How is ADHD diagnosed?
Many children go through naughty or disruptive phases. There's a big difference between children with attention deficit hyperactivity disorder (ADHD) and children who are just 'badly behaved'. Naughty children have a say in the matter. Children who are simply prone to misbehaviour can behave well when they want to. If they're offered a big enough incentive, they can sit still, wait their turn or concentrate. Children with ADHD may desperately want to be 'good' but they just can't help themselves.
If you or your child's teacher or doctor suspects that your child may have ADHD, it is likely your child will be referred to a specialist, usually a child psychiatrist, for assessment. The specialist may ask for a report from the school and may even want to observe your child doing certain tasks.
There is no simple test to diagnose ADHD. If your child's teacher or doctor suspects that your child may have ADHD, it is likely your child will be referred to a specialist. The specialist will be able to confirm the diagnosis by doing an assessment. This specialist may be a children's doctor (a specialist paediatrician), a child psychiatrist, a member of your local Child and Adolescent Mental Health Service, or an adult psychiatrist. The type of specialist depends on the age of your child and also the availability of services in your local area.
The assessment may involve a discussion with you and your child as well as a physical examination. The specialist may ask for a report from the school and may even want to observe your child doing certain tasks. You and your child may also see a nurse or other healthcare professionals for further testing and assessment.
There are a few aims of this assessment. These include:
- To confirm whether your child definitely has ADHD.
- To make sure that there are no other reasons that explain your child's behaviour. For example, a hearing difficulty, epilepsy or thyroid problem.
- To identify any other problems your child may have. For example, anxiety, low self-esteem or a learning difficulty.
For a doctor to make a firm diagnosis of ADHD, there are strict criteria that need to be fulfilled. For example, the symptoms of inattention and/or hyperactivity and impulsivity need to be present for at least six months. They also need to be causing problems in your child's life as well as being different from what would be expected for their age. They also must have started to occur before the age of 7 years, and be present in more than one setting - for example, at home and at school. In addition, other causes for your child's symptoms may need to be ruled out - for example, depression or anxiety.
Further reading and references
Attention deficit hyperactivity disorder: diagnosis and management; NICE Clinical Guideline (September 2008)
Management of attention deficit and hyperkinetic disorders in children and young people; Scottish Intercollegiate Guidelines Network - SIGN (October 2009)
Attention deficit hyperactivity disorder; NICE CKS, October 2015 (UK access only)
Post RE, Kurlansik SL; Diagnosis and management of adult attention-deficit/hyperactivity disorder. Am Fam Physician. 2012 May 185(9):890-6.
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