How to Write an ADHD Assessment Report | Guide for Assessors

An ADHD assessment is only as useful as the report that comes out of it. The report is what the GP reads, what a school or employer may act on and what the person themselves takes away. A rushed or vague one can leave everyone no clearer than before.

This guide sets out how to structure an ADHD diagnostic assessment report. It is written for registered healthcare professionals who are new to assessment or who want to tighten up their reports. It is general information, not clinical advice. Your own service’s templates and governance always come first.

What an ADHD report has to do

Every ADHD report needs to answer four questions. Does the person meet the diagnostic criteria? How confident are you? What else could explain the picture? What should happen next?

NICE NG87 describes diagnosis as the result of a comprehensive assessment. That includes a full clinical and psychosocial assessment, a developmental and psychiatric history, symptoms across settings, collateral information where appropriate and a mental state assessment. Your report should make that whole picture visible. A report that is only a list of scores does not.

A clear structure for the report

Services differ, so treat this as a starting point. A logical order helps the reader follow the reasoning from the evidence to the conclusion.

1. Reason for referral and presenting concerns. Who referred the person and what they or others are worried about.
2. Sources of information. Who you interviewed, which tools you used and which documents you saw, such as school reports. Be clear about anything you could not obtain.
3. Background history. Developmental, educational, family, medical, psychiatric and personal history.
4. Current symptoms and impact. What the difficulties look like across home, school or work and relationships, with examples.
5. Mental state and risk. Your observations and any risk or safeguarding concerns.
6. Results of structured tools. Interpret DIVA-5, Young DIVA, Conners 4 or QbCheck findings rather than pasting numbers.
7. DSM-5 criteria mapping. Show which criteria are met and what evidence supports each one.
8. Formulation and differential diagnosis. Pull the history together and explain what else you considered.
9. Conclusion. State the diagnosis or the reason you have not made one. Say how confident you are and what limits apply.
10. Recommendations and next steps. What should happen next and who is responsible for it.

For a deeper look at the tools behind steps two and six, read the guide to ADHD assessment tools.

Mapping the evidence to DSM-5

The criteria section is where many reports are weakest. Do not simply state that the criteria are met. Show the reader why. DSM-5 asks for the following:

• Six or more symptoms of inattention or hyperactivity-impulsivity for children and young people up to age 16. Five or more for age 17 and over.
• Several symptoms present before the age of 12.
• Symptoms present in two or more settings.
• Clear evidence that the symptoms interfere with functioning.
• Symptoms not better explained by another mental disorder.

For each one, link a specific piece of evidence to the criterion. A short example from the interview or a line from a school report is far more convincing than a general statement. If the evidence is thin on any point, say so plainly.

Alternative explanations and co-existing conditions

A strong report shows that you looked beyond ADHD. Anxiety, depression, trauma, sleep problems, autism, learning difficulties, substance use and medical causes can all look like ADHD or sit alongside it. Name the ones you considered. Explain why you ruled them in or out, or why they may be present as well.

This section protects the person as well as the reader. A diagnosis that has been properly tested against the alternatives is more likely to lead to the right support.

Writing recommendations that help

Recommendations are the part of the report people act on. Keep them specific and proportionate. Think about psychoeducation, practical strategies, adjustments at school or work, signposting to support and what the GP or receiving service needs to know.

Stay within your own scope of practice. Whether you can make treatment recommendations depends on your registration, experience and local governance. Where something falls outside your remit, say who should pick it up. The assessor framework page explains how to think about your scope.

Common mistakes in ADHD reports

• Listing scores without interpreting them. The reader needs to know what the numbers mean for this person.
• Conclusions that the evidence does not support. Every conclusion should trace back to something in the report.
• Ignoring conflicting information. If a parent and a teacher disagree, say so and explain how you weighed it.
• Copying text between reports. Reused paragraphs make a report feel generic and can carry errors from one person to the next.
• Skipping the limitations. Missing collateral, a short consultation or unavailable school records all affect confidence.
• Vague or jargon-heavy language. The person you assessed should be able to read their own report.

Practise report writing with a consultant psychiatrist

Report writing and care planning is one of the six parts of the ADHD Diagnostic Assessor Training. The day is led by Dr M A Faridi FRCPsych, a consultant child and adolescent psychiatrist. It covers how to structure the report, map findings to DSM-5, set out alternative explanations and write recommendations. Participants also work through two live case simulations and receive templates with their CPD certificate.

The course gives 6 CPD hours and is aligned with NICE NG87. It does not cover prescribing. It also does not give anyone authority to diagnose independently, because that depends on your registration, experience, supervision and local governance.

Frequently asked questions

How long should an ADHD assessment report be?

There is no single right length. It should be long enough to show the history, the evidence for each criterion, the alternatives you considered and clear recommendations. Many services have their own template, so check yours first.

Should the report include test scores?

Yes, where you used the tool. Always explain what the result means in context. Rating scales and objective tests add information but they do not decide the diagnosis on their own.

What if symptoms only show up in one setting?

DSM-5 expects symptoms in more than one setting. If you only find evidence in one, consider other explanations, such as a poor fit with the environment. Say clearly in the report what you found.

Can I write ADHD reports after a one-day course?

A course builds your skills but it does not give you authority to diagnose independently. Most new assessors begin with supervised assessments. Your registration, scope of practice and local governance decide what you can sign off.