Sue Scheff: How is ADHD Diagnosed

Kara Tamanini offers sound and understanding advice regarding ADD/ADHD children. Take the time to visit her website. Her books for children are excellent! I was very impressed and recommend them if you have a child that is ADD/ADHD.

The most important component at arriving at an accurate diagnosis of ADHD is to complete a thorough and comprehensive evaluation. Many times, I have seen children and they have have been brought in by their parents and diagnosed by their pediatrician after being seen for five to ten minutes. In addition, parents will often tell me that either their child’s pediatrician or a child psychiatrist, prescribed their child medication after being seen and the parent is uncertain as to whether or not their child received an accurate diagnosis. Unfortunately, this happens all too often and the steps to arrive at a diagnosis of ADHD should take more than 5-10 minutes in a doctor’s office.

First and foremost, a clinical interview should be completed with the parents to obtain a thorough background history. This should include developmental history, medical problems or complications, school and home issues, any behavioral problems, social/interpersonal skills, etc… In other words, everything else should be ruled out before a diagnosis of ADHD is given. ADHD is a diagnosis of exclusion. We need to rule out that their is not another issue or problem before we arrive at a diagnosis of ADHD. A medical evaluation may also be needed to determine that the behavior or symptoms are not caused by a medical issue.

Both a child’s parents and the child’s teacher should complete a behavior rating scale in order to determine the child’s behavior in both settings. In addition, this is a good method to compare if their are any discrepancies between the parent’s report of behavior and the child’s teacher’s report. If there is a huge difference between what the parents are saying and what the teacher is saying, this might strictly be a behavioral issue in one of the settings and we should be looking at a discipline problem and not an attentional issue.

The child should also be interviewed and behavioral observations should be made by the psychiatrist, psychologist, or a mental health professional that is conducting the evaluation. Direct behavioral observation of the child are often very helpful, however this is not a necessary component to reach a diagnosis of ADHD.

Also, intelligence and/or achievement testing is also beneficial to determine if their is a learning difficulty. Children who are struggling in school, often act out or are inattentive as a result of extreme frustration with their school work. A learning disability evaluation is often beneficial to rule out that the child is not struggling academically, which affects their behavior at school. Before any child can be diagnosed as having ADHD, a complete and thorough evaluation needs to be completed and all information obtained should be scrutinized carefully and all issues/problems ruled out that may be causing attentional difficulties. Most evaluations completed by a psychologist or psychiatrist to diagnosis ADHD last at least 2-3 hours in order to obtain the necessary clinical information. If your child has been diagnosed with ADHD after a 5-10 minute session with your child’s pediatrician than a comprehensive evaluation should now be completed.
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