The recognition and drug treatment of hyperkinetic disorder have been increasing in the U.K. during the late 1990s, but are still at a low rate by comparison with many other countries. This article will describe some clinical conclusions, taken mostly from recent research, that should be relevant to clinicians in countries such as the U.K., where there is little current use of the diagnosis of Attention Deficit or stimulant drug treatments. It includes some practical recommendations for therapy that go beyond the evidence base; but space does not allow full protocols, and more detailed guidelines for European practitioners are available elsewhere (Taylor et al., 1998). The recommendations are not necessarily appropriate for other cultural settings, and should not be taken to apply to countries where stimulant drugs are unavailable or where they are widely used in primary care.