How Is ADHD Diagnosed?

All kids struggle with paying attention, listening, and following directions from time to time, but for kids with ADHD, the struggles are harder and happen more often. ADHD stands for attention deficit hyperactivity disorder, and is a medical condition that affects brain development and activity. Because ADHD can affect a child at school, at home, and in friendships, it’s important to have your child evaluated if you think they may have symptoms. 

Signs of ADHD

While ADHD can be diagnosed at any age, it begins in childhood. Parents and teachers may notice that a child struggles with inattentiveness (easily distracted, trouble staying on task, doesn’t listen to directions well, seems forgetful), hyperactivity (fidgety, restless, easily bored, makes careless mistakes while rushing through tasks), or impulsiveness (acts too quickly before thinking, interrupts, finds it hard to wait, doesn’t ask for permission, has emotional reactions that seem too intense for the situation). While it’s normal for young children to be distracted, restless, impatient, or impulsive, it doesn’t mean a child necessarily has ADHD. Kids learn skills such as attentiveness, patience, and self-control over time from their parents and teachers. But for kids with ADHD, these skills don’t get better and start to cause problems in everyday life.

Diagnosing ADHD

In children between ages 3 and 12, your child’s doctor generally can identify ADHD with observation and behavioral testing. They will ask about your child’s health, behavior, and activity. Your doctor will ask you to complete checklists about these things, and also will need input from your child’s teachers or coaches as well. To diagnose ADHD, the doctor will look to see if the symptoms go beyond what is usual for your child’s age, have been going on since your child was young, interfere with your child’s success, and affect your child in more than one setting (home, school, activities). They also will perform a health check to make sure another health or learning issue isn’t causing the problems.

ADHD Assessments

Doctors rely on a variety of assessments to help determine if your child may have ADHD. Most tests for ADHD work best in children who are at least 6 years old, largely because they rely on observing baseline language and behavioral development and require input from how the child behaves in a structured environment (like preschool classes). However, doctors can assess and offer guidance in treating children as young as age 3.

Some of the tests used include:

  • Behavior Assessment System for Children (BASC): This test, for ages 2 to 25, combines self-assessment with parent and teacher observations of traits like aggression, self-control, and relationships with others. 
  • Conners Rating Scale: This test, for children 6 to 18 or for adults, looks for hyperactivity, interpersonal relationship skills, and academic problems.
  • Child Behavior Checklist/Teacher Report Form (CBCL): This test, for ages 6 to 18, assesses physical problems as well as attention issues, aggression, anxiety and depression, and behavioral problems. 
  • Tests of Variable Attention (TOVA): For ages 4 and up, this electronic test objectively measures focus, attention, and impulsiveness. It is presented as a simple yet boring computer game, and doesn’t depend on language. 
  • Vanderbilt ADHD Diagnostic Rating Scale (VADRS): This test, for ages 6 to 12, and is designed to measure the severity of ADHD symptoms.

    Treating ADHD

    When ADHD is not treated, it can be hard for kids to succeed. This can lead to low self-esteem, depression, oppositional behavior, academic failure, risk-taking behavior, or family conflict. However, the right treatment can help ADHD symptoms improve. Treatments can include a combination of medication, behavior therapy, parent coaching, and school support. Over time, children can be taught how to better manage their attention, behavior, and emotions. As they grow older, kids should be able to identify and improve their own attention and self-control.

    If you are concerned your child has symptoms of ADHD, talk with your pediatrician. They may refer you to a child psychiatrist for further testing and treatment if necessary. Visit Parent Resources for more information on ADHD.