What a careful ADHD assessment looks like for a child

If you’re reading this, someone has probably told you your child might have ADHD, a teacher, your paediatrician, a friend who’s already been through it. Or you’ve watched the same scenes play out for too long: the homework that should take twenty minutes and takes two hours, the morning routines that fall apart, the school report that says “capable, but…” What you’re looking for now is a clinician who will do the diagnostic work properly, listen to you, talk to your child, gather the teacher’s perspective, run the tests, and tell you what they actually find.

That’s what this assessment is for.

Why ADHD in children is harder to assess than most clinics will tell you

ADHD in childhood is not a check-box diagnosis. Plenty of things can look like ADHD in a six- to twelve-year-old: anxiety, sleep that isn’t restorative, undiagnosed hearing or vision issues, a specific learning difference, family stress, gifted-mismatch where bright kids are bored, autism with high masking that costs the child their composure by 3pm. ADHD also lives alongside many of these.

The clinical question is rarely “does this child have ADHD or not.” It’s “what’s actually going on, where does this child need support, and what can their family do that will help.”

A careful assessment is built around that question. The work I do here is shaped by training in three children’s mental health programmes, pediatric mood and developmental training under Dr. Eric Youngstrom at UNC, autism developmental seminars in Dr. Geraldine Dawson’s group at Duke, and parent-mediated behavioural treatment work in Dr. Stephen Whiteside’s group at Mayo Clinic.

The structure of the assessment reflects that lineage: multi-informant data, broad differential, cognitive and achievement profiling, formulation that treats the child as a whole, and a clear plan the family can act on.

What’s involved

The child ADHD assessment includes:

The conversations	A parent interview covering developmental history, current functioning, family context, and the questions you’ve come in with. And a clinical interview with your child, adapted to their age and how they communicate.
What others see	Multi-informant ADHD-specific rating scales (Conners-3 and Vanderbilt) completed by parents and at least one teacher, and a broad behavioural and emotional screen (BASC-3 or ASEBA) looking across attention, anxiety, mood, social, and conduct domains.
The testing	Cognitive assessment (WISC-V) to characterise reasoning, working memory, and processing speed, and achievement testing (WIAT-IV), included as standard, to look for specific learning differences and twice-exceptional profiles.
Looking deeper when needed	Targeted screens for autism, anxiety, mood, sleep, and trauma where the early data suggests them, and an optional classroom or home observation when that’s the kind of question the assessment is asking.
What you take home	An integrated written formulation and report: what we found, what it means, what to do about it. A feedback session with you, and a developmentally appropriate feedback conversation with your child if that’s right for them.

Sometimes a child is gifted and has ADHD at the same time, and the two hide each other. If that might be your child, here’s more on twice-exceptional (2e) assessment.

When you’ve already been told it’s just behaviour

For some families, this assessment is the first time anyone has actually run the differential. Your child may have been described as “behavioural” for years, defiant, oppositional, dramatic, lazy. Sometimes that framing is right. Often it isn’t. Often what looks like behaviour is exhausted cognition, unmet sensory needs, an anxious child whose anxiety hasn’t been named, or a girl whose inattention has been quiet enough that no one flagged it. The assessment is set up to tell the difference.

It’s also set up to give you something you can use. A diagnosis (or no diagnosis) is only useful if the formulation tells you what’s going on, what to do about it, and what to ask for from the school.

Why this isn’t a quick checklist

The two diagnostic traps in childhood ADHD work are mirror images of each other.

Over-diagnosis	The clinician sees the rating-scale scores, doesn’t elicit the family stress, doesn’t talk to the teacher, doesn’t think about the sleep, and arrives at ADHD because that’s what the form said. The treatment recommendations don’t fit, and a year later the family is back where they started.
Under-diagnosis	The clinician sees a bright, articulate child who holds it together in the room and decides ADHD isn’t there, missing the high-masking presentations more common in girls and in cognitively gifted kids; or fixates on a co-occurring anxiety and doesn’t see the ADHD underneath.

A careful assessment has to navigate both. That’s why the differential work, the multi-informant data, the broad screen, the cognitive and achievement profile, the family conversation, is at least as important as the ADHD-specific instruments. It’s also why this takes more than one appointment.

What happens after the assessment

The assessment is the start, not the end. Depending on what the formulation shows, the recommendations might include:

• Parent-mediated behavioural treatment, for younger children (typically 4–8) we may use Parent-Child Interaction Therapy (PCIT); for older school-age children, Parent-Child Emotion-focused Therapy (PCET). Both are evidence-based, and both are programmes I’ve trained in. Longer description on the parent behavioural training page.
• A school accommodations conversation, what to ask for, what’s reasonable, how to write the letter, who to send it to.
• Direct work with your child, depending on what’s there, this might be CBT for co-occurring anxiety, executive-function coaching, or social-cognitive work.
• Medication consultation, if medication is on the table, I’ll connect you with a paediatrician or child psychiatrist whose practice I trust. I don’t prescribe; the assessment will give them a clean clinical picture to work from.

You leave the feedback session knowing what the next step is, who handles it, and what to look out for.

Fees and what’s included

The assessment	From SGD 4,500, covering the full diagnostic battery. Parent and child interviews, multi-informant rating scales, a broad behavioural and emotional screen, cognitive assessment, achievement testing, targeted differential screens, a written clinical formulation and report, and a feedback session.
When the fee can rise	Where the clinical complexity warrants it: an additional differential needing full work-up, a school observation, or additional collateral. I’ll tell you upfront, before any work begins, if I’m recommending that.
Payment	The full assessment fee is due before the first appointment.

When this is the right starting point, and when it isn’t

This is a thorough private assessment, and it isn’t the right starting point for every family.

• If your child needs a fast triage screening to access a school accommodation on a tight timeline, there are clinics in Singapore that offer that pathway.
• If your child is in acute crisis, active suicidality, severe eating disorder, untreated psychosis, that needs to be addressed first, and I’ll help you find the right next step if you’ve landed here by mistake.
• If what you really need is a parent strategy session before any testing, the parent behavioural training page is probably the better starting point.

If your child is 13 or older, the teen ADHD assessment page is here. And if you kept recognising yourself while reading about your child, you are not imagining it: ADHD runs strongly in families, and it is common for a parent to book their own assessment after their child’s. I assess adults as well, so if that time comes, you will not have to start the story from scratch with someone new.

If you’re not sure whether this is the right starting point for your family, the free 15-minute Meet & Greet is exactly what it’s for.

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