What is school like for kids with ADHD in Hong Kong?

Historically, kids with ADHD are often treated in Hong Kong as though they have a behavioural problem, rather than having a difference in their neural wiring. In 2026, the Hong Kong government announced a new project: ‘Enhanced Support for Students with Attention Deficit / Hyperactivity Disorder’.

The initiative will run as a pilot for the three years – providing ‘small group training and other support services’ for kids in public sector primary and secondary schools. We’re yet to see what this policy will mean in action – but it marks positive progress in Hong Kong’s investment in supporting kids with ADHD.

It’s theorised that the qualities of ADHD - distractibility, impulsivity and intense drive to seek novelty were evolutionary advantages when we were hunter-gatherers. These traits gave our ancestors the drive they needed to hunt food, identify predators and find more fertile places to settle.

ADHD has a heritability rate of 70-80%, so these traits have persisted into our modern era, passed down from generation to generation. However, prehistoric advantages are now at odds with spaces that aren’t made for the neurodivergent. One of these spaces is the classroom.

This regimented learning environment goes against the instincts of kids with ADHD. Be quiet, sit still, stop daydreaming, are common refrains.

How common is ADHD in Hong Kong children?

Official figures suggest that the number of kids with ADHD in Hong Kong is approximately 6.4% according to a 2018 review of a database of 642,266 children from China, Hong Kong and Taiwan. This number is in line with international estimates of 5% prevalence of ADHD in children.

Yet, neurodiversity is underdiagnosed globally, particularly among girls, women and other marginalised groups. In fact, UK research has revealed that only 1 in 9 people with ADHD have a formal diagnosis, which suggests that 89% of people with ADHD are still undiagnosed.

“Kids have a natural tendency towards inattention and impulsivity, but if these qualities begin affecting their social or academic life, they would benefit from further exploration,” says naturopathic doctor Benita Perch.

“Even if your child doesn’t have a diagnosis, physical factors like toxin exposure can mirror symptoms of ADHD or exacerbate the condition,” she adds.

Classroom challenges of ADHD

Kids with inattentive traits of ADHD may struggle with concentration. They can be prone to daydreaming or frequently forget items needed for their lessons, like books, sports kit, or homework. Visual charts on the fridge can cue kids to remember what they need each day.

While fidgeting may be reprimanded by teachers, studies show that ADHDers fidget more during cognitively demanding tasks – and that it actually improves their attention to the task. Physical movement had a similar effect in improving their concentration - in fact, exercise has been shown to have an overall benefit to those with ADHD, improving their quality of life.

More progressive schools might permit discreet, silent fidget toys, but this will depend on the school and teacher. If their school doesn’t allow fidget toys, you could always give them a kneaded eraser, which can provide some sensory input for focus.

Impulsivity can affect kids’ school work, as ADHDers might not spend the time needed to carefully think through tasks, leading to mistakes. They may be frustrated by having to wait their turn to share their thoughts or when playing games.

At home practice for managing impulsivity can help – playing board games or card games where you have to wait your turn can help improve kids’ tolerance for waiting, improving emotional regulation in a context which has minimal consequences.

Impulsivity can impact kids’ mental health – they may be sad or anxious due to being disciplined by teachers for not following classroom rules like turn taking.

Rejection sensitivity disorder is common among kids with ADHD. It causes intense emotional pain in response to perceived rejection, triggering overthinking, anxiety and sometimes a fight or flight response.

“Anxiety among kids is one of the biggest issues I see in-clinic and neurodiverse kids are at significantly higher risk of having a mental health condition,” says Benita.

“Anxiety reduces the cognitive space that kids have for learning, making it more difficult for children to follow what their teacher is saying, and impacting their memory. It reduces creativity and problem solving skills. Emotional stress has a significant effect on neurodiverse brains, worsening symptoms,” she adds.

Which factors influence ADHD symptoms?

Kids with ADHD might have sensory aversions to certain foods, which can make it hard for them to meet their nutritional requirements. Nutritional deficiencies can affect impulsivity, inattention and hyperactivity. “Iron, magnesium, zinc, B vitamins and essential fatty acids like omega 3 all impact brain function, and when kids are deficient, they’re more likely to have trouble concentrating,” says Benita.

“Their diet also influences their gut health, which has a major impact on their cognitive health via the gut / brain axis. The health of your child’s gut informs the health of their brain and vice versa.”

Studies reveal that ADHDers often have impaired gut microbiomes, with lower diversity, higher levels of bad bacteria and fewer good bacteria. In fact, a review by the University of Warwick of 1.9 million study participants has shown that those with ADHD are almost 50% more likely to have gut problems like constipation, diarrhoea, IBS and more. Gut microbes help produce dopamine, a neurotransmitter which plays a key role in ADHD symptoms.

Exposure to toxins like mould and air pollutants exacerbates oxidative stress and causes difficulty concentrating, mood swings and behavioural problems, even among the neurotypical population. “When a child with ADHD is exposed to these toxins, their symptoms can worsen, making symptoms which were mild much more challenging to cope with,” explains Benita.

In their hunt for novelty, kids with ADHD are likely to rack up more hours of screen time, which is also associated with worse sleep – reducing quality and duration. Both excessive screen time and poor sleep stress the body and can intensify ADHD symptoms.

Support for kids with ADHD

Our clinical psychologists, psychotherapists and counsellors can work with children and teens who have ADHD, identifying emotional challenges and co-creating coping mechanisms to support their mental health. They can work with the school to ensure that their learning environment supports their specific needs.

Our naturopaths use testing to assess gut health, the toxic load and nutritional profile of kids with ADHD – identifying issues in their wellbeing.

The academic world isn’t designed with neurodivergent kids in mind, but by supporting their physical and emotional health we can give them the best start possible.

References
The Hong Kong Special Administrative Region of the People’s Republic of China, Policy Address: Chapter VII Enhance Social Wellbeing, 2026.
P Esteller-Cucala et al, Genomic analysis of the natural history of attention-deficit/hyperactivity disorder using Neanderthal and ancient Homo sapiens samples, 2020.
NICE, How common is attention deficit hyperactivity disorder?, 2025.
A Liu et al, The prevalence of attention deficit/hyperactivity disorder among Chinese children and adolescents, 2018.
University of Cambridge, ADHD is under-diagnosed – not over-diagnosed, says Department Head in response to ministerial review, 2025.
H Min Son et al, A quantitative analysis of fidgeting in ADHD and its relation to performance and sustained attention on a cognitive task, 2024.
L D Hargitai et al, Neurodiversity and mental health in adulthood: exploring the unique contributions of autism and ADHD in internalising problems, 2026.
S Blake et al, The association between attention-deficit hyperactivity disorder and gastrointestinal symptoms: a systematic review and meta-analysis, 2026.
University of Warwick, People with ADHD more likely to suffer from gut problems, major review finds, 2026.