What's involved in the evaluation for ADHD? continued...
If the patient is an adult, the doctor may talk with a spouse or other family member. That's to get an accurate medical and behavioral history to go with the patient's symptom assessment. For adults who may have ADHD, the doctor will ask for information to identify childhood symptoms. That will include:
- Behaviors at home
- Behaviors at school
- Interactions with peers and siblings
- Other clues of childhood ADHD
ADHD is often diagnosed in adults. It actually starts, though, in childhood. Having "proof" of ADHD behavior as a child can help the doctor reach an accurate diagnosis and treat the symptoms effectively. As many as two-thirds of children with ADHD will still have symptoms in adulthood.
Are there specific ADHD tests the doctor might use?
We've become accustomed to blood tests or other expensive laboratory tests to help doctors make a conclusive diagnosis. So parents often ask for blood work or a brain scan to diagnose ADHD.
The FDA has approved the use of the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, a noninvasive scan that measures theta and beta brain waves. The theta/beta ratio has been shown to be higher in children and adolescents with ADHD than in children without it. The scan, approved for use in those ages 6 to 17, is meant to be used as a part of a complete medical and psychological exam.
Some lab tests may help diagnose other medical conditions that mimic ADHD. But they do not diagnose ADHD.
The best way to diagnose ADHD is through:
- The use of standardized questionnaires or rating scales that assess inattentiveness, hyperactivity, impulsivity, and combined behaviors
- Interviews with the parents, child, and teachers
- Personal observation
- Psychological or psychoeducational testing
Which rating scales are used to assess ADHD symptoms?
When making a diagnosis, it's helpful if the doctor obtains one or more ADHD assessments or behavior checklists from the child's parents and the classroom teacher. If applicable, a teacher or caregiver from an after school program should also fill out an assessment. Some common rating scales used to assess children with ADHD include:
- The Vanderbilt Assessment Scale. This is a 55-question assessment tool. It reviews symptoms of ADHD according to the DSM-V criteria. It also screens for co-existing conditions such as conduct disorder, oppositional-defiant disorder, anxiety and depression, and more.
- Behavior Assessment System for Children (BASC). This scale assesses such things as hyperactivity, aggression, and conduct problems. It also addresses anxiety, depression, attention and learning problems, and lack of certain essential skills.
- Child Behavior Checklist/Teacher Report Form (CBCL). Among other things, this scale assesses physical complaints, aggressive or delinquent behavior, and withdrawal.