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Diagnosing ADHD

Since there is no real single test for attention deficit hyperactivity disorder, diagnosing ADHD generally involves making sure that the behavior is not due to other reasons. In other words, to rule in the diagnosis of ADHD, it is very important to rule out other conditions! ADHD-type symptoms can be seen for a variety of reasons: depression, anxiety, learning disabilities, trauma, abuse, change, abuse, psychosocial problems, stressors (eg – divorce, job changes, moving, birth or death,) low IQ , medical conditions (such as thyroid problems, high lead levels, etc.), hearing or vision problems, epilepsy, sleep disorders or poor sleeping habits, opposition, and even poor parental supervision and discipline.

I’ve seen many, many children misdiagnosed with ADHD who had hearing problems, learning problems, or trauma. Therefore, it is very, very important not to simply allow your child to be diagnosed based on behavioral observations or a simple behavioral rating scale. It tends to over-rely and place a degree of importance on a simple behavioral rating scale, such as Conners.

Many school systems have a teacher fill out a behavior rating scale, determine that the hyperactivity and/or inattention indices are significantly high, and tell the parents that their child has ADHD and that they should take her to a doctor and get medication. I have conducted dozens of professional teacher trainings on this topic. Not only does this border on practicing medicine without a license, but their interpretation is often inaccurate. What rating scales can show is that there are behaviors being displayed that are concerning and outside the normal range for a child of this age (based on normative scoring). A behavioral rating scale can be a useful diagnostic tool—a tool to be used in conjunction with other measures to ensure an accurate diagnosis.

A diagnosis of ADHD should be based on at least all of the following:

• Deep psychosocial history – the child does not live in a vacuum

• Observations of behavior (parents, teachers and others as applicable)

• Behavior rating scales

• Developmental and medical history

• A physical examination by a pediatrician – including vision and hearing and, if indicated, certain blood tests and sleep studies; many children have sleep disorders that produce symptoms similar to ADHD

When the question is still raised WHY such behaviors are manifested, then a psychological or psychoeducational assessment is indicated. Specific test instruments are determined based on the questions asked and what might be excluded or excluded. So assessment (I don’t use the word ‘tests’ with kids because it implies the possibility of failure and causes anxiety for many. I usually say we have a lot of work to do to see what they are good at and what they are not so good at, to help them have the best possible year in school.)

An assessment battery for diagnosing ADHD may include:

• IQ

• Academics

• Measures of processing and perception

• Emotional (projective and subjective instruments)

• Personality

• Behavior

It is a big mistake to make an immediate diagnosis of ADHD based only on behavioral observations or behavioral rating scales. It is extremely important to fully investigate the root causes of any behavioral difficulties your child may be exhibiting! Talk to your doctor, school staff, and child psychologist for a thorough evaluation to diagnose ADHD.

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