Diagnosing ADHD in Children
There is no single test to diagnose ADHD. A doctor will make a diagnosis based on a physical exam, history of behavior, and specific symptoms. Your cihld’s pediatrician may refer you to a mental health professional who is experienced in childhood disorders such as ADHD.
History of Behavior. The doctor will ask for a detailed history of the child’s behavior. Parents should describe specific problems encountered during the child’s development, family history of ADHD, and any recent life changes that may have affected the child.
Physical Exam. A physical exam should include a hearing test to rule out any hearing problems. The doctor will inquire about history of medical problems, including allergies, sleep disturbances, poor vision, or chronic ear infections.
Diagnostic Criteria. The American Psychiatric Association (APA) has specific criteria that must be met for a diagnosis of ADHD. These symptoms should have occurred in two or more settings (home and school) and not be due to a learning disability or another mental health disorder (bipolar disorder, depression, anxiety, schizophrenia). These diagnostic criteria evaluate symptoms in comparison to what is considered normal for a child’s developmental level.
For a diagnosis of ADHD, at least six of the following symptoms should have been present for at least 6 months.
Symptoms of Inattention (at least six must be present):
- Often fails to give close attention to detail or makes careless mistakes
- Often has difficulty sustaining attention in tasks or play
- Often does not seem to listen when spoken to directly
- Often does not follow through and fails to finish tasks
- Has difficulty organizing tasks and activities
- Avoids or dislikes tasks requiring sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
Symptoms of Hyperactivity and Impulsivity (at least six must be present):
- Often fidgets or squirms when sitting
- Has difficulty remaining seated when required to do so
- Often runs about or climbs excessively in inappropriate situations
- Has difficulty playing quietly
- Is often "on the go"
- Often talks excessively
- Often blurts out answers to questions before they have been completed
- Has difficulty waiting for his or her turn
- Often interrupts or intrudes on others
Based on these symptoms, a child may be diagnosed with predominantly inattentive type ADHD, predominantly hyperactive-impulsive type ADHD, or combination type ADHD.
Diagnosing ADHD in Adults
ADHD in adults always occurs as a continuation of childhood ADHD. Symptoms that begin in adulthood are due to factors other than ADHD.
ADHD in adults can be difficult to diagnose. The doctor will inquire about childhood history of ADHD or ADHD-type symptoms. The patient may be asked to provide school records, or information from parents or former teachers. The doctor will ask the patients about these types of symptoms:
- Inattention and memory problems. (Losing or forgetting things, being absent-minded, not finishing things, misjudging time, depending on others for order, having trouble getting started, changing jobs or projects midway)
- Hyperactivity and restlessness. (Always being on the go, fidgety, easily bored, taking risks, liking active and fast paced jobs and activities)
- Impulsivity and emotional instability. (Saying things without thinking first, interrupting others, being annoying to others, easily frustrated, easily angered, having unpredictable moods, driving recklessly, having high relationship and job turnover)
- Problems with self worth. (Avoids new challenges, appears confident to others but not to oneself)