Unlike many disorders, there is no simple imaging or blood test that can diagnose ADHD. An ADHD diagnosis is based on such factors as interviews with parents, teachers, and others who can provide information, a physical examination, and observing the child in various settings, including the classroom. Medical conditions, such as hearing loss, and other behavioral and psychological conditions should also be considered. How the ADHD diagnosis is done may vary depending on the professional involved, the child's symptoms, and parent preferences.
There are several ratings scales commonly used. The Conners' Rating Scale, for example, evaluates a variety of behavioral difficulties, including sleeping, eating, and problems with peers. It's available in several versions, including those for parents, teachers, and children.
In our survey, we asked parents to tell us what each provider did during the diagnostic process. Because a majority of children saw more than one professional, the survey results presented below show whether or not a particular procedure was conducted at all during the process.
Overall, interviews with the children (93 percent) and parents (92 percent) were the most frequently used techniques. Teachers were not included in the diagnostic process as often as they should have been; only in 73 percent of the cases did they complete questionnaires, and in only 52 percent of the cases were they interviewed. (Twenty-seven percent of the parents had teachers do both.)
Professional guidelines emphasize the importance of obtaining information about the child's symptoms in more than one setting, especially in schools, but almost one-third of the parents (27 percent) indicated that teachers did not complete questionnaires. Professionals did not interview teachers in 48 percent of the cases and did not observe the child in a classroom setting in 59 percent of the cases. These omissions undermine the goal that most parents have in seeking help in the first place: acquiring knowledge about how to improve their child's behavior and/or academic performance.
When it came to ruling out other medical explanations for attention problems, 70 percent of the children had a physical exam, but only 48 percent were given a hearing test.
Procedure done during the diagnostic process
|Had parent(s) complete questionnaires
|Underwent formal diagnostic testing (e.g., took a test and provided a report of results with a diagnosis)
|Had teacher(s) complete questionnaires
|Had a hearing test
|Observed child in classroom setting
|Had a neurologic examination