May 25, 2017
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ADHD in Children (cont.)

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How do health care professionals assess childhood ADHD? Are there ADD or ADHD tests? What types of doctors diagnose ADHD in children?

In order for a child to receive an ADHD diagnosis, he or she must exhibit six symptoms of inattention or six symptoms of combined hyperactivity and impulsivity, while an older teen or adult need only have five of either group of symptoms. The ADD symptoms should start before 12 years of age, be present in more than one setting (for example, home and school), be severe enough to cause problems for the person, and not be able to be better explained by another condition for criteria for the diagnosis of ADHD to be met. There are three kinds of ADHD: predominately inattentive presentation, predominately hyperactive/impulsive presentation, and the combined (inattentive, hyperactive, and impulsive) presentation.

Many health care professionals, including licensed mental health therapists, pediatricians and other primary-care providers, psychiatrists, clinical psychologists, psychiatric nurses, and social workers may help make the diagnosis of ADHD in children. One of these professionals will likely perform or refer for an extensive medical interview and physical examination as part of the assessment. One of the key issues in assessing children and teens for ADHD is determining whether the behaviors being exhibited are part of normal behavior or of ADHD. Individuals with ADHD also often have a learning disability or one of a number of other mental health problems, like symptoms associated with exposure to trauma, as well as depression, bipolar disorder, obsessive compulsive disorder and other anxiety disorders, Asperger's syndrome, and other autism-spectrum disorders. Childhood ADHD is also often associated with other behavior disorders, like conduct disorder and oppositional defiant disorder. Therefore, the health care professional will likely screen for signs of depression, manic depression, anxiety, and other mental health symptoms. The symptoms of ADHD may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, health care professionals often perform routine laboratory tests during the initial evaluation to rule out other causes of ADD symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help establish the diagnosis. Some ADHD symptom checklists for children include the Vanderbilt Rating Scale and the Connors' Rating Scales.

In an effort to encourage thoughtful, deliberate assessment and treatment of ADHD rather than premature treatment with medication, a stepped diagnostic approach to this condition is being encouraged by many mental health practitioners, except if the child's symptoms are severe such that the need for treatment is urgent. The steps in this approach include the following:

  • Gathering information about the child from more than one source (such as from the school and home)
  • Exploring what other issues may be causing symptoms (such as symptoms of a medical illness or reaction to trauma)
  • Continue to monitor and assess potential symptoms over time
  • If issues continue, provide an intervention like education materials on ADHD
  • If the minimal intervention does not result in adequate symptom management, provide or refer for a brief number of counseling sessions to teach the child and his or her family ways to decrease and manage the child's symptoms.
  • If issues continue despite the previous interventions, consider assessment for treatment with medication for ADHD.
Medically Reviewed by a Doctor on 5/2/2016


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