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| |    How Is ADHD Diagnosed? by Robert Needlman, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. Doctors diagnose ADHD the same way they diagnose a lot of other medical problems: by taking into account all of the child's symptoms and many other factors, and seeing if they fit into the picture of ADHD and not into some other condition. This process is called "clinical judgment." What makes ADHD different from, say, a urine infection or diabetes, is that there are laboratory tests for these conditions, while there is still no laboratory test that can confirm a diagnosis of ADHD. This is too bad. I think many parents and doctors would feel more comfortable if there were a blood test for ADHD. But there isn't. Information from school and home In making a diagnosis of ADHD, doctors need to collect information from both the parents and the teachers. There are a couple of reasons for this: First, symptoms of ADHD often are not present in the doctor's office. And second, children face different challenges at home and at school, so parents and teachers have different perspectives. For example, parents can observe how a child responds to chores or to the temptations of the grocery store. And teachers can observe how a child handles taking turns, listening intently, and screening out distractions from other children. If parents and teachers agree in their observations, I feel much more confident that what they are telling me is accurate. When they disagree significantly, I try to find an explanation. It might be a sign to look for another diagnosis. For example, if your child only makes trouble in math class, he might have a learning disability for math, not ADHD. Questionnaires Paper-and-pencil questionnaires also are very helpful when it comes to diagnosing ADHD. They make it possible to collect a lot of information quickly (for the doctor!) and to compare your child to a so-called normal group. One kind of questionnaire asks specifically about symptoms of ADHD. Another asks about a broad range of problems, both medical and psychological, that can sometimes imitate ADHD. Both types of questionnaire are useful. Interview and examination Along with the questionnaires, the ADHD evaluation should include a careful interview (medical history) and physical exam. The interview should cover pregnancy and birth; developmental milestones and temperament; past and present illnesses; the family history (ADHD? Any related conditions?); and any stressors in the home, school, or neighborhood. If your doctor already knows you well, this could be rather quick. If not, the history can take an hour or more. This is time well spent. You want to be very confident that the doctor has all of the facts before making the diagnosis of ADHD.
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