Attention Deficit Hyperactivity Disorder: Diagnosing ADHD

Reviewed by Smitha Bhandari, MD on June 11, 2019

There is no single test used to diagnose ADHD. Experts diagnose ADHD after a person has shown some or all of the symptoms on a regular basis for more than 6 months and in more than one setting.

Diagnosing ADHD in Children

Health care professionals such as pediatricians, psychiatrists, and child psychologists can diagnose ADHD with the help of standard guidelines from the American Academy of Pediatrics or the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

You can also find a professional who specializes in ADHD diagnosis through your health plan, your child’s teacher or school counselor, other parents of children with ADHD, or nonprofit organizations such as Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

The diagnosis involves gathering information from several sources, including schools, caregivers, and parents. The health care professional will consider how a child's behavior compares with that of other children the same age, and they may use standardized rating scales to document these behaviors.

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Some symptoms that suggest ADHD in children include inattention, hyperactivity, and impulsivity. Many children with ADHD:

  • Are in constant motion
  • Squirm and fidget
  • Make careless mistakes
  • Often lose things  (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile phones)
  • Do not seem to listen
  • Are easily distracted
  • Do not finish tasks
  • Often leave their seat in situations when remaining seated is expected
  • Often run about or climb in situations where it isn’t appropriate (adolescents or adults may be limited to feeling restless)
  • Can’t play or take part in leisure activities quietly
  • Talk excessively
  • Blurt out an answer before a question has been completed
  • Have trouble waiting for their turn
  • Interrupt or intrude on others (e.g., butting into conversations or games)
  • Have trouble organizing tasks and activities
  • Forget daily activities

To diagnose ADHD, your child should have a full physical exam, including vision and hearing tests. Also, 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 aged 6 to 17 years, is meant to be used as a part of a complete medical and psychological exam.

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The evaluation may also include interviewing you, your child's teachers, and any other adults who are a big part of your child's life. The evaluator may ask each of you to fill out standardized forms, known as “behavior rating scales,” to rate different aspects of your child’s behavior. These scales may also be used later to track progress with treatment.

The health care professional should take a complete medical history to check for other conditions that may affect a child's behavior. Certain conditions that could mimic ADHD or cause the ADHD-like behaviors are:

  • Recent major life changes (such as divorce, a death in the family, or a recent move)
  • Undetected seizures
  • Thyroid problems
  • Sleep problems
  • Anxiety
  • Depression
  • Lead toxicity

Though many children show some of the behaviors for ADHD, they do not necessarily have the disorder. An ADHD diagnosis requires that these behaviors have been persistent for at least 6 months, that some symptoms began before age 12, that symptoms are present in two or more settings (such as school and home), and that they significantly affect the child in at least two places (social life, school, etc.).

Diagnosing ADHD in Adults

It is not easy for a health care professional to diagnose ADHD in an adult. Sometimes, an adult will recognize the symptoms of ADHD in themselves when their child is diagnosed. Other times, they will seek professional help for themselves and find that their depression, anxiety, or other symptoms are related to ADHD.

In addition to symptoms of inattention and impulsiveness, adults with ADHD may have other problems, including:

  • Chronic lateness and forgetfulness
  • Anxiety
  • Poor organizational skills
  • Low self-esteem
  • Employment problems
  • Short temper
  • Hard time finishing a task
  • Unthinking and immediate response; hard time controlling behavior
  • Restlessness

If these difficulties are not managed appropriately, they can cause emotional, social, occupational and academic problems in adults.

In order to be diagnosed with ADHD, an adult must have persistent, current symptoms that date to childhood. ADHD symptoms continue as problems into adulthood for up to half of children with ADHD. For an accurate diagnosis, the following are recommended:

  • A history of the adult's behavior as a child
  • An interview with the adult's life partner, parent, close friend, or other close associate
  • A thorough physical exam that may include neurological testing
  • Psychological testing
WebMD Medical Reference

Sources

SOURCES:

Searight, H. R. Am Fam Physician, November 2000.

FDA: “FDA permits marketing of first brain wave test to help assess children and teens for ADHD.”

Walt Karniski, MD, developmental pediatrician; executive director, Tampa Day School, Florida.

Dana Stempil Herzberg, head of school, Lexis Preparatory School, Scottsdale, AZ.

National Institute of Mental Health: “Attention Deficit Hyperactivity Disorder (ADHD).”

CDC: “Attention-Deficit/Hyperactivity Disorder (ADHD).”

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