ADHD/ADD Testing & Diagnosis

Medically Reviewed by Zilpah Sheikh, MD on May 01, 2024
Written by Marijke Vroomen Durning, RN, Amy Gopal
9 min read

If you think you or your child may have attention deficit hyperactivity disorder (ADHD), the earlier you get a diagnosis, the better. There's no single test to diagnose ADHD, a common brain disorder whose symptoms first show up during childhood. Sometimes people are only diagnosed when they are adults, after years of not understanding their symptoms.

An ADHD screening 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

Your doctor needs to see how much your child’s symptoms affect their daily moods, behavior, productivity, and lifestyle habits. And they need to rule out other conditions.

It's important for anyone who seems to have symptoms of ADHD to get a proper diagnosis because many other mental and physical issues can cause similar symptoms.

When can you test for ADHD in children?

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.

Some personal problems and other concerns can also cause symptoms mimicking ADHD. The screening should take into account such factors, which may include:

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.

ADHD test interviews with family and teachers

Interviews with family and teachers are an important part of ADHD tests and diagnosis for children. These interviews help your doctor get a better overall look at your child’s life.

The interviews usually include questions about how your child acts in different situations, such as at home or school. You or the teachers may be asked:

  • Is there anyone else in your family who might have ADHD or has been diagnosed with it?
  • Does your child fidget a lot and squirm when asked to be still for a long time?
  • Does your child have trouble finishing or staying on a task or project, especially if it’s a challenging one?
  • Is your child easily distracted by either noise or activity? If so, how often?
  • Can your child wait their turn or are they too impatient?
  • How old was your child when you started noticing these behaviors? 
  • When are the behaviors most obvious?
  • What are your child’s report cards like? 
  • What is your family's medical history?

School or home observation

Diagnosis depends a lot on what parents and teachers observe and how they see the child acting at home, in the classroom, and elsewhere. Quiet observation doesn’t disturb your child, so they don’t need to do anything specific and can behave naturally without feeling the need to act in a certain way.

You may be asked to keep a journal or follow a checklist as you and the teachers observe your child for certain behaviors. For example, they may:

  • Have difficulty paying attention to instructions or the task at hand
  • Not seem to listen
  • Frequently lose items
  • Fidget or squirm
  • Not stay seated
  • Jump, run, or be strongly physically active when they shouldn’t be (such as when standing in line or during quiet play)
  • Speak out or act up out of turn

Family history of ADHD

ADHD can run in families, which is why ADHD screening asks if there are any family members who either have ADHD symptoms or have been diagnosed with the condition. An adult with ADHD has up to a 91% chance of passing it on to their children.

Psychological and medical tests for ADHD

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
  • An electroencephalogram (EEG) to measure electrical activity in their brain
  • A 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.

ADHD questionnaires

ADHD questionnaires and rating scales are helpful when trying to make a diagnosis of ADHD. Some questionnaires are for the parents, others for teachers.

ADHD and school performance

The interviews and questionnaires for the teachers give the expert a lot of information to work with, and so do your child’s school performance reports. The expert or doctor will likely want to see your child’s report cards or progress reports, to look for any patterns that could help diagnose ADHD.

ADHD testing for adults

Screening for ADHD in adults is a bit different. The doctor may want to talk with your spouse or other family members. They'll want to find out if you 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: inattentive, hyperactive-impulsive, and combined

Inattentive type: A person must have at least six (five for those 17 and older) out of the following nine symptoms along with 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 instructions or complete schoolwork, chores, 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

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 too much
  • Blurts an answer before the question has been completed
  • Has trouble waiting their turn
  • Interrupts others

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 American Psychiatric Association guidelines, your doctor may use rating scales to help them evaluate and track ADHD symptoms.

Rating scales help doctors take a more objective look at you or your child’s behaviors and any difficulties with behavior or completing tasks. There are several scales that doctors and other professionals may use. Some of the most commonly used ones include:

Vanderbilt assessment scale. This scale reviews symptoms of ADHD and looks for other conditions such as conduct disorder, oppositional-defiant disorder, anxiety, and depression.

Child attention profile (CAP). It is generally filled out by teachers and tracks common ADHD symptoms.

Behavior assessment system for children (BASC). It 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, the CBCL looks at physical complaints, aggressive or delinquent behavior, and withdrawal.

Conners rating scale. It looks at things such as behavior, work or schoolwork, and social life. It can show how these symptoms affect things such as grades, jobs, home life, and relationships.

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.

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 relieve symptoms and make ADHD easier to manage.

Involve your child in the treatment plan as well. Talk to your child with age-appropriate facts and language. Having ADHD doesn’t define who your child is. It's a medical condition that can be helped with treatment.

 

ADHD is a common brain disorder. Unfortunately, there is no single ADHD test to determine if you or your child has ADHD, and it can take time to come up with a diagnosis. But by ruling out other possible causes and using screening tools and rating scales, your doctor can diagnose ADHD to help you move forward with a treatment plan.

What tests are done to diagnose ADHD?

There is no one ADHD test. However, doctors can do tests to rule out other causes and confirm an ADHD diagnosis. Doctors can also recommend ADHD screening, using screening tools that rate how a child or adult is behaving.

How do you get diagnosed with ADHD?

ADHD is diagnosed using a combination of tools. Doctors or other experts work with parents, guardians, and teachers to do screening and ratings, to see if the child fits in the ADHD guidelines. Doctors will also rule out other medical conditions that could cause similar symptoms.

What diagnostic tool is used to diagnose ADHD?

There is no specific ADHD diagnostic tool, but doctors can use a variety of scales or profiles to help diagnose ADHD. They include:

  • Vanderbilt assessment scale
  • Child attention profile (CAP)
  • Behavior assessment system for children (BASC)
  • Child behavior checklist/teacher report form (CBCL)
  • Conners rating scale

What is the most accurate ADHD test?

There are various rating and screening tests that a doctor can do to help diagnose ADHD. However, since each person and situation is different, no one screening test is better than another.

What are the 3 levels of ADHD?

The three levels or types of ADHD include:

  • Hyperactive-impulsive. A person with this type of ADHD can pay attention but has difficulty with impulsivity and hyperactivity. It is the least common type of ADHD.
  • Inattentive. A person with this type of ADHD is, as the name suggests, inattentive and easily distracted.
  • Combined. This is the most common type. A person with combined ADHD has trouble paying attention, gets easily distracted, and is impulsive and hyperactive.

Can you see ADHD on a brain scan?

Yes, it might be possible to see evidence of ADHD on a brain scan. A study showed 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).