Diagnostic

Diagnosing ADHD is a multi-step process because there isn’t a single test to determine if someone has it. Only mental health professionals such as psychologists, psychiatrists, or primary care provider like a pediatrician with experience in the field, should make the diagnosis.

The Diagnostic Process Usually Includes

A thorough conversation with the child/adolescent and their parents or primary caretakers.
A medical exam, including hearing and vision tests.
A questionnaire for the patient and the parent or caregiver, sometimes the teacher.
Additional psychological testing, if needed, to assess the severity of symptoms or check for other health and mental health conditions.

During the conversation, the healthcare provider will ask questions about the symptoms, when they started and the environment at home. They will also inquire about current and past academic performance, upbringing, family history, and medical, psychiatric, and neurological history of the patient and the family. For younger children, parents play a significant role in these conversations because younger kids might have more have more difficulty expressing themselves and describing their symptoms.

A thorough and multi-step diagnostic process is essential because other conditions can mimic ADHD. These conditions include thyroid conditions, learning disorders, mood disorders, anxiety, substance use, personality disorder, bipolar disorder, obsessive compulsive disorder.

To be diagnosed with ADHD, the first symptoms must appear before age 12 and continue for at least 6 months.

Symptoms must further:

Create impairment in 2 or more areas (such as school, at home, playground, community, or social settings).
Make life significantly more difficult socially, academically, or occupationally.
Not be part of a developmental disorder or a temporary difficult phase.

Healthcare providers typically use the DSM-5 criteria for diagnosing ADHD.

DSM-5 Criteria

DSM-5 criteria include symptoms of inattention and hyperactivity/impulsivity. For each category, an individual must have 6 or more symptoms up to age 16, or 5 or more symptoms at age 17 and older. These symptoms must persist for at least 6 months and be inappropriate for the person’s developmental level.

Inattention:

Difficulty paying attention and making careless mistakes at school or home.
Trouble holding attention on tasks or play activities, frequently changing tasks.
Appearing not to listen when spoken to directly.
Failing to follow through on instructions or complete schoolwork or chores.
Difficulty organizing tasks and activities.
Reluctance or dislike for tasks requiring sustained mental effort.
Often losing things.
Easily distracted.

Hyperactivity and Impulsivity:

Fidgeting or tapping with hands or feet.
Leaving the seat when remaining seated is expected.
Running or climbing in inappropriate situations .
Inability to play quietly.
Talking excessively.
Blurting out answers before questions are completed.
Trouble waiting their turn.
Often interrupting others.

Based on these diagnostic tools and findings, healthcare providers can assess if an individual has ADHD, the type of ADHD and the severity of the condition. This information is crucial for developing an effective treatment plan.