The teacher has raised concerns: what now?

For many families this is where it starts. A parents' evening, a note home, or a quiet word at pick-up. It can feel like criticism, but a teacher raising something is usually a sign they are paying attention.

What the teacher is probably seeing

Teachers rarely use clinical language. What they describe tends to be practical: work that is started but not finished, difficulty following instructions with several steps, calling out, difficulty settling after break, disorganised belongings, or homework that is completed but never handed in.

What makes their observation valuable is context. They see your child alongside thirty others of the same age, every day, in a setting with high demands on attention and self-control. That comparison is something no parent has access to.

Questions worth asking the school

Before anything else, get a clearer picture. Useful questions include:

• How long has this been going on, and is it getting worse?
• Does it happen in every lesson, or particular ones?
• Is it worse at particular times of day?
• How does it compare to others in the class?
• Is it affecting friendships as well as work?
• Has anything been tried already, and did it help?

The answers matter. Difficulties confined to one subject or one time of day point somewhere different from difficulties that appear across the whole day.

What it might be

Attention and behaviour difficulties at school have several possible explanations, and ADHD is only one.

• ADHD, if difficulties are long-standing and appear at home as well as school
• A specific learning difficulty such as dyslexia, where avoidance and inattention can result from finding the work genuinely hard
• Anxiety, which frequently looks like distraction or avoidance
• Hearing or vision problems, which are simple to check and easy to miss
• Sleep problems, which produce inattention in any child
• Something happening at home or at school that the child is responding to

An assessment is partly about working out which of these fits, and often more than one applies.

What to do first

Rule out the simple things. A hearing and vision check is quick and occasionally explains everything.

Look at sleep. Genuinely. A child who is chronically short of sleep will struggle to attend, and this is worth addressing before anything else.

Notice whether it happens at home. ADHD requires difficulties in more than one setting. If school is the only place, that points elsewhere.

Ask the school to keep notes. Specific observations over a few weeks are far more useful at assessment than a general impression.

What an assessment involves

If you decide to pursue an assessment, expect it to gather information from more than one source. It usually includes a detailed conversation with you about development and history, rating scales you complete, a rating scale completed by your child's teacher, and screening for other conditions.

The teacher's form is not optional. Because symptoms must be present in more than one setting, a report from school is required, and the assessment cannot be completed without it. It takes a teacher about five minutes.

Talking to your child

Children usually know when something is being discussed. It tends to help to be straightforward: that you have noticed some things are harder for them than they should be, that you are going to find out why, and that this is about getting help rather than being in trouble.

Many children are relieved. They have often known for a while that something was harder for them, and have drawn their own conclusions about why.

This article is for general information and is not medical advice. It cannot diagnose ADHD or any other condition. Only a licensed clinician can make a diagnosis, after a full assessment. If you are concerned about yourself or your child, please speak to a healthcare professional. If you are in crisis, call 911. For mental health support, call or text 988 at any time.