ADHD — MAKING THE DIAGNOSIS

Your pediatrician will determine whether your child has Attention-Deficit/Hyperactivity Disorder (ADHD) using standard guidelines developed by the American Academy of Pediatrics. These diagnosis guidelines are for children 6 to 12 years of age.

It is difficult to diagnose ADHD in children 5 years of age and younger. This is because many preschool children have some ADHD symptoms in various situations. In addition, children change very rapidly during the preschool years. It is also difficult to diagnose ADHD once a child becomes a teenager.

There is no single test for ADHD. The process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other caregivers should be involved in assessing your child's behavior.

Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. Your pediatrician will look at how your child's behavior compares to that of other children his own age, based on the information reported about your child.

To confirm a diagnosis of ADHD these behaviors must:

· Occur in more than one setting, such as home, school and social situations.

· Be more severe than in other children the same age.

· Start before the child reaches 7 years of age. (However, these may not be recognized as ADHD symptoms until a child is older.)

· Continue for more than six months.

· Make it difficult to function at school, at home, and/or in social situations.

In addition to looking at your child's behavior, your pediatrician will do a physical examination. A full medical history will be needed to put your child's behavior in context and screen for other conditions that may affect your child's behavior. Your pediatrician also will talk to your child about how he acts and feels.

Your pediatrician may refer your child to a pediatric sub-specialist if there are concerns in one of the following areas:

· Mental retardation

· Developmental disorder, such as speech problems, motor problems or a learning disability

· Chronic illness being treated with a medication that may interfere with learning

· Trouble seeing and/or hearing

· History of abuse

· Major anxiety or major depression

· Severe aggression

· Possible seizure disorder

As a parent, you will provide crucial information about your child's behavior and how it affects her life at home, in school and in other social settings. Your pediatrician will want to know what symptoms your child is showing, how long the symptoms have occurred, and how the behavior affects your child and your family. You may need to fill in checklists or rating scales about your child's behavior.

In addition, sharing your family history can offer important clues about your child's condition.

For an accurate diagnosis, your pediatrician will need to get information about your child directly from your child's classroom teacher or another school professional. Children 6 to 12 years of age spend many of their waking hours at school. Teachers provide valuable insights. Your child's teacher may write a report or discuss the following with your pediatrician:

· Your child's behavior in the classroom

· Your child's learning patterns

· How long the symptoms have been a problem

· How the symptoms are affecting your child's progress at school

· Ways the classroom program is being adapted to help your child

· Whether other conditions may be affecting the symptoms

In addition, your pediatrician may want to see report cards and samples of your child's schoolwork.

Other caregivers also may provide important information about your child's behavior. Former teachers, religious leaders or coaches may have valuable input. If your child is homeschooled, it is especially important to assess his behavior in settings outside of home.

Your child probably does not behave the same way at home as he does in other settings. Direct information about the way your child acts in more than one setting is required. It is important to consider other possible causes of your child's symptoms in these settings.

In some cases, other mental health care professionals also may be involved in gathering information for the diagnosis.

You may have heard theories about other tests for ADHD. There are no other proven tests for ADHD at this time. Many theories have been presented. But studies have shown that the following tests have little value in diagnosing an individual child:

· Screening for high lead levels in the blood

· Screening for thyroid problems

· Computerized continuous performance tests

· Brain imaging studies such as CAT scans, MRI's, etc

· Electroencephalogram (EEG) or brain-wave test

While these tests are not helpful in diagnosing ADHD, your pediatrician may see other signs or symptoms in your child that warrant blood tests, brain imaging studies or an EEG.