ADHD Diagnosis
Children mature at different rates and have different personalities, temperaments, and energy levels. Most children get distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may be mistaken for ADHD.
ADHD symptoms usually appear early in life, often between the ages of 3 and 6, and because symptoms vary from person to person, the disorder can be hard to diagnose.
Parents may first notice that their child loses interest in things sooner than other children, or seems constantly “out of control.” Often, teachers notice the symptoms first, when a child has trouble following rules, or frequently “spaces out” in the classroom or on the playground.
No single test can diagnose a child as having ADHD.
To diagnose ADHD, a health professional needs to gather information about the child, and his or her behavior and environment.
Some pediatricians may assess a child themselves, but many will refer the family to a mental health specialist with experience in childhood mental disorders such as ADHD.
The first step is to consider whether there are other explanations for the symptoms. Certain situations, events, or health conditions may cause temporary behaviors in a child that seem like ADHD:
- undetected seizures that could be associated with other medical conditions
- middle ear infection that is causing hearing problems
- undetected hearing or vision problems
- medical problems that affect thinking and behavior
- learning disabilities
- anxiety or depression, or other psychiatric problems that might cause ADHD-like symptoms
- significant and sudden environmental change, such as the death of a family member, a divorce, or parent’s job loss.
The second step is to check school and medical records for clues, to see if the child’s home or school settings appear unusually stressful or disrupted, and to gather information from the child’s parents and teachers, coaches, babysitters, and other adults who know the child well.
The third step is to consider whether the symptoms meet criteria in terms of severity, timing, and based on the child’s development.
- Are the behaviors excessive and long-term, and do they affect all aspects of the child’s life?
- Do they happen more often in this child compared with the child’s peers?
- Are the behaviors a continuous problem or a response to a temporary situation?
- Do the behaviors occur in several settings or only in one place, such as the playground, classroom, or home?
It is important to consider the child’s behavior during different situations. Some situations are highly structured, some have less structure. Others would require the child to keep paying attention.
Most children with ADHD are better able to control their behaviors in situations where they are getting individual attention and when they are free to focus on enjoyable activities. These types of situations are less important in the assessment.
There are tests to help determine whether a child has ADHD. But the tests can only provide guidance.
- Some children have normal tests, but struggle in their environment with symptoms that clearly indicate a diagnosis of ADHD.
- Some children may have abnormal tests, but their symptoms can be better explained by other factors, and they do not have ADHD.
A child may sometimes be evaluated to see how he or she acts in social situations.
Finally, if after gathering all this information the child meets the criteria for ADHD, he or she will be diagnosed with the disorder.