Before the ADHD Review: A One-Page Record That Keeps the Conversation About the Child

A review is a conversation with a purpose

ADHD medication reviews can feel oddly formal. There is often a form, a blood pressure check, a few quick questions and a sense that you are meant to have the right answers. But the appointment is not a court hearing, and you are not there to pass or fail. It is a check-in: is this medication still helping, is it causing problems, and is the current plan still the right one for this child at this point in their life?

In the UK, reviews may be led by a paediatrician, psychiatrist, specialist nurse or GP, depending on local shared care arrangements. The exact pattern varies. What tends to stay the same is the need for a clear picture of everyday life — not just the good days or the difficult ones, but the pattern across both.

What the six-month check is actually for

A medication review usually looks at four things: benefit, side effects, physical health and the wider context. Benefit might mean easier mornings, better focus at school, less impulsive behaviour or a calmer household. Side effects might include sleep changes, appetite loss, headaches, mood shifts or a feeling of being ‘flat.’ Physical checks may include height, weight, blood pressure and pulse. The wider context includes school, home, friendships and any other support in place.

This is shared decision-making in practice. The clinician brings knowledge about medication. You bring knowledge about your child. Your child, where possible, brings their own experience. All three matter.

Do not turn home into a clinic

You do not need to chart every hour. A home that feels like a research lab is not helpful to anyone. What clinicians usually need is a sense of pattern: when things are better, when they are worse, and whether the changes are consistent enough to act on.

Try a light-touch approach. Note the basics two or three times a week, and add a line when something stands out. For example: ‘Appetite low at lunch but fine at breakfast,’ ‘Slept badly after late football practice,’ or ‘Teacher says focus was better this week.’ That is enough to start a conversation.

Track benefits without turning them into a score

It can help to write down what ‘better’ looks like for your child, in plain terms. Maybe it is getting through homework with less conflict. Maybe it is staying in a lesson for longer. Maybe it is being able to stop and think before acting. These are real outcomes, even if they are not tidy numbers.

Also note what has not changed. If medication helps focus at school but home evenings are still very hard, that is useful information. It does not mean the medication has failed. It means the review needs to look at the whole day.

Side effects: the ordinary things that matter

Families often worry about reporting side effects in case it sounds as though they are complaining about the medication. But side effects are part of the review, not a criticism of it. Keep an eye on:

• sleep: falling asleep, staying asleep, early waking
• appetite: breakfast, lunch, evening meal, snacks, weight changes
• mood: irritability, anxiety, low mood, tearfulness, feeling flat
• physical symptoms: headaches, stomach aches, tics, dizziness
• timing: whether problems cluster after a dose wears off

If something is mild and occasional, note it. If something is affecting daily life, say so clearly. You are giving the clinician information, not making a diagnosis.

The one-page record

A single sheet can be surprisingly powerful. It keeps the appointment focused and means you do not have to remember everything while sitting in a waiting room. Your child can help make it, which often makes the appointment feel less like something happening to them.

You might include:

• What we are reviewing: medication name, dose, time taken, and how long since the last review
• What is better: two or three specific examples from home and school
• What is harder: sleep, appetite, mood, school, friendships, mornings, evenings
• What has changed: new school year, exam stress, puberty, family changes, other medication
• What our child says: a sentence or drawing, if they want to contribute
• What we want to ask: two or three questions, not a long list

Keep it to one side of A4. You can print it, write it by hand or use a notes app and show the screen. The format matters less than the clarity.

Questions worth asking

You do not need to ask everything. Pick the ones that matter most right now. Useful questions include:

• Is the current dose still the right one for my child’s age, weight and daily life?
• Would a different timing help with sleep or appetite?
• What should we do if a dose is missed?
• Are there signs that would mean we should contact you before the next review?
• How does school feedback feed into the review?
• What is the plan if this medication stops working well?
• What support is available alongside medication?

If your child is old enough, ask them what they would like to know. Some young people want to understand why the dose changes. Some want to say that they hate the afternoon crash. Some want to be asked before a decision is made. All of that belongs in the conversation.

If school input is hard to get

Sometimes school feedback is patchy. You can still bring what you have: a message from the class teacher, a note from the SENCO, or your own observations of homework and mornings. Ask the clinician whether they would like the school to complete a short questionnaire. If the service has a standard form, use it. If not, a brief email summary is better than nothing.

When to ask for an earlier review

Do not wait for the six-month date if something feels wrong. Ask for an earlier conversation if your child has a significant change in mood, sleep, appetite or behaviour, if you are worried about their physical health, or if the medication seems to be causing more harm than good. You can also ask if the plan no longer fits family life — for example, if school times have changed or your child is now taking the medication at a different time.

After the appointment

Before you leave, make sure you know what happens next. Who will update the prescription? When is the next review? What should you do if you notice a problem? Write it down, even if it feels obvious in the room. A quick note on your phone is fine.

A good medication review should leave you feeling clearer, not judged. It should be a conversation about your child, with your child’s everyday life at the centre. The one-page record is not paperwork for its own sake. It is a way of making sure the small, ordinary details are heard.