Diagnosing ADHD in Childrenby Eileen Bailey Health Writer
When you think your child might have strep throat or the flu, you head to the doctor and, after completing some laboratory tests, the doctor will let you know what condition your child has and how to treat it. However, with ADHD there is no blood test or any other lab test to show whether ADHD is present.
The diagnosis of ADHD is based on questionnaires completed by the patient, if they are old enough, the parents, other caregivers and teachers. Based on the results of the questionnaire, along with in-depth discussions, your medical provider determines whether your child has ADHD. Physicians, Psychologists, Psychiatrists and Social Workers all routinely diagnose ADHD.
Once your medical provider has gathered all the relevant information, he or she compares the symptoms your child is experiencing with the Diagnostic and Statistical Manual. The DSM-V provides a complete list of symptoms and helps medical professionals determine if your child should be diagnosed with ADHD.
The complete process for diagnosing ADHD should include the following:
A physical examination is normally completed to rule out any medical causes of the symptoms. Conditions such as vision problems and hearing problems are sometimes associated with some symptoms of ADHD and these areas should be checked first.
ADHD is considered to be hereditary. Similar symptoms may be present in other family members or parents might remember similar characteristics from when they were growing up. Some adults discover their diagnosis of ADHD during the diagnostic process for their child.
Your physician might ask about the pregnancy and birth, early milestones and whether there seemed to be any developmental delays. (Developmental delay is not a symptom of ADHD and may indicate other problems.)
In addition to the family history, you should discuss with your doctor any present situations in your household such as divorce, new sibling, or a recent move. Sometimes the stress of these situations can create similar behaviors, such as inability to focus or hyperactivity.
A diagnosis of ADHD requires symptoms being present for more than six months. If you feel your child needs to be evaluated for ADHD, you should take some time to write down specific reasons why. Consider the following questions when thinking about why you feel your child should be evaluated for ADHD:
What behaviors have you seen?
Did these behaviors just begin or have they been causing problems for some time?
What problems is your child having in school or in day care?
Does your child have a history of being suspended or of always being in trouble?
Keep a record of situations to help you remember to discuss them with your physician.
Your medical provider should supply you with a questionnaire to complete. The questionnaires include questions regarding behaviors, school progress and additional information on your child. If your child attends school, you will be asked to provide the teacher with a questionnaire and ask them to complete it.
If your child has a babysitter, they may also be requested to complete the questionnaire. The more information your doctor has, the better he or she can make an accurate diagnosis. Teachers are also asked to complete the questionnaire because the DSM indicates that symptoms must be present in at least two settings, such as at home and at school. This is to help rule out special circumstances as the cause of symptoms, for example, stress at home or problems with a teacher. In addition, if a problem exists at school, but not at home, learning disabilities might be present and your doctor could suggest testing for different learning disabilities.
Some of the common rating scales used for the diagnosis of ADHD are:
Child Behavior Checklist (CBLC)
Conners Teacher/Parents Rating Scales (CTRS)
ADD-H Comprehensive Teacher Rating Scale (ACTeRS)
Child Attention Problems (CAP) Rating Scale
ADHD Rating Scale-IV
Russell Barkley's Home and School Situations Questionnaires
Your physician may request additional psychological testing, although this step is not always included in the diagnostic process. Sometimes, an IQ test is requested if there is a large discrepancy between your child's perceived abilities and their school performance. The psychiatrist or psychologist might also discuss co-existing conditions that are commonly seen with ADHD, such as depression or bipolar disorder, especially if there is a history of such in your family or if your child is exhibiting problem symptoms that are not directly associated with ADHD.
Although there is not a single definitive test for ADHD, doctors and mental health professionals familiar with the diagnostic criteria and process can make an accurate diagnosis.