How is ADHD Assessed?

Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD, and effectiveness of any treatment received. Screening questionnaires or rating scales as well as interviews should be used. In the case of adolescents, information should be gathered from the youth himself or herself as well as parents or other caregivers. However, this information may not be as valid due to potential limitations in the adolescent's ability to reflect and accurately report on his or her own behavior. Information from people with direct knowledge of the child's or adolescent's functioning in school (for example, teachers or guidance counselors) is essential. In the case of adults, information from people with direct knowledge of the person's functioning in childhood is advisable in light of potential difficulties in recall, especially in cases where he or she has not previously been evaluated. Psychological testing (for example, to rule out learning disabilities as causes for the symptoms), laboratory tests (to rule out physical causes), consultation between mental health specialists, or review of records of previous evaluations and treatment may also be involved.

How Is ADHD Diagnosed?

The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. The Predominantly Inattentive subtype requires at least six symptoms of inattention, while the Predominantly Hyperactive/Impulsive subtype requires at least six symptoms of hyperactivity/impulsivity. The Combined subtype requires at least six symptoms of inattention and at least six symptoms of hyperactivity/impulsivity. Regardless of subtype, symptoms be present for at least six months, some impairment from the symptoms must be present in two or more settings (for example, at school or work and at home), and some symptoms causing impairment must have been present before age seven. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms (for example, mental retardation, autism or other pervasive developmental disorders [PDD], mood disorders, anxiety disorders).