Aims and Method: There is poorer control of hyperactivity symptoms in community clinics than research settings, and difficulty in detecting such symptoms without standardised measures. Hyperkinetic children (n = 29) were evaluated at follow-up using the parental version of the Strengths and Difficulties Questionnaire (SDQ) and, independently, routine clinic reports to test the value of a parental questionnaire. Results: The parental SDQ identified symptoms in more patients (25, 86% v. 13, 45%), but high levels of symptoms did not necessarily imply impairment. Even clinically identified hyperactivity provoked no change in treatment. Clinical Implications: Parental questionnaires alone are unlikely to improve clinic practice. Research is needed into what factors influence clinical decisions regarding treatment maintenance for hyperkinesis, and the adaptation of structured protocols from major research trials should be considered.