Do I need a GP referral to book a private ADHD assessment?

No. You can self-refer directly to Harley Mind Care without a GP referral. Simply book online or contact the clinic.

How much does a private adult ADHD assessment cost?

A private adult ADHD assessment at Harley Mind Care costs from £800. This includes a full diagnostic report, the first prescription if medication is recommended, and a shared care agreement with your GP.

How much does a private child ADHD assessment cost?

A private child or adolescent ADHD assessment at Harley Mind Care costs from £1,245. This includes a full diagnostic report, the first prescription if medication is recommended, and a shared care agreement with your GP.

How much does a private autism assessment cost?

A private adult autism assessment costs from £1,600. A child or adolescent autism assessment costs from £1,850.

Are in-person ADHD and autism assessments available?

Yes. In-person assessments are available at 10 Harley Street, London, and at Gravesham Community Centre in Kent. All in-person appointments are by arrangement — contact the clinic to confirm availability.

Can a private autism or ADHD diagnosis be used for an EHCP?

Yes. Harley Mind Care produces detailed diagnostic reports suitable for EHCP applications, accepted by schools and local authorities.

Does Harley Mind Care accept private health insurance?

Yes. Harley Mind Care works with Vitality Health, Bupa, AXA, Aviva, Alliance Health Group and other major insurers. Patients should confirm coverage with their insurer before booking.

Is Harley Mind Care CQC registered?

Yes. Harley Mind Care Psychiatrists Ltd is registered with the Care Quality Commission (CQC), the independent regulator of health and social care in England.

My child seems fine at school but completely different at home. Is it still worth getting them assessed for ADHD?

Yes — and this contrast between school and home is one of the most clinically meaningful patterns we see. What you are describing has a name: masking. Many children with ADHD expend enormous effort holding themselves together in structured environments like school, and then completely decompress once they are home and feel safe enough to let go. Teachers saying 'we do not see it here' does not mean there is nothing to assess. It means your child is working very hard to appear neurotypical in public. At Harley Mind Care, we look at your child's functioning across all settings — home, school, social situations, and unstructured time. Your account as a parent carries equal clinical weight to the school questionnaire. Our pre-assessment Conners 4 questionnaires collect input from you as a parent AND from a teacher, so we can compare presentations across settings.

My daughter is quiet and dreamy, not hyperactive. Could it still be ADHD?

Yes. The hyperactive picture of ADHD is predominantly male. Girls are far more likely to present with the inattentive subtype: daydreaming, losing track of conversations, forgetting things, struggling to start or finish tasks, and feeling internally chaotic while appearing outwardly calm. Girls also tend to be significantly better at masking — what gets noticed instead is anxiety, low self-esteem, or a child who seems to be trying hard but never quite keeping up. Our consultants at Harley Mind Care are experienced in identifying ADHD in girls, including presentations that have been missed for years. ADHD in girls is not rare — it is underrecognised.

My child was already seen by an educational psychologist. Do they still need a psychiatric assessment?

It depends what you are hoping to achieve. An educational psychologist (EP) assessment maps your child's cognitive profile and identifies learning needs, but educational psychologists cannot diagnose ADHD and cannot prescribe medication — they are not medical doctors. At Harley Mind Care, assessments are conducted by consultant child psychiatrists — medically qualified doctors who can make a clinical ADHD diagnosis, recommend medication if appropriate, initiate prescriptions, and set up a shared care agreement with your GP. If your child already has an EP report, please share it with us before the assessment. It is genuinely useful background, but it does not replace a psychiatric diagnostic assessment.

How do I prepare my child for their ADHD assessment? Should I tell them what it is for?

We recommend being honest with your child, calibrated to their age. For younger children (under 10), keep it simple: 'We are going to meet a doctor who helps understand how different brains work.' For older children and teens, saying 'we are going to see someone who can help us understand why some things feel harder for you' tends to land well. One important note: please do not coach your child on what to say or try to suppress their behaviour beforehand. We need to see an accurate picture of how they are. Our consultants are experienced at working with children who are not thrilled to be there.

My child's difficulties seem connected to anxiety. Should we deal with the anxiety before seeking an ADHD assessment?

Often the anxiety is not separate from the ADHD — it is a consequence of it. Years of struggling to focus, falling behind, and being told off for things you cannot control reliably produce anxiety. In many children, treating the underlying ADHD reduces the anxiety significantly. Anxiety and ADHD can also look similar on the surface — both cause difficulty concentrating, irritability, and avoidance of tasks. A proper diagnostic assessment considers both possibilities and helps distinguish what is driving what. You do not need to choose which to assess first. Our consultants are trained in diagnosing and treating co-occurring conditions.

Can I stay in the room with my child during the ADHD assessment?

The assessment has two distinct parts. In the parent interview — which covers your child's developmental history and your observations — you are a central part of the process. For the one-to-one session with your child, we ask parents not to be present in the room, as children often present differently when a parent is watching. Your child may need you for the first minute or two to settle, and you will remain nearby throughout. If your child has additional needs that make separation particularly difficult — significant anxiety, autism alongside ADHD, or a very young age — please let us know before the assessment so we can make appropriate arrangements.

What does the Conners 4 questionnaire measure? What are you looking for?

The Conners 4 is a standardised rating scale and one of the most widely used and clinically validated tools for assessing ADHD in children and adolescents. It comes in three versions: one completed by you as a parent, one by a teacher, and one by the child themselves if old enough. It covers inattention, hyperactivity, impulsivity, emotional dysregulation, executive functioning, and peer relations. It also screens for anxiety and mood difficulties that commonly co-occur with ADHD. Results are scored against age and gender norms. The Conners 4 generates a profile rather than a single number, meaning our consultants can see which specific domains are most affected — shaping both the diagnosis and the personalised recommendations in your child's report. Please complete the questionnaires based on how your child actually is, not on their best days.

What happens if the ADHD assessment does not result in a diagnosis?

A thorough assessment always has value — even when the outcome is not a diagnosis. If our consultant concludes that your child does not meet the criteria for ADHD, you will receive a clear explanation of what they found, why the diagnostic threshold was not met, and what the difficulties you are observing are most likely to reflect instead. In many cases where ADHD is not the primary diagnosis, assessments reveal something equally important: significant anxiety, processing differences, emotional dysregulation, or traits consistent with autism that warrant further investigation. You leave with answers, not just a negative result. If a different condition is identified or suspected, our consultant will outline the appropriate next steps.

How do I tell my child they have ADHD without making them feel labelled or different?

The worry about labelling is natural, but the evidence consistently shows that children who understand their diagnosis almost always do better than those kept in the dark. The label does not create the difficulty — it explains it. For younger children, frame it around brain differences: 'Your brain is wired in a really interesting way — it is brilliant at some things and needs a bit more support with others.' For older children and teens, many feel immediate relief at finally having a name for something they have struggled with silently. Avoid framing it as something that needs to be fixed. The goal is self-understanding. We will always spend time with you in the feedback session discussing how to have this conversation with your specific child.

Could my child have both ADHD and autism? How do you assess for both?

Yes, and it is more common than many parents realise. Research shows that around 50–70% of autistic children also meet criteria for ADHD. Our consultant will consider both possibilities during the assessment regardless of your initial referral reason. ADHD primarily affects attention regulation and impulse control; autism primarily involves differences in social communication, sensory processing, and rigid or repetitive patterns of behaviour. If significant autistic traits are identified alongside ADHD, our consultant will discuss whether a separate autism assessment is indicated. Harley Mind Care offers autism assessments for children and adolescents, so both pathways can be supported here. Please tell us about any sensory sensitivities, communication differences, or rigid routines — everything is relevant.

My child is about to start secondary school. Is now a good time to get assessed for ADHD?

Now is an excellent time — and arguably one of the most important windows. Secondary school transition is one of the most common triggers for ADHD that was previously manageable to suddenly become unmanageable. The demands on independent organisation, self-directed study, managing multiple teachers and subjects, and navigating far more complex social dynamics are exactly the areas where ADHD creates the most difficulty. Children who coped in primary school often hit a wall at Year 7. Getting a diagnosis before or shortly after the transition means support can be put in place at the new school from the outset. If your child is in Year 5 or 6 and you have concerns, do not wait — getting support established before secondary school starts is significantly easier than retrofitting it after a difficult first year.

How do I tell my child's school about the ADHD diagnosis, and what should I ask them to do?

Start with the SENCO — not the class teacher. Request a meeting specifically to share the diagnostic report and discuss what support will be put in place. Schools are legally required under the Equality Act 2010 to make reasonable adjustments for children with a disability, and ADHD qualifies. Reasonable adjustments can include preferential seating away from distractions, written instructions alongside verbal ones, extended time for tasks, movement breaks, a quiet space for tests, and more frequent check-ins from a key adult. If you want exam access arrangements such as extra time in GCSEs, apply through the school's exams officer as early as possible. Our diagnostic report provides the clinical evidence that supports these applications. Our written reports include a recommendations section specifically designed to be shared with schools.

How long will it take to receive the written ADHD assessment report?

You will receive a verbal summary of findings at the feedback session at the end of the assessment, so you know the key outcome on the day itself. The full written report — which includes clinical history, assessment findings, diagnostic conclusion, and detailed recommendations — is typically delivered within 2 to 3 weeks of the assessment date. If you need the report urgently for a school meeting, EHCP application deadline, or GP appointment, please let us know at the time of booking and we will do our best to accommodate an expedited timeframe. Letters to schools, GP covering letters, and additional copies of the report can be requested at any time through your secure Harley Mind Care patient portal.

The child ADHD assessment costs £1,245. Can we spread the cost and what does it cover?

Yes — Harley Mind Care offers an instalment plan for families who need to spread the cost. Please contact us before booking to discuss the options available. The £1,245 covers the complete assessment fee for a child or adolescent: the pre-assessment Conners 4 questionnaires (parent, teacher, and self-report forms), the clinical assessment with a consultant child psychiatrist (60–90 minutes), the feedback session, the full written diagnostic report, the first prescription at no additional cost if medication is recommended, a free shared care agreement letter to your GP, and lifetime access to the Harley Mind Care patient portal. If cost is a concern, please speak to us before ruling it out — we would rather find a way to make this work for your family than have a child go without an assessment they need.

Does health insurance cover a private ADHD assessment for my child at Harley Mind Care?

Possibly — and it is worth checking before you pay out of pocket. We work with major UK health insurers, and some policies do cover ADHD or neurodevelopmental assessments for children. Vitality Health, for example, has a specific ADHD and autism pathway that Harley Mind Care works within. The key is to check with your insurer before booking, not after. Ask specifically whether your policy covers child psychiatry or paediatric psychiatry, ADHD diagnostic assessments, and whether pre-authorisation is required. Please call us on 020 7047 8888 or email hello@harleymindcare.com before booking and tell us your insurer — we can advise on whether we are recognised by your plan. Do not assume your policy does not cover this. Many parents discover it does, and one call before booking can save you the full fee.

What is an EHCP and how does a private assessment help?

An Education, Health and Care Plan (EHCP) is a legal document produced by your local authority that sets out your child's educational, health and social care needs and the support they must receive. A private assessment report from a consultant psychiatrist or paediatrician can be submitted as evidence when applying for an EHCP. Local authorities are legally required to consider evidence from all qualified clinicians under the SEND Code of Practice 2015. You do not need to wait for an NHS diagnosis to apply for an EHCP — a private report from Harley Mind Care carries equal legal weight and includes specific recommendations for educational adjustments and support.

Can I apply for an EHCP without an NHS diagnosis?

Yes. Many families commission a private assessment specifically to support an EHCP application while they wait on NHS waiting lists. The assessment report provides the clinical evidence the local authority needs to consider your application. At Harley Mind Care, our reports are written by consultant psychiatrists and paediatricians, follow NICE guidelines, and include specific recommendations for educational adjustments and support — the detail that local authority panels look for when making EHCP decisions. You can request an EHCP assessment directly from your local authority at any time, without a GP referral.

What is a Phase Transfer and why does it matter for ADHD?

A Phase Transfer is when a child moves from one educational phase to another — most commonly from primary to secondary school at Year 6. This is one of the most common trigger points for ADHD to become apparent or to worsen significantly. Primary school provides a structured, single-classroom environment that can mask ADHD for years. Secondary school removes that scaffolding overnight — multiple teachers, subjects, and an expectation of independent organisation. If your child has an existing EHCP, the Phase Transfer must be reviewed by the local authority before the move. If they do not have an EHCP but are struggling, a Phase Transfer is a critical moment to seek a private assessment, as early support in secondary school can significantly affect long-term outcomes.

My child's school says they do not qualify for SEND support. What can I do?

Schools can put support in place based on observed need without a formal diagnosis. You can ask the SENCO (Special Educational Needs Coordinator) directly to place your child on the school's SEND register. If the school is not responding adequately, you have the right to request a statutory Education, Health and Care Needs Assessment from your local authority directly — this right belongs to parents, not schools, and does not require the school's agreement. A private clinical assessment report from a consultant psychiatrist significantly strengthens an EHCP application and often changes a school's position. At Harley Mind Care, our reports are specifically written to support educational applications and include the detailed functional recommendations that schools and local authorities require.

How do annual EHCP reviews work and can Harley Mind Care help?

EHCPs are reviewed annually by the local authority. At each review, updated evidence about your child's needs can be submitted by parents, schools, and clinicians. If your child's needs have changed, if the current plan is not working, or if they are approaching a Phase Transfer, an updated clinical assessment from Harley Mind Care can provide the evidence needed to request amendments to the plan. We can also write specific supporting letters for annual reviews, transition meetings, and tribunal proceedings on request. Please speak to our team about what your review requires.

Where can I find support after my child's autism diagnosis?

Following diagnosis at Harley Mind Care, your report includes specific recommendations for next steps and support. Beyond our clinic, key organisations include the National Autistic Society (autism.org.uk), your local authority SEND team who can advise on EHCP applications, and your child's school SENCO who can put adjustments in place immediately. We are always available to write supporting letters for school, EHCP applications, and annual reviews. Please contact hello@harleymindcare.com

What Are the 7 Triggers That Make ADHD Worse?

Introduction

ADHD symptoms are not constant. They fluctuate — sometimes dramatically — depending on circumstances, environment, and the demands being placed on the person. Understanding what makes ADHD worse is practically useful, both for individuals managing their own symptoms and for parents supporting a child with ADHD.

Here are the seven most clinically significant triggers, drawn from current research and our clinical experience at Harley Mind Care.

1. Poor sleep

Sleep and ADHD have a complex, bidirectional relationship. ADHD makes it harder to fall asleep — the brain’s arousal system does not switch off easily, and many people with ADHD experience what is described as a “racing mind” at bedtime. But poor sleep also significantly worsens ADHD symptoms the following day. Attention, impulse control, emotional regulation, and working memory are all degraded by sleep deprivation — and in a person already working harder to manage these functions, the impact is disproportionate.

2. Unstructured time

Counter-intuitively, having nothing to do is harder for many people with ADHD than having too much to do. Without external structure — deadlines, schedules, appointments — the ADHD brain struggles to self-initiate. Unstructured weekends, school holidays, and periods between jobs are common flashpoints. This is one of the reasons ADHD often goes undetected until a major transition, such as starting university or the end of a structured school environment.

3. Stress and anxiety

Stress narrows cognitive bandwidth — and in a person with ADHD, that bandwidth is already constrained. High-stress periods reliably worsen executive function, working memory, and emotional regulation. Anxiety and ADHD frequently co-occur, and each makes the other harder to manage. One of the key clinical challenges is distinguishing whether anxiety is a separate condition, a secondary consequence of living with ADHD, or both.

4. Hormonal changes

ADHD symptoms in women and girls are significantly affected by hormonal fluctuations. Many women report that their ADHD worsens in the week before menstruation, during the postnatal period, and during perimenopause — all periods of significant oestrogen decline. Oestrogen plays a role in dopamine regulation, which is central to ADHD. This explains why women who managed their ADHD reasonably well in their twenties and thirties can find symptoms becoming significantly harder to manage in their forties and beyond.

5. Screens and digital overstimulation

Digital environments are designed to capture and hold attention through constant novelty — which is temporarily very satisfying for the ADHD brain. But prolonged screen time, particularly social media and short-form video, trains the brain to expect very rapid stimulation and makes it harder to sustain attention on slower, more demanding tasks. This is a significant issue for children with ADHD and increasingly for adults. Screen use does not cause ADHD, but it can significantly worsen executive function and attention regulation in people who already have it.

6. Diet and blood sugar instability

The relationship between diet and ADHD is frequently oversimplified in public discussion, but blood sugar regulation is genuinely relevant. Skipping meals, eating high-sugar foods, and the subsequent blood sugar crash reliably worsen concentration and impulse control. Many people with ADHD also have difficulty with hunger awareness — they become absorbed in what they are doing and forget to eat — which then leads to the very blood sugar instability that worsens their symptoms. Regular meals with a reasonable protein content help maintain the metabolic stability that supports cognitive function.

7. Boredom

Boredom is not just unpleasant for people with ADHD — it is neurologically aversive. The ADHD brain requires a certain level of stimulation to function optimally, and in the absence of that stimulation it seeks it elsewhere. This is the neurological basis of many behaviours that look like disruptiveness, inattention, or impulsivity — they are the brain attempting to regulate itself. Repetitive tasks, long meetings, subjects that hold no interest, and waiting are all particularly difficult.

What this means in practice

Understanding your personal trigger pattern — or your child’s — is one of the most practical aspects of managing ADHD well. It allows you to anticipate difficult periods, put structures in place, and make adjustments that reduce the impact. This kind of practical knowledge is one of the things a good ADHD assessment and post-diagnosis support should provide.

Book an assessment at Harley Mind Care

Harley Mind Care is a CQC-registered private psychiatry clinic at 10 Harley Street, London. All assessments are conducted by consultant psychiatrists or paediatricians. No GP referral needed. Virtual appointments available UK-wide.

🌐 harleymindcare.com | 📞 020 7047 8888 | ✉ hello@harleymindcare.com

How much does ADHD medication cost privately in the UK?

The cost of private ADHD medication depends on whether your GP agrees to a Shared Care Agreement. If your GP takes over prescribing — which most do — you pay standard NHS prescription charges (currently £9.90 per item in England, or free if you hold an exemption certificate). If your GP declines shared care and your consultant continues prescribing privately, costs vary by medication but typically range from £80 to £180 per month for stimulant medications including the prescription and any dispensing fees. At Harley Mind Care, your first prescription following diagnosis is included in the assessment fee at no additional cost. We actively support Shared Care Agreements to minimise your ongoing costs.

What is the overall cost of a Virtual Adult ADHD Assessment?

No	Description	Cost	Time
1	A virtual Adult ADHD assessment 1. This includes a full report, including diagnosis and treatment plan. 2. The first free medication prescription. 3. A free Shared Care Agreement with your GP (if required).	£800	60-90 Mins
2	Following diagnosis, medication titration involves follow-up consultations costing. £150 per 15-minute session. Titration can last between 8 and 12 weeks and potentially require multiple visits, depending on your response. to the medication. Our goal is to complete this process as quickly and safely as possible.	£150	15 Mins
3	ADHD medication, being a controlled substance, requires a monthly prescription. If the patient isn’t transferred to the NHS under a shared care agreement, there will be an approximate monthly cost of £55 per repeat prescription.	£55 per month
4	According to the NICE guidelines, the treatment response for all ADHD drugs should be reviewed Annually at £300 per 30-minute session. (This review includes a comprehensive assessment of clinical needs, benefits, and side effects, taking into account the views of the patient and carers, the effect of missed doses, planned dose reductions, and brief periods of no treatment.)	£300 every 12 Months	30 mins

Once you have subscribed to our secure portal at Harley Mind Care, you will have access for life. We will provide the following services.

No	Type	Patient Portal Lifetime benefits
1	Patient Portal	You will have access to view and upload documents, billing activity, reports, and Educational resources (see below)
2	Automated Reminders	We will send out automated reminders for appointments, questionnaires, and 12-monthly reviews.
3	Educational Resources	We will upload educational videos on managing ADHD and pamphlets to assist you in things like monitoring your blood pressure and other health-related matters.
4	Communications	Portal, Email, Telephone, and WhatsApp.