Diagnosing ADHD in Children

Although some pediatricians with special training in the disorder will diagnose ADHD in children, most will refer you and your child to a mental health professional such as a psychologist, psychiatrist, counselor, or social worker trained in diagnosing and treating the disorder.

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).

ADHD Types and Symptoms

There are three types of ADHD: hyperactive-impulsive, inattentive, or a combination of both types. Different types of ADHD involve different symptoms in children.

The person who evaluates your child will check on symptoms for each type:

Hyperactive and Impulsive

  • Often fidgets with or taps hands or feet, or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  • Often unable to play or take part in leisure activities quietly.
  • Often "on the go" acting as if "driven by a motor".
  • Often talks excessively.
  • Often blurts out an answer before a question has been completed.
  • Often has trouble waiting his/her turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

Inattentive

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
  • Often has trouble holding attention on tasks or play activities.
  • Often does not seem to listen when spoken to directly.
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  • Often has trouble organizing tasks and activities.
  • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
  • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
  • Often easily distracted
  • Often forgetful in daily activities.

Although many children display 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 impair the child in at least two places (social life, school, etc.).

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Diagnosing ADHD in Children

The first step toward diagnosing ADHD should be a full physical exam by your child’s pediatrician or family practitioner to rule out other medical causes for his or her behaviors. The physician, psychologist, or other mental health professional evaluating your child for ADHD will probably then set up an interview with you and two or more sessions with your child before making a final diagnosis.

The evaluator will check on other possible causes of your child’s behavior. To do this, they will check your child’s medical and school records, and ask about what else is going on in your child's life. They may also give your child tests to determine if there might be a learning disorder or some other mental or emotional problem that may be causing the behaviors.

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.

It's possible that your child's behavior isn't related to a condition. If they've been through a major life change (such as a move or a divorce, for example), that might also be affecting their behavior. Figuring out what's going on is all part of the evaluation process.

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 also ask each of you to complete 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.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on February 14, 2019

Sources

SOURCES: 

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

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

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

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

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

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