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Objectives To study the clinical patterns and audit the service delivery processes in children diagnosed with ADHD at a community-based Child Development Centre with a view to improve quality of careMethods Clinico-epidemiological and treatment data was collected from case records of all children aged 4-18years, diagnosed with ADHD, who attended from January 2023-December 2023. Adherence to the SOP for assessment, diagnosis and intervention was evaluated by listing the various stipulated procedures/actions of the Sethu SOP and documenting professional action for each.Results and Conclusions The socio-demographic profile of the families revealed high parental education at graduate level, with a preponderance of extended families. Almost half the families self-referred to Sethu, which can be due to better awareness among educated parents. Combined presentation of ADHD was seen in two-thirds of cases. More than half of the children had complex ADHD and co-occurring neurodevelopmental conditions, the most common being SLD and ASD. The clinical audit of the ADHD SOP identified good adherence in practices like thoroughness of initial assessment, identification of strengths, completion of parent and teacher checklists, screening for co-occurring conditions, psychoeducation given to families, emphasis on parental mental health and collaborative decision making with titration for medication use. The audit also identified areas for improvement like ensuring hearing and vision assessments, increasing school liaison and improving follow up for behavior management sessions. Clinical audits in ADHD management can assess adherence to protocols and offer strategies to improve quality of care.