In this paper, a response is made to the assertion that discourses surrounding attention-deficit hyperactivity disorder (ADHD) are dominated by those who choose to frame such difficulties within a biomedical paradigm, and that valid alternative explanations are often marginalised as a result. It is suggested, however, that if such a discontinuity exists between the medical professionals and others who are involved with ADHD, it is as much a structural as a cultural divide and reflective of a fragmented approach to child mental health in general. The tendency of the media to frame discussions about ADHD as a polemic distracts policy makers and service providers from the core duty of finding what works best for children and directs practitioners instead towards justifying our positions rather than advancing forms of support for those who need it. That ADHD is best understood as a bio-psycho-social disorder involving complex gene-environment interactions should now be accepted, and around this consensus the diagnostic label should be seen as the beginning of a series of questions about the individual and how he or she relates to others and to themselves, rather than a gateway to simplistic intervention.