ADHD - He's got it right?

Picture this. It's 5pm. Your kiddo has been asked, for the fourth time, to put their shoes on. They are not putting their shoes on! Instead, they are doing something inexplicable with a piece of string and appear to have completely forgotten that you, the request, shoes, and the outside world, exist.

You're not angry. You're something beyond angry. You're exhausted and confused and wondering, for what feels like the hundredth time this month, whether this is normal. Whether something is going on. Whether it might be ADHD.

You are not alone. This is one of the most common questions I hear from parents. And it's a really good one to ask. Tricky part is, that the answer isn't so straightforward.

First, Let's Talk About Behaviour

Before we get into ADHD specifically, it helps to understand something about children's behaviour in general: most of what looks like defiance, inattention, or impulsivity in kids is not a character flaw. It's brain development.

Children's brains are still very much under construction, particularly the prefrontal cortex, which is the part responsible for things like impulse control, planning, and the ability to stop doing one thing and start doing another. That bit doesn't fully mature until the mid-twenties. Yes. The mid-twenties.

So when your child bolts across the car park without looking, can't seem to sit still at dinner, or melts down because their sandwich is cut the wrong way, a part of what you're seeing is a developing nervous system doing its best.

The question with ADHD is whether these patterns are significantly more pronounced than expected for age, happening across multiple settings, and getting in the way of everyday life.

So What Actually Is ADHD?

ADHD stands for Attention Deficit Hyperactivity Disorder, though many clinicians and researchers are starting to feel that name doesn't quite capture what's actually going on. (ie. "attention deficit" is a bit of a misnomer. People with ADHD can often hyperfocus for hours on something they love. The issue is more about regulating where attention goes, not a blanket shortage of it.)

At its core, ADHD is a neurodevelopmental condition, meaning it relates to how the brain develops and functions, not to parenting, diet (sorry, it's not the sugar), laziness, or lack of effort.

There are three presentations:

•        Predominantly Inattentive = difficulty sustaining focus, following through on tasks, keeping track of things, listening when spoken to directly. These kids often fly under the radar because they're not disruptive. They're just somewhere else mentally (teachers sometimes describe them as "dreamy" or "a bit vague").

•        Predominantly Hyperactive-Impulsive = can't seem to stop moving, talks constantly, acts before thinking, struggles to wait. This is the presentation people most commonly picture when they think of ADHD.

•        Combined = a mix of both, which is actually the most common presentation in children that we see.

What It Looks Like at Home

In real life, ADHD in children can look like:

• Starting homework and somehow ending up reorganising their pencil case for forty minutes

• Losing things constantly - shoes, bags, that library book you've replaced three times

• Interrupting conversations, not out of rudeness, but because if they don't say it now, it's gone

• Explosive emotional reactions that seem disproportionate to the situation

• Struggling to transition between activities (sound familiar?)

• Forgetting instructions immediately after you've given them

• Being told they're "not trying" or "not listening" when they genuinely are trying very hard

Remember - all kids will do all of these things, some of the time. The important part is how frequently these behaviours disrupt your child's healthy functioning.

The Brain Science (The Interesting Bit, I Promise)

Here's where it gets genuinely fascinating. ADHD is largely understood as a difference in the dopamine and noradrenaline systems in the brain - these are the chemical messengers that help regulate attention, motivation, and executive functioning.

In neurotypical brains, routine tasks generate enough dopamine to keep the brain engaged. In ADHD brains, the same routine task might not produce enough dopamine to sustain attention so the brain goes looking for stimulation elsewhere.

This is why children with ADHD can focus beautifully on video games, Lego, or something they're genuinely passionate about. In these situations the brain is getting the dopamine hit it needs. It's not that they choose not to pay attention to the maths worksheet. It's that their brain is not getting rewarded for it the same way.

Research also shows differences in how ADHD brains develop, particularly in areas involved in executive functioning - things like working memory (holding information in mind while using it), cognitive flexibility (switching between tasks), and inhibitory control (stopping yourself from doing something impulsive). The Institute of Child Psychology and leading researchers like Dr Russell Barkley describe ADHD as primarily a disorder of executive functioning — not just attention.

It's also worth knowing: ADHD is highly heritable. If your child has it, there's a good chance someone else in the family tree does too (possibly the person who just lost their keys ... again).

But Is It Definitely ADHD? Or Is It Something Else?

This is such an important question and one that a good assessment will help answer.

Many of the behaviours associated with ADHD can also appear in children who are anxious, sleep-deprived, experiencing stress at home or school, have sensory processing differences, or are simply at the more active, impulsive end of the normal developmental range.

ADHD also frequently co-occurs with other things. Anxiety is particularly common, as are learning difficulties, sleep problems, and in some children, autism spectrum traits. A thorough assessment looks at the whole picture, not just the presenting behaviour.

Ultimately, it's not about labelling your child. It's about understanding them and getting them the right support.

The Assessment Process in Sydney

If you're wondering whether to pursue an assessment, know that the process is thorough, collaborative, and genuinely useful, regardless of the outcome. Here's how it typically works:

STEP 1 - Start with Your GP

Your first port of call is usually your GP. They can rule out any medical factors (thyroid issues, sleep apnea, vision or hearing problems), provide a referral, and in some cases co-ordinate a Mental Health Care Plan which can subsidise psychological assessment costs under Medicare. If you are one of our patients at Manly Minds, we can help you find excellent GPs in our area who can help.

STEP 2 - Psychological or Paediatric Assessment

ADHD can be assessed by a clinical psychologist or a paediatrician (or ideally, both working together).

A comprehensive psychological assessment typically includes:

• A detailed clinical interview with parents about developmental history, current concerns, and family context

• Behaviour rating scales completed by both parents and teachers — because ADHD needs to be present across multiple settings, not just at home

• Cognitive and attention testing with the child directly

• Sometimes, additional testing for learning difficulties, memory, or processing speed

At Manly Minds, we approach assessment with curiosity rather than confirmation bias, meaning we're looking at the full picture, not just ticking a box. The goal is always to understand your child, not just assign a diagnosis.

STEP 3 - Feedback and Recommendations

After the assessment, you'll receive a detailed feedback session and a written report. This will outline findings, whether a diagnosis is supported, and most importantly, what to do next.

STEP 4 - What Comes Next I Support & Treatment

ADHD is very treatable. And treatment is almost never one-size-fits-all. Depending on age, severity, and what else is going on, support might include:

• Parent coaching — learning how to structure the environment and respond in ways that work with the ADHD brain, not against it.

The American Psychiatric Association considers 'parent training' as the gold standard

treatment for children and teens with ADHD. At Manly Minds, this is an integral component

of our treatment plan.

• Cognitive Behaviour Therapy (CBT) for the child. Includes building skills in organisation, emotional regulation, and self-awareness

  
  

• School support. Liaising with teachers to put appropriate adjustments in place (more time in tests, movement breaks, seating considerations)

  
  

• Medication. For some children, stimulant medication (prescribed and monitored by a paediatrician or psychiatrist) can be genuinely life-changing. This is a decision made collaboratively, never lightly, and always alongside other supports

The Australasian ADHD Professionals Association (AADPA) and the Australian Psychological Society both emphasise a multimodal approach, meaning a combination of strategies tailored to the child and family tends to produce the best outcomes.

What You Can Do Right Now

Whether or not your child ends up with an ADHD diagnosis, there are things that help all high-energy, easily-dysregulated kids:

• Structure and predictability. Brains do better with clear routines, visual schedules, and consistent expectations

• Sort, clear instructions. One or two steps at a time, not a list of five

• Movement. Physical activity is one of the best natural supports for attention and regulation

• Positive reinforcement. Catching them doing the right thing and naming it specifically works far better than punishment

• Compassionate curiosity. When behaviour escalates, asking yourself what's underneath it, rather than assuming it's deliberate

And please remember, go gently on yourself too. Parenting a child whose brain works differently is genuinely hard. It doesn't mean you're doing it wrong. It means you're navigating something real. Parenting is tricky at the best of times, but when all the 'usual' parenting strategies don't seem to be working, it can be utterly exhausting!

A Final Thought

Getting clarity about your child's brain is not about giving them an excuse. It's about giving them a map. When children understand why things feel harder for them, and when the adults around them understand it too, everything shifts. Less shame. More strategy. More connection.

If you're concerned about your child and would like to talk through what to do next, reach out to us at Manly Minds.