Refer a child or young person to secondary care (such as a child psychiatrist, paediatrician, or specialist ADHD CAMHS) for assessment if their behavioural and/or attention problems persist with at least moderate impairment following a period of watchful waiting of up to 10 weeks or after a parent support programme, especially if the problems are having an adverse impact on their development or family life NICE NG87.
For children and young people, if behavioural and/or attention problems are associated with severe impairment, referral should be made directly to secondary care for assessment NICE NG87.
In adults, if symptoms of ADHD are associated with moderate or severe psychological, social, educational, or occupational impairment and there is no prior childhood diagnosis, they should be referred for assessment by a mental health specialist trained in ADHD NICE NG87.
Adults previously treated for ADHD as children or young people should be referred to general adult psychiatric services for assessment if they present with symptoms suggestive of continuing ADHD and significant impairment NICE NG87.