NICE requires persistent significant impairment after environmental modifications have been implemented and reviewed before medication for children aged five and over, with information discussion and baseline assessment. It also permits watchful waiting up to 10 weeks and group-based ADHD-focused support before a formal diagnosis.
Offer medication to children aged 5 years and over and young people only if their ADHD symptoms are still causing a persistent significant impairment in at least one domain after environmental modifications have been implemented and reviewed.
Recommendation 1.5.13
NICE requires persistent significant impairment after environmental modifications have been implemented and reviewed before medication for children aged five and over, with information discussion and baseline assessment. It also permits watchful waiting up to 10 weeks and group-based ADHD-focused support before a formal diagnosis. Recommendation 1.5.9 requires a second specialist opinion before medication under age five. NICE also advises against general elimination of artificial colors/additives and against dietary fatty-acid supplementation for ADHD, and describes few-foods-diet evidence as limited and short term.