First Steps For Diagnosing ADHD

diagnosing-adhd-in-preschoolers-young-childrenDeciding if a child has ADHD is a several step process. There is no simple test to diagnose ADHD. Other problems like anxiety, depression, and certain types of learning disabilities can have similar symptoms or can exist with ADHD. The American Psychiatric Association’s Diagnostic and Statistical Manual, 5th Edition is used to help diagnose ADHD. People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. There typically are symptoms present in two or more settings, and there is clear evidence that the symptoms interfere with, or reduce the equality of, social, school, or work functioning.

ADHD is a neurodevelopment disorder affecting both children and adults. It is described as a persistent or on-going pattern of inattention and/or hyperactivity-impulsivity that gets in the way of daily life or typical development. Individuals with ADHD may also have difficulties with maintaining attention, executive function and working memory.

It is a common misperception that a person can be “tested” for ADHD. No single test can accomplish the task of diagnosing ADHD. This is because making the diagnosis requires that all of the following judgments be made:

  • Does the child show a sufficient number of ADHD symptoms to possibly warrant the diagnosis?
  • Have the symptoms persisted for at least 6 months and are they present at a level that is developmentally inappropriate?
  • For a child older than 7, was there impairment from symptoms prior to this age?
  • Do the symptoms cause impairment in more than one setting?
  • Do the symptoms cause clinically significant impairment in academic, social, or occupational functioning?
  • Are the symptoms better accounted for by another psychiatric condition?

Clearly, questions such as these cannot be adequately addressed by any single test.

A child’s parents and teachers are in the best position to provide information about the presence and intensity of ADHD symptoms. Because parents and teachers may have different perceptions of the same child, input from both is essential. It is just not possible for a physician or psychologist to make this determination based on the child’s behavior in the office. An excellent way to help determine whether enough symptoms are present to possibly warrant an ADHD diagnosis is to have parents and teachers complete standardized behavior rating scales. Two examples are the Conners rating scale and the Vanderbilt rating scale. Formal psychological testing may be a necessary part of an ADHD evaluation, but test themselves cannot be used in isolation to make the diagnosis.

In addition to gathering specific information on ADHD symptoms, it is extremely important to obtain a comprehensive assessment of the child’s overall level of functioning. This will generally require interviews with parents and with the child. It is important that a child have a thorough medical examination as part of the evaluation to rule out possible medical causes for symptoms and to identify any other medical issues that may need to be considered.

If you have further questions or concerns, contact our office to schedule an appointment for your child.