Although many attempts have been made to identify ADHD using standardized psychological testing, there is no standard test or set of tests to diagnose ADHD. The diagnosis is a matter of degree and must be made by a mental health professional with experience in this area who has thoroughly assessed your child’s behavior in a variety of situations.
Family and teachers or employers (in the case of teens or adults) must be involved in this process. All the elements of the evaluation are matters of opinion, expectation, and comparison. Furthermore, all the behaviors associated with ADHD are normal, to some degree, in all children at certain stages of development.
It is important to identify other possible causes for the inappropriate behavior. This may include:
Physical conditions such as
epilepsyEnvironmental challenges such as family problemsPsychiatric disordersLearning disabilities
Children with ADHD often have other problems, such as: Anxiety
depressionOppositional defiant disorderConduct disorderLearning and language disorders
Physical conditions (eg,
Comprehensive testing and evaluation is key to properly assessing your child.
The most detailed diagnostic criteria are found in the
Diagnostic and Statistical Manual of Mental Disorders
. Because most cases of ADHD are diagnosed in childhood, diagnostic criteria are geared toward children.
The American Academy of Pediatrics recommends that the following guidelines be used for diagnosis in children 4-18 years old:
Evaluation should be initiated if a child shows signs of:
InattentionHyperactivityImpulsivityPoor school performanceBehavior problems
During diagnosis, the following information should be gathered directly from parents, caregivers, teachers, or other school professionals:
Assessment of symptoms of ADHD in different settings (home and school)Age at which symptoms startedThe degree to which the behavior affects the child's ability to function
The healthcare professional should examine the child for other conditions that might be causing or aggravating symptoms, such as:
, thyroid dysfunction,
, or other conditions
Learning or language disordersAggressionDisruptive behaviorDepression
For a diagnosis of ADHD to be made, symptoms must:
Be present in two or more of the child's settings (home, school, activities)Have started by the time the child is seven years of ageMake it hard to function at school, at home, and/or in social situationsInterfere with the child's ability to function for at least six months
Connors Continuous Performance Testing (CPT), a computerized attention test, is often used to help confirm the diagnosis of ADHD. Examples of standardized behavior checklists that also assist in diagnosing ADHD include:
Achenbach Behavioral ChecklistADD-II Comprehensive Teacher Rating Scale (ACTeRS)Child Behavior Rating ScaleCopeland Symptom Checklist for Attention Deficit DisorderConners Rating ScalesVanderbilt Rating Scale