A thorough evaluation of ADHD requires the recording of a detailed history from parents, a discussion with or observation of the affected child, and some backup evidence from someone outside the home. A qualified doctor can accomplish this at an appointment with you and your child. Although the diagnosis will generally be apparent from a child’s history, an interviewer most likely will ask you, your child, and your child’s teachers to complete appropriate questionnaires.
A detailed history is essential to diagnosing ADHD. It
should include information about your child’s birth;
illnesses; early language and motor milestones; infant,
toddler, and preschool years; educational progress and
motivation; homework habits; social interactions and
interests; and hobbies and extracurricular activities. A
family medical and social history is also important.
A detailed history will often include anecdotes that give
the doctor a more complete picture of your child’s past
and present.
The diagnosis of ADHD requires that the child have
symptoms that interfere in at least two settings. By definition,
outside sources are required. Although getting a
description directly from a teacher—by questionnaire or
in person—is useful, parents’ description of what they
have been told about classroom behavior often suffices.
Sometimes, teacher questionnaires are useful not only
for diagnosis, but to show parents how a teacher rates
their child’s attention and behavior in a quantitative,
rather than a qualitative or descriptive way (such as they
would hear at a parent–teacher conference).
A doctor will also try to obtain a complete “picture” of
your child. This may involve performing a physical
examination, asking questions about school and outside
interests, or asking your child to do some simple tasks
(e.g., walking on toes and heels or drawing a picture).
The objective is to develop an accurate sense of your
child for diagnostic purposes.
Whom do I consult to get a proper diagnosis of ADHD?
A number of different kinds of doctors can diagnose
ADHD.Which type you choose to examine your child
depends in part on your access to subspecialists and in
part on the degree of ADHD and the presence of
accompanying disorders. A regular pediatrician or a
developmental pediatrician (a pediatrician who specializes
in learning issues) can generally manage a child with
relatively mild ADHD. Both neurologists and psychiatrists
diagnose and treat children with ADHD. Often,
they see children whose ADHD is complicated by other
medical or psychiatric problems. Pediatricians may refer
a patient to either a neurologist or a psychiatrist when
the diagnosis is unclear or when they feel that adequately
managing an affected child is becoming difficult. A
psychiatrist might be a particularly good option for a
child with comorbid problems involving oppositional
behavior, anxiety, or mood. Conversely, a neurologist
might be the right choice for a child with comorbid tics,
Tourette’s syndrome, or a specific neurological problem
(e.g., seizures).
Although psychologists can not prescribe medication,
they can diagnose and treat problems associated with
ADHD. However, several types of psychologists are
available, and their methods of assessment will differ.
Clinical psychologists may use techniques similar to
those of a psychiatrist. They will interview parents and
child, gaining both historical and current information
about developmental, academic, social, and emotional
issues and other aspects of the child’s behavior. Other
psychologists, usually educational psychologists or neuropsychologists,
will use more quantitative measurements
to make a diagnosis. Besides following the more typical
interview procedures, these clinicians will perform
several hours of testing to arrive at a diagnosis. Most
certainly, significant school difficulties or outstanding
social and emotional issues are symptoms that may warrant
a more complete assessment by a psychologist, either
through the board of education or on a private basis. In
this way, a fuller picture of a child’s particular strengths
and weaknesses can be obtained.
I took my child to a doctor who made the
diagnosis in 30 minutes. Can doctors really
make a diagnosis of ADHD that quickly?
Yes. Although parents may have difficulty understanding
this, professionals may be able to make the diagnosis
of ADHD quite quickly. First, as qualified professionals,
they see many children with the same set of critical
characteristics. Similar to diagnosing a medical condition,
such as diabetes, a personal history in combination
with symptoms may quickly point to the right
diagnosis. In fact, a child’s personal history alone is often
the most important part of the diagnosis. In addition,
if you and your child have provided the doctor with
completed questionnaires that point out problems with
inattention, hyperactivity, or impulsivity, the diagnosis
is often immediately apparent. Very often the history is
confirmed by a child’s unruly behavior in the office:
however, the key element of the diagnosis is the history,
not the inappropriate office behavior.
Read More: ADHD Diagnosing
