How do I find out if my child has ADHD?
Real Mom Problem
“What is the correct testing for ADHD? We started seeing a pediatric neurologist who had us and his teachers fill out forms. They spoke to us for a little while, looked over the forms, and diagnosed him. Is there any other testing that should be done to confirm this is the correct diagnosis?”
- 1. The Conners' Index Scale -- or Conners' Test -- is frequently used to diagnose ADHD
- 2. Many doctors prefer to wait until a child is of school age to make an ADHD diagnosis
- 3. Evaluations generally involve input from teachers and parents, as well as observations of your child's behavior
- 4. ADHD is usually diagnosed over a series of doctor visits and evaluations; not after a single, short appointment
- 5. Mental health professionals, pediatricians, and neurologists are all qualified to diagnose ADHD. Read some of the advantages and disadvantages to using any of them below
Real Mom Solutions
Mommy instinct, teacher recommendation, overt symptoms, or subtle clues all might be pointing to ADHD. But how do you know for sure? Let a children's behavioral expert, and the moms of CafeMom, walk you through the most common steps towards diagnosis.
Our Expert Says...
The Conners' Index Scale is the most frequently used method of diagnosing ADHD. But keep in mind while it looks like a "test," it really is only a checklist that teachers and/or parents use to rate (via their opinions) a child. This is different from direct psychological and neuropsychological testing that an examiner does one-on-one with a child.
The Conners' Test is a good place to start. Next, a qualified pediatric specialist (such as a neurologist), takes a thorough history and then a diagnosis can be given. This is the way it's basically done. As you can see, there's no direct objective measurement of anything. That's the limitation we currently have with an ADHD diagnosis. It's not like diabetes or cardiovascular issues where medical tests can be used to really identify if a problem exists.
In my book I talk about the high rate of misdiagnosis for childhood behavioral and psychiatric issues, such as ADHD, Asperger's Syndrome, autism, bi-polar, anxiety disorder, etc. It's important to take your time diagnosing (should never be done in a single 15-20 appointment), and don't rush to diagnose if a child is younger than seven for ADHD as they tend to show much progress every 3-6 months. Also, with ADHD, many children diagnosed - approximately half - may not carry the diagnosis a year later. Yet, we tend to think of it as a lifelong issue.
Finally, if a child is six-and-a-half or older, and there are ADHD signs and challenges in the classroom, I often recommend more one-on-one neuropsychological testing (done by a qualified and experienced psychologist). This helps us determine if there's ADHD and/or other learning problems that require changes to be made in the classroom. If your child shows academic problems, don't only think of ADHD as the explanation. It's the first (and sometimes only) thing we think about - and we can miss important other problems.
For more than 20 years, Dr. Rao worked in the Department of Psychiatry at Children's Hospital and served as instructor at Harvard Medical School, where he trained psychologists and physicians in the use of Cognitive Behavior Therapy, or CBT. Dr. Rao has been the featured expert on documentaries for the A&E series "Investigative Reports" and MTV's "True Life" series. Dr. Rao has been interviewed for articles in "The New Yorker," "Parents Magazine," "The Boston Globe," and" The Washington Times." His editorial letters and opinions have appeared in "Newsweek," "Scientific American," "The New York Times," and "New York Magazine." His book, "The Way of Boys: Promoting the Social and Emotional Development of Young Boys," is about the crisis in American boyhood. Dr. Rao answered questions for moms in our Kids' Health group here.
The Moms of CafeMom Say...
When my son was evaluated there were two separate forms filled out by me and his teacher. Both forms asked in-depth questions about his behavior, moods, sense of self, social skills etc. I was kind of surprised at how detailed they were. Along with that my son had a full blood workup to rule out other disorders or allergies. He was evaluated by a psychiatrist and a psychologist. They would not give him the diagnosis unless all three doctors agreed that it was ADHD.
The school psychologist strongly suggested my son has ADD but where I live, only a psychiatrist can make that diagnosis.
My six-year-old was diagnosed with ADHD this school year. His pediatrician's office has a set of doctors who specialize in ADHD (they get extra training so they can diagnose it). They do it based upon information from teachers and parents. My son showed classic signs so it wasn't hard.
My step daughter has been tested and it's obvious she has it. Her evaluation was about six months long through the school. The school did not do the whole evaluation. They had the child psychologist and counselors talk to us and her also, but it all happened while she was in school so we didn't have to have appointments after school.
The process we went through was an evaluation with a child psychiatrist and a counselor and a meeting with the school. We also had to hand out an evaluation questionnaire to his teacher and other people who knew him.
We've had my son evaluated at two different schools which is not a formal diagnosis. We have also taken him to two different child psychiatrists. Lastly we had full panel testing by a neuropsychiatrist. The first psychiatrist was hesitant about adding any labels, along with the neuropsychiatrist. They talked more about characteristics, and needs as opposed to "your son has____ and so you should give him ____." The second psychiatrist was more pushy with meds, and labeling so I guess it just depends on who is doing the evaluating. I trust the NPs findings the most as he really tested my son in all different aspects, and was genuinely interested in his mind as an individual rather than a blanket label.
You need to find a psychologist that specifically works with children or a behavioral specialist. Once this is done they can make the diagnosis and decide if ODD is also a possibility. They do not like to diagnose ADHD/ADD in children under the age of five but will in extreme cases; they also do not like to give drugs at this age. Try behavioral therapy first and see if that helps - it is helping my son who is four. And make your own decisions! You know what is right for your child and your family.
You can try what our doctor calls the home ADHD test....give him a cup of STRONG coffee (no sugar in it) and see what it does to his behavior.... a child who truly has ADHD will CALM DOWN!
First my daughter's pediatrician ruled out petit mal seizures. (Honestly, I knew it was ADHD and not seizures but I went along with my doctor's suggestion to test her for them.) After we ruled out the possibility of seizures we visited a child psychologist for a psychological evaluation (parent consult -- one hour, child evaluation -- three hours, and post appointment conference -- 30 minutes). The psychologist diagnosed her with ADHD and ODD. The psychological evaluation included an IQ test, ADHD testing, verbal and reasoning skills test, and a few others. My daughter's pediatrician says that ODD (Obsessive Defiance Disorder) is basically just a child acting out of frustration due to their ADHD and inability to cope as the other children.
What you want the psychiatrist/psychologist/developmental professional/whoever to do is called a Conners' Test. That is how they diagnose ADHD. Do your homework, and have a proper psych doctor monitor your child. A pediatrician doesn't have the time to properly diagnose or monitor it. One more thing - look into getting an IEP or 504 plan for your child so she can get extra help in school if she needs it. It helped me out SO MUCH and if I recall correctly, they can be taken to college too, when she gets to that age. Best of luck to you, and be supportive and understanding of your child. Do your research, be her number one advocate, and LOVE HER NO MATTER WHAT!