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Attention deficit hyperactivity disorder

How do doctors diagnose ADHD?

Attention deficit hyperactivity disorder (ADHD) can be difficult to diagnose. Doctors don't have a simple test that tells them for sure whether a child has it.

Doctors take great care to make sure that a child really does have ADHD before they treat it.

Source:
Mercugliano M.
What is attention-deficit/hyperactivity disorder?
Pediatric Clinics of North America. 1999; 46: 831-843.

¹ However, doctors disagree about how to decide if a child has ADHD. This means that while one doctor may say your child has ADHD, another doctor may disagree. A wrong diagnosis can be harmful because your child may be given unnecessary treatment or your child may not receive the treatment they need.

If you are worried about your child's behavior, talk with your doctor or your child's teacher. Both doctors and schools can arrange for you and your child to see a specialist.

Asking parents and teachers

To make a diagnosis, doctors usually ask parents and teachers to supply information about a child's behavior. As a parent, you might be asked to:

Fill out forms that rate how your child behaves in various settings (these forms look at different types of ADHD behavior)
Describe your child's behavior problems, when they happen and how long they have been going on.

This information helps the doctor develop a picture of behavior that shows whether your child has ADHD. Your doctor will pay special attention to how your child behaves in different situations, such as in school and on the playground, and when doing things that require lots of concentration, like reading or playing a board game.

To learn more about ways teachers can help your child, see Educational Options.

Checking for symptoms

Your doctor will then compare your child's pattern of behavior to the symptoms of ADHD put together by the American Psychiatric Association. These symptoms are listed in a book called the Diagnostic and Statistical Manual of Mental Disorders.

DSM states that to be diagnosed with ADHD:

Source:
Guevara JP, Stein MT.
Evidence based management of attention deficit hyperactivity disorder.
BMJ. 2001; 323: 1232-1235.

Your child must have six or more symptoms of not paying attention, or six or more symptoms of being overly active and acting before thinking
These symptoms must have started before your child was 7 years old
These symptoms must have been present for at least six months
Your child's behavior must be causing problems in at least two places, such as at home and at school.

To learn more, see the Symptoms checklist.

Checking for other causes

Your doctor may also want to rule out other causes of your child's symptoms by:

Asking about your child's health and your own health. For example, an injury to your child's head could lead to behavior problems
Checking for other illnesses. Your doctor will carry out a physical exam and ask questions to see if your child's behavior problems could be caused by something other than ADHD. To learn more, see Conditions that are similar to ADHD
Checking for a learning disability. Your doctor may test your child's intelligence and learning skills to see if he or she has a learning disability

Source:
Smucker WD, Hedayat M.
Evaluation and treatment of ADHD.
American Family Physician. 2001; 64: 817-829.

³
Treating other disorders. Your child may have other health problems as well as ADHD. Your doctor will check for these, and provide treatment if necessary.

Source:
Smucker WD, Hedayat M.
Evaluation and treatment of ADHD.
American Family Physician. 2001; 64: 817-829.

³ To learn more, see Conditions that can occur alongside ADHD
Testing your child's hearing. A hearing problem may explain why your child is doing poorly at school.

Source:
Zametkin AJ, Ernst M.
Problems in the management of attention-deficit-hyperactivity disorder.
New England Journal of Medicine. 1999; 340: 40-46.

⁴

Collecting this information takes time. You and your child may need to make several visits to your doctor's office.

ADHD cannot explain all bad behavior in children. If your child's behavior does not match the symptoms of ADHD, then treatment for ADHD probably won't help.

But if your child is diagnosed with ADHD, it's important to recognize that this is a serious medical condition that needs professional help and treatment. To learn more, see What treatments work for ADHD?

Sources for the information on this page:

Mercugliano M.What is attention-deficit/hyperactivity disorder?Pediatric Clinics of North America. 1999; 46: 831-843.

Guevara JP, Stein MT.Evidence based management of attention deficit hyperactivity disorder.BMJ. 2001; 323: 1232-1235.

Smucker WD, Hedayat M.Evaluation and treatment of ADHD.American Family Physician. 2001; 64: 817-829.

Zametkin AJ, Ernst M.Problems in the management of attention-deficit-hyperactivity disorder.New England Journal of Medicine. 1999; 340: 40-46.

This information was last updated on May 12, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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