Attention Deficit Hyperactivity Disorder, “ADHD” (also formerly known as “ADD”), is one of the most common mental health disorders of childhood, that consists of symptoms in areas related to attention, impulsivity, and hyperactivity. As a physician, I often have parents coming into my office with concerns that their child has ADHD. Sometimes a child’s teacher will also bring forward these concerns to parents, and sometimes it is the parents themselves.
I often get asked by my patients “How will I really know if my child has ADHD or not.” What I tell my patients, is that there are two main categories of symptoms in ADHD: 1) difficulties with attention, and 2) difficulties with hyperactivity and impulsivity. Sometimes features of hyperactivity or impulsivity may be normal, therefore to evaluate if your child does have ADHD – this must include a medical assessment, thorough developmental history, as well as evaluation of your child’s educational, psychological and social development. It is important that a doctor can collect this information to determine if your child does, or does not have ADHD.
In addition to an history and exam done by your doctor, they may also use additional tools to help make a diagnosis of ADHD. This can be done by parent, caregiver and teacher questionnaires, self-reporting symptom scales, and one-on-one tests performed by a psychologist. Symptoms of ADHD are not always observable by your doctor when you take your kid to their doctors appointment, so information needs to be collected from other people that observe your kid more often in more natural settings. This can include teachers, daycare workers, nannies, aunts, uncles, grandparents, or parents.
To screen for ADHD, doctors will often give parents a questionnaire that you and one other family member, caregiver, or teacher can complete. Because symptoms of ADHD need to be present in two or more settings (for example: school, home, daycare, etc.) it is most helpful if the second person that fills out this questionnaire is a teacher or another person who is often with your kid when they are outside of the home. As children get older, they may be better able to convey what symptoms are causing them challenges in life, and your doctor might give them a rating scale to fill out to evaluate the presence of ADHD symptoms. If needed, there are also more extensive tests that psychologists can perform that include administering tests that observe your child’s their symptoms first-hand.
These additional questionnaires and scales may give doctors extra information, to help them make an informed diagnosis if your child has has ADHD.
Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management, Wolraich M, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011; 128:1007.