Your pediatrician will determine whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics. These diagnosis guidelines are specifically for children 4 to 18 years of age.
It is difficult to diagnose ADHD in children younger than 4 years. This is because younger children change very rapidly. It is also more difficult to diagnose ADHD once a child becomes a teenager.
There is no single test for ADHD. The process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child’s school, and other caregivers should be involved in assessing your child’s behavior.
Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. See the behaviors listed in the table below.
Your pediatrician will look at how your child’s behavior compares to that of other children her own age, based on the information reported about your child by you, her teacher, and any other caregivers who spend time with your child, such as coaches or child care workers.
The following guidelines are used to confirm a diagnosis of ADHD:
- Symptoms occur in 2 or more settings, such as home, school, and social situations, and cause some impairment.
- In a child 4 to 17 years of age, 6 or more symptoms must be identified.
- In a child 17 years and older, 5 or more symptoms must be identified.
- Symptoms significantly impair your child’s ability to function in some of the activities of daily life, such as schoolwork, relationships with you and siblings, relationships with friends, or the ability to function in groups such as sports teams.
- Symptoms start before the child reaches 12 years of age. However, these may not be recognized as ADHD symptoms until a child is older.
- Symptoms have continued for more than 6 months.
In addition to looking at your child’s behavior, your pediatrician will do a physical and neurologic examination. A full medical history will be needed to put your child’s behavior in context and screen for other conditions that may affect her behavior. Your pediatrician also will talk with your child about how your child acts and feels.
Your pediatrician may refer your child to a pediatric subspecialist or mental health clinician if there are concerns in one of the following areas:
- Intellectual disability (formerly called mental retardation)
- Developmental disorder such as speech problems, motor problems, or a learning disability
- Chronic illness being treated with a medication that may interfere with learning
- Trouble seeing and/or hearing
- History of abuse
- Major anxiety or major depression
- Severe aggression
- Possible seizure disorder
- Possible sleep disorder
How can parents help with the diagnosis?
As a parent, you will provide crucial information about your child’s behavior and how it affects her life at home, in school, and in other social settings. Your pediatrician will want to know what symptoms your child is showing, how long the symptoms have occurred, and how the behavior affects your child and your family. You may need to fill in checklists or rating scales about your child’s behavior.
In addition, sharing your family history can offer important clues about your child’s condition.
Keep safety in mind:
If your child shows any symptoms of ADHD, it is very important that you pay close attention to safety. A child with ADHD may not always be aware of dangers and can get hurt easily. Be especially careful around:
- Swimming pools
- Tools such as lawn mowers
- Poisonous chemicals, cleaning supplies, or medicines
How will my child’s school be involved?
For an accurate diagnosis, your pediatrician will need to get information about your child directly from your child’s classroom teacher or another school professional. Children at least 4 years and older spend many of their waking hours at preschool or school. Teachers provide valuable insights. Your child’s teacher may write a report or discuss the following topics with your pediatrician:
- Your child’s behavior in the classroom
- Your child’s learning patterns
- How long the symptoms have been a problem
- How the symptoms are affecting your child’s progress at school
- Ways the classroom program is being adapted to help your child
- Whether other conditions may be affecting the symptoms
In addition, your pediatrician may want to see report cards, standardized tests, and samples of your child’s schoolwork.
How will others who care for my child be involved?
Other caregivers may also provide important information about your child’s behavior. Former teachers, religious and scout leaders, or coaches may have valuable input. If your child is homeschooled, it is especially important to assess his behavior in settings outside of the home.
Your child may not behave the same way at home as he does in other settings. Direct information about the way your child acts in more than one setting is required. It is important to consider other possible causes of your child’s symptoms in these settings.
In some cases, other mental health care professionals may also need to be involved in gathering information for the diagnosis.
Are there other tests for ADHD?
You may have heard theories about other tests for ADHD. There are no other proven tests for ADHD at this time.
Many theories have been presented, but studies have shown that the following tests have little value in diagnosing an individual child:
- Screening for high lead levels in the blood
- Screening for thyroid problems
- Computerized continuous performance tests
- Brain imaging studies such as CAT scans and MRIs
- Electroencephalogram (EEG) or brain-wave test
While these tests are not helpful in diagnosing ADHD, your pediatrician may see other signs or symptoms in your child that warrant blood tests, brain imaging studies, or an EEG.