Which Tests Can Diagnose ADHD?
There's no single test to diagnose attention-deficit hyperactivity disorder (ADHD), a common brain disorder whose symptoms first show up during childhood.
If you think you or your child might have ADHD, your doctor will likely do an ADHD screening. This is a detailed process that may involve:
- Interviews with the adults who interact with the child
- Personally watching you or your child
- Questionnaires or rating scales that measure symptoms of ADHD
- Psychological tests
The doctor needs to see how much a person’s symptoms are affecting their daily moods, behavior, productivity, and lifestyle habits. And they need to rule out other conditions.
Getting a proper diagnosis is important for anyone who seems to have symptoms of ADHD because many other mental and physical issues can cause similar issues.
You can have an ADHD evaluation for a child as early as age 4 if they have certain symptoms, such as being too talkative or having trouble listening or following directions.
An ADHD screening with a professional will likely include:
- Interviews with you, your child, relatives, and your child's teachers.
- Review of your family's medical history.
- Time observing your child's behavior at school or home.
- Medical evaluations and psychological tests to see if your child meets the American Psychiatric Association’s Diagnostic and Statistical Manual criteria for ADHD.
- Questionnaires or rating scales that measure symptoms of ADHD .
Your doctor or mental health professional will ask how old your child was when their behavior began and in what circumstances they're most obvious. They might want to see their report cards and schoolwork. They may test your child for other learning disabilities if they're struggling.
Your doctor may do tests to rule out physical health problems that can have similar symptoms to those of ADHD, such as:
- Hearing and eyesight tests
- Blood tests for lead levels and other diseases
- EEG to measure electrical activity in their brain
- CT scan or MRI to check for brain abnormalities
The expert will also consider other mental and emotional health issues that can cause symptoms that look like ADHD. They include:
- Mood disorders
- Autism spectrum disorders
- Learning disorders
- Oppositional defiant disorder
It's common to have one or more of these issues along with ADHD.
The screening should also take into account personal problems and other concerns that can cause symptoms that mimic ADHD, such as:
- Short attention span. Some kids can't focus as long as others.
- Emotional issues. Kids who feel anxious or sad may have trouble paying attention.
- Problems at home. Children who are having crises at home might have trouble focusing at school.
- Classroom chaos. If a classroom is noisy and poorly managed, a child's attention can wander from the task at hand.
Screening for ADHD in adults is a bit different. The doctor may want to talk with their spouse or other family members. They'll want to find out if the patient had symptoms in childhood. Knowing if an adult had ADHD behavior as a child is important for making a diagnosis.
To diagnose ADHD, doctors use guidelines established by the American Psychiatric Association (APA). The group has identified three types of ADHD:
1. Inattentive type: A person must have at least six (five for those 17 and older) out of the following nine symptoms and a few symptoms of the hyperactive-impulsive type:
- Doesn't pay attention to detail or makes careless mistakes
- Doesn't stay focused on tasks
- Doesn’t listen
- Doesn't follow through on instructions and doesn't complete schoolwork, chorines, or duties
- Has trouble organizing tasks or activities
- Avoids or dislikes doing things that take effort or concentration
- Loses things
- Is easily distracted
- Is forgetful
2. Hyperactive-impulsive type: A person must have at least six out of these nine symptoms along with a few symptoms of the inattentive type:
- Fidgets or squirms a lot
- Gets up from their seat a lot
- Runs or climbs at inappropriate times
- Has trouble sitting or playing quietly
- Always “on the go” as if “driven by a motor”
- Talks excessively
- Blurts an answer before the question has been completed
- Has trouble waiting their turn
- Interrupts others
3. Combined type. This is the most common type of ADHD. People with it have symptoms of both inattentive and hyperactivity-impulsivity types.
Along with these APA guidelines, your doctor may also use rating scales to help them evaluate and track ADHD symptoms. A few examples are:
- Vanderbilt assessment scale. This assessment tool reviews symptoms of ADHD and looks for other conditions such as conduct disorder, oppositional-defiant disorder, anxiety, and depression.
- The child attention profile (CAP). This scale is generally filled out by teachers and tracks common ADHD symptoms.
- Behavior assessment system for children (BASC). This test looks for things such as hyperactivity, aggression, and conduct problems. It also looks for anxiety, depression, attention, and learning problems, and lack of certain essential skills.
- Child behavior checklist/teacher report form (CBCL). Among other things, this scale looks at physical complaints, aggressive or delinquent behavior, and withdrawal.
- Conners rating scale. This questionnaire asks about things such as behavior, work or schoolwork, and social life. They can show how these symptoms affect things such as grades, job, home life, and relationships.
What to Know About ADHD Screening for Your Child
If you're having your child screened for ADHD, take these steps to ensure the best results:
- Go to the right professional. The best thing you can do is find a health care professional with expertise in ADHD. Your child's school might have someone on staff who can evaluate them. Other options include a child psychiatrist or a psychologist. You also can ask your pediatrician for references.
- Ask a lot of questions. Be prepared to discuss your child's symptoms with the expert you find. And ask about steps you can take to deal with their behavior.
- Include their teacher. Many cases of ADHD are first noticed by teachers, either during preschool or elementary school. So, be sure to keep your child's teacher informed and included in discussions. You may need to ask them to fill out questionnaires or have them talk to your child's doctor or mental health care provider.
- Expect more than an ADHD drug for therapy. Medication helps some kids, but not all of them. And it's not always necessary. Therapy should include helping your child learn to change their behaviors. Your child's doctor can help you make a plan and put it into action at home and school.
- Stay on top of changes. Monitor your child's medications and behavioral plan as they get older. The medications they use and their dosages may need to change as they grow. Some kids have a harder time focusing as they enter middle school and start changing classes.
Because ADHD is a brain developmental disorder, scientists have been using brain scans for decades and are now looking to electroencephalography (EEG) to help diagnose ADHD.
One large study that analyzed decades of research found that people with ADHD have lower levels of brain arousal in frontal areas of their brains, as well as too many theta waves (slow brainwaves) and not enough beta waves (fast brainwaves).
Some doctors believe people with ADHD can learn to increase the arousal levels in their frontal lobes, which will improve their ADHD symptoms.
However, other research suggests that currently available EEG devices, including the FDA-approved Neuropsychiatric EEG-Based Assessment Aid (NEBA), aren't accurate and are best used to help with traditional ADHD diagnoses.
After an ADHD Diagnosis
If your doctor makes an ADHD diagnosis, it's important to follow the treatment plan. The doctor may recommend both medications and behavioral therapy. These treatments can bring relief from symptoms and make ADHD easier to manage.