Diagnosing ADHD

May 24, 2011

Diagnosing ADHD can be tricky.  There are no laboratory tests.  There are no CAT scans or MRIs either.  If you are a parent who suspects that your child has ADHD you need to take your child to be for an ADHD assessment, otherwise known as an ADHD evaluation. 

You have a few options.  You can bring your child to a pediatrician,  psychologist,  psychiatrist, social worker, or  neurologist (although in  today’s insurance driven society your pediatrician is most likely to be your first step).  But you should come as prepared as possible.  The first stage of the pediatrician’s evaluation is going to be an extensive interview in which the doctor will need to know as much as he can about your child.  Try to think ahead of time about what you want to get across.

To help the professionals in diagnosing ADHD, make some notes for yourself: What are your major concerns?  When did the problems begin?  Where do they generally occur – at home?  In school?  In the playground?  With friends?  Discuss your child’s difficulties with his teachers and get the teacher’s impressions.  Bring a signed consent form for your  doctor to talk to your child’s teachers.  If you are not meeting with the pediatrician, discuss your child’s medical history with the doctor and bring a consent form for the doctor to speak to your pediatrician.  Speak to the doctor about any family issues that might be bothering your child – divorce, health problems, a move, death etc.  Anything that you can think of that relates to your child that might be significant should be passed on to the doctor.  Here is a list of things you should try to remember to bring to your appointment: Your notes, report cards and letters from teachers, names and contact information of teachers, any IQ testing, personality assessments, or any previous ADHD evaluation, individualized education plans, medical history, contact information of pediatrician,  and insurance information. All of these factors will assist you in getting the best ADHD assessment for diagnosing ADHD.

The doctor will also request a meeting with your child to get a sense of your child’s understanding of the situation.  An IQ test or a neuro-developmental screening might be requested by the doctor to rule out other conditions, in which case the doctor will discuss these matters with you.  The doctor will also perform a physical exam to rule out other things that can be confused with ADHD like a seizure disorder, hearing impairment, depression, or thyroid disease.  This extensive ADHD evaluation might require more than one visit.

 While diagnosing ADHD is not an exact science there are guidelines set out by the American Psychiatric Association in their Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) which is used by doctors to diagnose people with ADHD.  The criteria in the manual is as follows:

If a person has six or more of the following ADHD symptoms of inattention for at least 6 months to a point that is inappropriate for developmental levels:

 1.  Does not pay close attention to details/careless mistakes in schoolwork

2.  Has trouble keeping attention on tasks

3.  Does not seem to listen when spoken to directly

4.  Does not follow through on instructions

5.  Has trouble organizing activities

6.  Avoids dislikes

7.  Loses things needed for tasks and activities

8.  Easily distracted

9.  Forgetful in daily activities

 If a person has six or more of the following ADHD symptoms for at least 6 months to the extent that it is disruptive and inappropriate for developmental levels:

1.  Fidgets with hands and feet/ squirms in seat

2.  Gets up from seat

3.  Excessively runs about

4.  Has trouble playing quietly

5.  Is often “on the go”

6.  Talks excessively (Impulsivity)

 7.  Blurts out answers before questions are finished

8.  Has trouble waiting for turn

9.   Interrupts

When diagnosing ADHD, the conclusions are as follows:

If some of these ADHD symptoms were present before age 7, some impairment from these symptoms occur in two or more settings, there is evidence that the symptoms cause impairment in social, school or work functioning and the symptoms are not caused by other disorders the child will be diagnosed with Attention Deficit Hyperactivity Disorder.  The child will be diagnosed with ADHD, predominantly inattentive type (where she exhibits symptoms from the first list but not the second), ADHD, predominantly hyperactive-impulsive type  (where she exhibits symptoms from the second list but not the first), or ADHD, combined type (where she exhibits symptoms from both lists).

Mom’s Take:

When I first got the diagnosis I  must admit I was torn.  A part of me was relieved that I had an answer but another part of me was disappointed.  A diagnosis of ADHD is not a simple one.  There is no cure for ADHD.  It’s a disorder that people just have to learn to live with.  I was also a bit upset with the idea that my son would have to go about his life with this new label.  But later that night when my son and I cuddled up next to one another to read a book I realized that a diagnosis of ADHD is really in the final analysis just that – a diagnosis.  Diagnosing ADHD doesn’t define my son. It doesn’t even describe him well.  It’s just a group of letters that scientists have determined aptly describe a disorder that he has.  And we’ll learn to deal with that…later.  But for the moment we were dealing with something much more important.  We were cuddling. 

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