ADHD diagnoses have risen 67% in the past 20 years, and almost 1 in 10 children in the US are diagnosed with it. What is ADHD? How does it develop? And why the dramatic rise in recent diagnosis? Keep reading to find out.

Characteristics of ADHD

Diagnosing ADHD can be difficult. There is no one test that can indicate it. ADHD shows up in three different forms, across a wide spectrum of severities, and can look totally different across genders and cultures. Furthermore, studies indicate that the vast majority of people with ADHD also have at least one other disorder, with symptoms that could overlap. If all this wasn’t enough, most general practitioners don’t receive enough specialized training in ADHD and its related complications to perform the meticulous evaluations necessary for an accurate diagnosis.

As a result, many families of children with ADHD struggle for years with ineffective treatments because their child was misdiagnosed, or a comorbid condition was missed.

Understanding the process of evaluation for ADHD is vital so that parents can ensure that their child’s providers are equipped to administer a thorough and accurate diagnosis. Keep reading to learn about how to find a qualified evaluator, and what a comprehensive assessment entails.

Who can diagnose ADHD?

Only a medical professional, like a pediatrician, psychologist, psychiatrist, or advanced practice registered nurse, should diagnose ADHD. However, a degree is not enough. Because of the nuances and complications involved in ADHD, families should be careful to find a provider with specialized training and considerable experience diagnosing ADHD in children. Ask potential evaluators what tests they use and how long they typically take to make a diagnosis. The process should take several hours, at least.

If your child’s doctor does not meet this criteria, you can ask them for a referral to a professional that specializes in ADHD assessments. Private assessment services are also available. Be sure to fully research and interview any provider you consider, even if they claim to specialize in ADHD.

Can my child’s school diagnose them with ADHD?

There are several differences between a medical diagnosis and an educational diagnosis. ADHD is a neurological condition, and can only be diagnosed by a medical professional. For your child to get a medical diagnosis, or be prescribed medication, they must be diagnosed by a doctor.

Schools evaluate kids to determine if they qualify for extra services to help them in school through special education. For a child to qualify for special education, they must meet the criteria for one of 13 disability categories outlined in IDEA special education law. There is no disability category called “ADHD”. Instead, ADHD characteristics fall under a category called “Other Health Impairment” (OHI).

If you would like your child to receive services at school through special education, you will have to request a school evaluation. If you would like your child to get a medical diagnosis of ADHD and receive a prescription for medication, they will need to be evaluated by a medical professional.

The Evaluation Process:

1

Physical Exam and Medical History: Sometimes, symptoms that look like ADHD can be caused by other underlying medical problems. A full physical exam can rule out any of these conditions. A medical history is also important, because many conditions, ADHD included, are genetic. Understanding any medical issues from your family’s past is vital for practitioners to accurately diagnose your child.

2

Interviews: During this stage of the evaluation, a practitioner will talk to parents, teachers, and other adults who know your child well to get a sense of what their day-to-day functioning looks like. If your child is older, they may interview them as well. These consultations will give the evaluator a holistic view of your child’s strengths and weaknesses in a variety of settings.
Throughout the interviews, it is important that you are open and honest about what your home life looks like. This information is essential for the evaluator to develop a thorough understanding of all the factors that could be affecting your child. These interviews should feel thorough, and the practitioner should elicit feedback from several different people–including someone who works with your child at school. For some kids, symptoms are most noticeable in the classroom, so information about how they function there can be very valuable.

3

Rating Scales: Rating scales are norm-referenced tests that can help a practitioner determine if a child has ADHD, or another disorder. Evaluators should ALWAYS screen for disorders that commonly appear alongside ADHD, like mood disorders, OCD (Obsessive-Compulsive Disorder), ODD (Oppositional-Defiant Disorder), or learning disabilities. Brain scans and computerized tests are generally unnecessary, and are not scientifically proven to assist in the diagnosis of ADHD.

Post-Diagnosis: What to Leave your Appointment With

  • A thorough understanding of the diagnosis: This is the time to get your questions answered. No question is too big, or too small.
  • A game plan for treatment, which should include:

    • Recommendations for medication (if using)
    • A list of suggested accommodations to support your child at school
    • A plan for appointments with a therapist, executive functioning coach, or another expert who can support your child
    • A schedule of follow-up appointments with the practitioner who evaluated your child, to see how the treatment is going

For more information, check out this infographic.

Common Evaluation Mistakes

  • Not screening for co-occurring conditions: It is estimated that at least 50% of people with ADHD have one or more comorbid conditions. Practitioners sometimes fail to screen for these disorders during an ADHD evaluation, or, conversely, they might identify another condition while missing the underlying ADHD. This leaves a huge part of the puzzle missing, and can result in an inaccurate diagnosis and an ineffective plan for treatment.

  • Not understanding the complexity of ADHD: A few generations ago, the medical community thought that ADHD only looked one way–a jittery, impulsive kid who couldn’t stay in his seat in class. Now, we know that ADHD is incredibly complex, and looks different in everyone. ADHD should not be ruled out because a child performs well in school or has a high IQ. Most mental health professionals will use the checklist of symptoms in the DSM (the Diagnostic and Statistical Manual of Mental Disorders) as a guide when diagnosing ADHD. However, the DSM is a guide, and cannot account for the myriad of ways that ADHD shows up. Thus, a child may not meet all of the 6 symptoms outlined in the DSM, but still have ADHD.

  • Rushing through the evaluation: If a practitioner chats with you for 15 minutes and then pulls out the prescription pad, something is wrong. A complete ADHD evaluation should take several hours, at least. A rushed diagnosis can lead to months, or even years, of unsuccessful treatment. Be sure to do your research on a practitioner before beginning the evaluation, to ensure that they are experts in ADHD diagnoses, and that they have the skills to complete a comprehensive and detailed evaluation.

Want more information? Check out this podcast by ADDitude, “What Is ADHD? Everything You Need to Know Before and After an ADHD Diagnosis”

Published On: September 17th, 2021 / Categories: ADHD /