Could you cope with a child who cannot sit still, cannot hold on to an instruction, and runs at a different speed to everyone else in the house? It is a fair thing to wonder about before you apply. This article sets out what ADHD is, why it turns up more often among children in foster care than you might expect, how an assessment actually works, and the question that is easiest to get wrong: who is allowed to say yes to medication.
Please note: this is general information for people thinking about fostering, not medical advice about a particular child. Clinical decisions belong to the child’s doctors. The NHS guidance quoted here was current when we wrote this in September 2026.
What ADHD actually is
The NHS puts it about as plainly as it can be put. ADHD, or attention deficit hyperactivity disorder, is “a condition where the brain works differently to most people”. On the cause, the NHS is honest that the picture is incomplete: “The cause of ADHD is not always known. ADHD may be caused by genetic differences and often runs in families.” That page was last reviewed on 19 March 2025.
Two things follow, and both matter if you are weighing up whether to foster. It is nobody’s fault, so no parenting style caused it and none will make it disappear. And because it is a difference in how a brain works, the useful question is what needs to change around the child so they can get through a Tuesday morning.
The signs the NHS lists fall into two groups. On the inattentive side it names “being easily distracted”, “finding it hard to listen to what people are saying or to follow instructions” and “forgetting everyday tasks, like brushing their teeth or putting on socks”. On the hyperactive and impulsive side it lists high energy, fidgeting, talking noisily, restlessness and “finding it hard to wait their turn, or interrupting conversations”. Most children show some of both.
One line on that page is one to carry around with you. “ADHD is thought to be recognised less often in girls than boys. This may be because girls with ADHD more commonly have inattentive symptoms and these can be harder to recognise.” A girl who drifts and goes quiet at the back of the class is not making anyone’s life difficult, so she does not get noticed. If you are fostering a girl who is struggling in ways nobody has put a name to, raise it yourself and do not wait for someone else to.
Why the question comes up so often in fostering
Here is something that rarely makes it into a fostering brochure. The national clinical guideline on ADHD, NICE guideline NG87, opens its section on recognition by listing the groups of people who are more likely than the general population to have ADHD. Its recommendation 1.2.1 says:
“Be aware that people in the following groups may have increased prevalence of ADHD compared with the general population: people born preterm; looked-after children and young people; children and young people diagnosed with oppositional defiant disorder or conduct disorder; children and young people with mood disorders (for example, anxiety and depression); people with a close family member diagnosed with ADHD; people with epilepsy; people with neurodevelopmental disorders (for example, autism spectrum disorder, tic disorders, learning disability [intellectual disability] and specific learning difficulties); adults with a mental health condition; people with a history of substance misuse; people known to the Youth Justice System or Adult Criminal Justice System; people with acquired brain injury.”
Eleven groups, and the second one is children in care. The guideline uses the statutory phrase “looked-after children and young people”, which is care-system language of a kind no child would choose for themselves, but the point it makes is one every foster carer should know. NICE is telling clinicians across the country to have ADHD in mind when the child in front of them is in care.
That cuts both ways. A carer who raises ADHD is not being dramatic or reaching for a label. And the opposite risk is real: if everyone around a child assumes restlessness and poor concentration are simply what you would expect after what has happened to him, a condition NICE says is more common in exactly this group can go unlooked-for for years.
For scale, NHS England’s ADHD release of 27 August 2026 estimates that “2,478,000 people in England have ADHD, including those without a diagnosis”, of whom “an estimated 737,000 are children and young people (aged 5-24).” Those are estimates in a management information release, so take them as a sense of scale and nothing finer.
Is it ADHD or is it what happened to him?
This question tends to get asked as though the answer has to be one or the other. It does not. A child can have lived through frightening things and have a brain that was always going to work this way. NICE builds that into how a diagnosis is reached, treating it as part of the picture and not an awkward complication.
Recommendation 1.3.1 says a diagnosis “should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD”, on the basis of a full clinical and psychosocial assessment and a full developmental and psychiatric history. Recommendation 1.3.3 requires the symptoms to “be pervasive, occurring in 2 or more important settings”, and requires the process to “include an assessment of the person’s needs, coexisting conditions, social, familial and educational or occupational circumstances and physical health.”
The child’s history, in other words, is part of the assessment, and the clinician is not meant to look past it. A good specialist holds both possibilities at once and works out what each one explains. Your job is to describe accurately what you see, in the setting only you can see it in. For the background on the other half of that picture, we have written separately about what trauma and attachment mean in foster care.
The “two or more settings” requirement is also why your observations carry real weight. School sees the child for six hours in a structured room. You see mornings, homework, birthdays, the twentieth minute of a car ride. Nobody else has that view.
How an assessment starts, and how long it takes
The NHS route usually begins with the school rather than the doctor. Speak to the child’s teacher, who will normally make a referral to the school’s special educational needs co-ordinator. The NHS advice is direct: “Speak to a GP or SENCO to request a referral for an ADHD assessment.” In fostering there is a third person in that conversation, the child’s social worker, and it helps to involve them before the referral goes in.
Now the hard bit. NHS England records that in June 2026 there were “up to 959,662 open referrals that may be for an ADHD assessment”, and that in the same month “up to 37,105 new referrals were received to mental health services for a possible ADHD assessment. This is an increase of 46.7% (11,815) from June 2025.” The wording is cautious because the data counts referrals that may be for ADHD rather than confirmed ones, and NHS England warns that submissions from February 2025 onwards are not directly comparable with earlier months. Even allowing for that, the queues are long.
In practice the wait is likely to be measured in many months, and almost none of what helps a child at home depends on reaching the front of it. Everything useful can start the day the child arrives.
Who decides about medication
This is better understood before you apply than in the middle of a clinic appointment. As a foster carer you do not hold parental responsibility. Volume 4 of the Children Act 1989 statutory guidance is explicit that those who hold it keep it: “Those with PR for a child (the mother will have PR, the father might do too) retain their PR once a child becomes looked after.” What you get instead is delegated authority, and the guidance is keen for you to have plenty of it.
“Foster carers should be given the maximum appropriate flexibility to take decisions relating to children in their care, within the framework of the agreed placement plan and the law governing parental responsibility (PR). Except where there are particular identified factors which dictate to the contrary, foster carers should be given delegated authority to make day to day decisions regarding health, education, leisure, etc.” (Volume 4, paragraph 3.10)
Who can consent to what has to be written down and named: paragraph 3.14 requires that “The person(s) with the authority to take a particular decision or give a particular consent must be clearly named on the placement plan”. On health, paragraph 3.61 is more specific still:
“Foster carers must be given, at the time a child is placed with them, written permission from a person with parental responsibility to administer first aid and non-prescription medication, and to consent to any other form of medical or preventive treatment as may be agreed within a scheme of delegated authority. This should be recorded in the placement plan.”
The National Minimum Standards for fostering say the same from the other direction. Standard 6.5 requires that “Children’s health is promoted in accordance with their placement plan and foster carers are clear about what responsibilities and decisions are delegated to them and where consent for medical treatment needs to be obtained.” “Placement plan” is the statutory name for the written agreement setting out how a child is to be cared for in your home.
So if a paediatrician proposes starting medication, the decision is not yours alone and was never meant to be. It runs through the people named on that plan, usually the child’s parents or the local authority or both, with the child’s own views sought as well. Check on day one what your delegated authority covers, because that is a much easier question to settle calmly than urgently.
Knowing what NICE says about medication itself stops any of it landing as a surprise. Recommendation 1.5.13 says it should be offered to children aged 5 and over “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”. If it is started, recommendation 1.7.7 says to “Offer methylphenidate (either short or long acting) as the first line pharmacological treatment for children aged 5 years and over and young people with ADHD.” Recommendation 1.5.4 sets out the conversation that comes first, and asks clinicians to encourage “children and young people to give their own account of how they feel”.
Notice the order. Changes to the child’s surroundings come first and are reviewed, and medication is considered after that. Which brings us to the part you control.
What helps at home
Most of what helps is unglamorous and free. Shorter instructions, given one at a time, facing the child rather than called through a doorway. Predictable mornings, so the hardest hour of the day is at least a familiar one. Somewhere to put energy before it has to be sat on. Written or drawn reminders for anything with more than two steps in it, because holding a sequence in your head is exactly the thing that is hard. Homework in fifteen-minute pieces with movement in between, never one long siege.
NICE is clear about diet in both directions. Recommendation 1.6.1 says “Healthcare professionals should stress the value of a balanced diet, good nutrition and regular exercise for children, young people and adults with ADHD.” But on the thing most often suggested at the school gate, recommendation 1.6.2 says “Do not advise elimination of artificial colouring and additives from the diet as a generally applicable treatment for children and young people with ADHD.” Recommendation 1.6.4 says the same about fatty acid supplements. So if someone tells you confidently to strip out the E numbers and watch the difference, you now know where the national guideline stands.
For younger children there is a specific recommendation to ask about. Recommendation 1.5.7 says to “Offer an ADHD-focused group parent-training programme to parents or carers of children under 5 years with ADHD as first-line treatment.” Ask whether one is available locally, and ask whether foster carers can attend it, because the answer is not the same everywhere.
The notes you keep do double duty
Recording is part of the job anyway, and with ADHD it does double duty. A specialist needs evidence across settings and over time, and the only person generating that at home is you. Short dated notes describing what happened and what was going on around it are worth far more at an assessment than an impression formed six months later.
On the medication side the standards make it a requirement. Standard 6.10 says “Foster carers are trained in the management and administration of medication. Prescribed medication is only given to the child for whom it was prescribed, and in accordance with the prescription.” Standard 6.11 adds that carers “keep a written record of all medication, treatment and first aid given to children”, and Standard 6.9 requires medicines to be stored safely and accessible only by those for whom they are intended. Our guide to what foster carers have to write down covers the whole picture.
Getting school on side
School is where the difficulty usually shows up first and where small adjustments pay off fastest. A seat away from the door, instructions repeated in writing, a legitimate reason to get up and move, extra time for work that needs sustained attention. None of that waits on a diagnosis, and a good special educational needs co-ordinator will put it in place on the strength of what you and the teachers are already seeing.
The child’s social worker and the virtual school at the local authority that looks after them are both involved in this. A child who has recently moved in has usually had their education disrupted more than once, and the first few weeks are when most of the arrangements get made, which we cover in our guide to the first two weeks after a child arrives.
Your own week matters too
NICE has two recommendations aimed squarely at the adults. Recommendation 1.4.6 asks clinicians to “Ask families or carers of people with ADHD how the ADHD affects themselves and other family members, and discuss any concerns they have.” Recommendation 1.4.7 goes further and encourages family members or carers “to seek an assessment of their personal, social and mental health needs” in their own right.
That sits in a national clinical guideline, which makes asking for support for yourself the expected thing to do, and no sort of admission that you are struggling. Days that run on this much structure are tiring in a cumulative rather than a dramatic way. Build in what keeps you steady before you need it.
What South Coast Fostering offers alongside you
Every South Coast carer has a supervising social worker who knows the household and the child, and support is available around the clock if something cannot wait. Our training and development programme runs face to face, live online and through online resources, so a carer can build knowledge in the areas that match the children they care for. You can read more about the support you would have as a foster carer.
A web page can only take you so far. If you want to know whether we currently have carers looking after children with ADHD, what our training covers on it specifically, or how consent and medication are handled with the councils we work with, ask us. Those are proper questions to put to any agency you are considering, and a good one will answer them plainly.
Does fostering a child with ADHD pay more?
Not by itself, and we would rather say so than let you find out later. South Coast pays one weekly amount per child, combining an allowance for the child’s care with a professional fee for your role:
- £479.50 per week for a child aged 0 to 10
- £507.50 per week for a child aged 11 or over
- £987 per week for parent and child fostering, which may be adjusted if the parent receives benefits
We also offer a council tax contribution. Beyond the standard arrangement, our fostering payments page says that “Other specialist placements can involve different payments depending on the needs and care required. Ask us to explain the proposed package, what is included and any additional expenses.” A diagnosis on its own does not move a child into that category. The level of care a particular child needs can, and that is a conversation about the child, not the label. The practical costs to raise early are travel to appointments that are rarely close by, and the time they take out of a working week.
You won’t have to do this alone
Fostering a child with ADHD asks for structure, patience and a willingness to explain the same thing calmly for the ninth time. It does not ask you to be a clinician. The specialists diagnose, the plan says who consents to what, and your part is the steady day-after-day care that gives a child somewhere reliable to land. At South Coast Fostering we believe a child isn’t just given a home, they’re given a chance.
If you are wondering whether you could do this, that wondering is the right place to start. Have a look at what becoming a foster carer involves, or talk it through with us with nothing riding on the conversation.
A 15 to 20 minute call, no pressure and no obligation.
Or register your interest and we will come back to you.
More from our guides for carers: Neurodiversity Celebration Week
Frequently asked questions
Can I foster a child with ADHD without any medical training?
Yes. You are not being asked to diagnose or treat anything. The National Minimum Standards expect your agency to train you in the management and administration of medication and to give you guidance and training where a child has complex health needs. The role asks for consistency, clear observation and a willingness to work with the child’s clinicians.
Can I give a child their ADHD medication?
Only within what the placement plan allows. Statutory guidance says you must be given written permission from someone with parental responsibility at the time the child moves in, covering first aid, non-prescription medication and any other treatment agreed within your delegated authority. Prescribed medication is given only to the child it was prescribed for and only as prescribed, and every dose is recorded.
How long does an ADHD assessment take to come through?
Longer than anyone would like. NHS England recorded up to 959,662 open referrals that may be for an ADHD assessment in June 2026, with new referrals up 46.7 per cent on the year before, and waits vary a great deal by area. Almost everything that helps at home and at school can be started while you wait.
Is it really ADHD, or is it a reaction to what the child has been through?
It can be both, and a proper assessment is designed to work that out rather than assume. NICE names children in care as a group with a higher likely prevalence of ADHD, and it requires the assessment to take in the child’s social and family circumstances and any coexisting conditions.
Do foster carers get paid more for a child with ADHD?
Not automatically. South Coast pays 479.50 pounds a week for a child aged 0 to 10 and 507.50 pounds for a child aged 11 or over, whatever diagnoses a child has. Different arrangements can apply to specialist fostering depending on the level of care a child needs, and we will explain any proposed package in full.