Diagnosis of Attention Deficit Hyperactivity Disorder

Diagnosis of Attention Deficit Hyperactivity Disorder

If Attention-Deficit Hyperactivity Disorder is suspected, to whom can the family turn? What kinds of specialists do they need?

Ideally, the diagnosis should be made by a professional in your area with training in ADHD or in the diagnosis of mental disorders. Child psychiatrists and psychologists, developmental/behavioral pediatricians, or behavioral neurologists are those most often trained in differential diagnosis. Clinical social workers may also have such training.

The family can start by talking with the child’s pediatrician or family doctor. Some pediatricians may do the assessment themselves, but they often refer the family to an appropriate mental health specialist they know and trust. There are also various state and local government agencies and volunteer organizations that can help identify specialists.

Specialty	Can diagnose ADHD	Can prescribe medication, if needed	Can provide counseling or training
Psychiatrists	YES	YES	YES
Psychologists	YES	NO	YES
Pediatricians	YES	YES	NO
Neurologists	YES	YES	NO
Clinical Social Workers	YES	NO	YES

Whatever the specialist’s expertise, his or her first task is to gather information that will rule out other possible reasons for the child’s behavior. The National Institute of Mental Health lists the following as possible causes of ADHD-like behavior:

• A sudden change in the child’s life—the death of a parent or grandparent; parents’ divorce; a parent’s job loss
• Undetected seizures, such as in petit mal or temporal lobe seizures
• A middle ear infection that causes intermittent hearing problems
• Medical disorders that may affect brain functioning
• Underachievement caused by learning disability
• Anxiety or depression.

Ideally, specialists check school and medical records, being particularly alert for school records of hearing or vision problems, and home and classroom environments.

Next, the child is interviewed and observed in order to gather information on the child’s ongoing behavior. Current and former teachers are asked to rate their observations of the child’s behavior on standardized evaluation forms, known as behavior rating scales, to compare the child’s behavior to that of other children the same age. (Teachers who have worked with many children over the years often develop reliably accurate judgment.)

The child’s teachers, parents, baby-sitters and others may be interviewed.

In most cases, the child will be evaluated for social adjustment and mental health. Tests of intelligence and learning achievement may be administered in an effort to discover any learning disabilities.

Specialists pay special attention to the child’s behavior during situations that demand exceptional self-control, noisy or unstructured situations such as parties, or during tasks that require sustained attention, like school assignments and board games.

All of this information is put together to form a profile of the child’s behavior, which can in turn be used to make a diagnosis.

New Diagnosis

The first biological test for Attention-Deficit Hyperactivity Disorder was announced in January 2005. Researchers claim the diagnosis, which is based on examination of eye movements, is more than 93% accurate. The study was led by Giorgos Pavlidis at the University of Brunel, UK, who said, “Children with ADHD show large difference in eye movements compared with normal children.”

The short (ten-minute) test is relatively easy for AD/HD sufferers to sit through and could benefit children as young as three years old. It is also thought that the test might indicate which patients are likely to respond well to drugs.

Is It Really ADHD?

Remember that not everyone who is overly hyperactive, inattentive, or impulsive has Attention-Deficit Hyperactivity Disorder. After all, most of us sometimes blurt out things we don’t mean to say, jump from one task to another, or become disorganized and forgetful. So how can specialists tell if the problem is ADHD?

It’s basically a matter of degree; the diagnosis requires that such behavior be demonstrated to a degree that is inappropriate for the person’s age. The diagnostic guidelines also contain specific requirements for determining when the symptoms indicate Attention-Deficit Hyperactivity Disorder. The behaviors must appear early in life, before age seven, and continue for at least six months.

The behaviors must create a real handicap in at least two areas of a person’s life, like home and the classroom, or the classroom and on the playground. Thus, an individual who exhibits some symptoms but whose academic performance or social life are not impaired would not be diagnosed with ADHD.

Looking at it another way, we’ve already discussed the specific symptoms of Attention-Deficit Hyperactivity Disorder. Specialists also consider several critical questions regarding the quality of those symptoms when determining if a child needs hELP: Are these behaviors Excessive, Long-term, and Pervasive?

In other words, do they occur more often than in other children the same age? Are they a continuous problem, not just a response to a temporary situation? Do the behaviors occur in several settings? The person’s pattern of behavior is compared against a set of criteria and characteristics of the disorder as listed in the DSM-IV-TR.

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