possible, behavioural support in the classroom — with medication considered only if those don’t help enough. For school-age children and teenagers, the AAP recommends FDA-approved medication, ideally alongside behavioural treatment, with school support at every age. These are decisions to make with your clinician, who will know your child.

Whatever the plan, daily structure does a lot of the work at home: predictable routines, short instructions, and rewards that arrive immediately. Our guide to building a daily routine for a child with ADHD covers how.

If your child isn’t diagnosed

That doesn’t mean you imagined it. It may mean the difficulties are better explained by something else, are within the range of normal for the age, or aren’t clear yet. Ask what would make it worth looking again, keep your notes going, and carry on with the routines and support that help. A "not now" at five can be a different answer at seven.

Questions to ask the clinician

• What did you see that pointed towards, or away from, ADHD?
• What else did you consider, and how did you rule it out?
• What do you recommend first, and how will we know if it is working?
• Can you write something we can share with the school?
• When should we come back?

If you are still deciding whether it is worth starting, our guide to whether it is too early to tell if your child has ADHD covers what is normal at each age and what else can look like ADHD.

Sources

• Wolraich ML et al. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents. Pediatrics, 2019.
• Centers for Disease Control and Prevention. Diagnosing ADHD.
• US Department of Education. IDEA regulations, §300.8 Child with a disability and §300.301 Initial evaluations.

This guide is general information for US families, not medical or legal advice. Processes and timelines vary by state and school district. For decisions about your child’s health, talk to your child’s doctor.

A routine your child can run

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Use Starday on the web