When you think your child may have strep throat or the flu, you take them to the doctor. 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 simple test to show whether or not 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 will determine whether your child has ADHD. Physicians, psychologists, psychiatrists and social workers all routinely diagnose ADHD.
Once your medical provider has gathered the information, they will compare the symptoms your child is experiencing with the Diagnostic and Statistical Manual. The DSM-IV provides a complete list of symptoms and helps medical professionals determine if ADHD is present.
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 can be associated with some of the symptoms of ADHD, and these areas should be checked first. (See 10 Medical Symptoms That Share Symptoms with ADD/ADHD).
ADHD is considered to be hereditary. Similar symptoms may be present in other family members or parents may remember that they shared similar characteristics when they were growing up. Some adults have discovered their diagnosis of ADHD during the diagnostic process for their child.
Your physician will ask about the pregnancy and birth, the 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 and present situations in your household such as divorce, new siblings, or a recent move. Sometimes the stress of these situations can create behaviors similar to those seen with ADHD.
The diagnosis of ADHD will depend on 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. 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 so that you will remember to discuss them with your physician.
Your medical provider will supply you with a questionnaire to complete. You will be required to answer questions regarding behaviors, school progress and additional information about 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. This is done because the Diagnostic Criteria for ADHD 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 may suggest testing for this.
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
This step is not always included in the diagnostic process; however, your physician may request additional psychological testing. Sometimes an IQ test is requested if there is a large discrepancy between your child's perceived abilities and their school performance. The medical professional may also want to 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 no single definitive test for ADHD, much research has been done into the diagnosis of ADHD in children and many doctors are well qualified to make a diagnosis of ADHD.