Major advances have been made in ADHD over the years, both in terms of diagnostic validity, different subtypes, comorbidities and treatment options. A comprehensive assessment needs to include medical, developmental and educational history using multiple sources of information and across different settings. In certain cases, additional investigations and neuropsychological testing may need to complement basic physical and neurological examination. The focus of treatment must include not only the core ADHD symptoms but also additional comorbid problems, family and peer relationships, and academic achievement. Treatment should therefore be multi-modal with simultaneous medication, behavioural and educational management. Both diagnosis and treatment response needs to be reviewed regularly to ensure optimal response with minimal adverse side effects.
The increased awareness of ADHD by both clinicians and other professionals has resulted in a huge increase of referrals for assessment, diagnosis and treatment. In particular, families are becoming increasingly knowledgeable about the disorder and are rightly requesting adequate assessment and treatment of their children. It is therefore essential that all clinicians are equally knowledgeable about the advances in this area and offer a service to families which represents good clinical practice. This article reviews what constitutes good clinical practice in ADHD.