How Is ADHD Diagnosed in Children?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a well-known and recognized medical condition.

Most often, ADHD is identified in school-aged children when symptoms lead to disruption in the classroom or problems with schoolwork. However, this isn't always the case. The signs of ADHD can vary, as can the type of ADHD an individual has, and it can be diagnosed at any age.

With that said, many parents wonder, how is ADHD diagnosed in children? If your child is in need of an ADHD evaluation, how can you obtain it? Let's discuss how ADHD is detected in kids and teens, what the diagnostic process can look like, and how to move forward when you receive a diagnosis.

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Symptoms of ADHD

ADHD is characterized by ongoing patterns of inattention and/or hyperactivity-impulsivity symptoms, and it affects people from all walks of life across the globe. 

There are three main presentations of ADHD: primarily inattentive ADHD, primarily hyperactive/impulsive ADHD, and ADHD with a combined presentation. Medical and mental health professionals use the symptoms and criteria listed in the most recent version of the DSM, currently the DSM-5, to diagnose ADHD.

Inattentive symptoms may include: 

●   Forgetfulness

●   Difficulty listening when spoken to

●   Poor attention span

●   Losing and/or misplacing items

●   Being sidetracked easily

●   Making seemingly careless mistakes

●   Difficulty following instructions

●   Difficulty staying focused on or completing assignments

Hyperactive/impulsive symptoms may include: 

●   Talkativeness

●   Squirming and/or fidgeting

●   High energy (discover the differences between a high energy child and ADHD).

●   Marked restlessness that's difficult to control

●   Seeming as though one is "driven by a motor" or is always/often "on the go"

●   Difficulty engaging in leisure activities in a quiet manner

●   Trouble staying seated in class or other settings

●   Interrupting other people or blurting out statements/answers/etc.

●   Difficulty waiting for one's turn

●   Becoming frustrated quickly

Kid's symptoms of ADHD can range in severity and may change somewhat over the course of time.

Diagnosing ADHD

The American Psychological Association indicates that an estimated 8.4% of children and 2.5% of adults in the United States live with ADHD. 

To be diagnosed with ADHD, a person must experience symptoms and/or behaviors such as those listed above for six months or more in two or more settings (IE, at home, school, daycare, preschool, work, or in after-school activities). There are some differences in how diagnosing ADHD will look for young children vs. older children and those who are 17+.

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Children 

Those aged 17 or under must display six or more symptoms of ADHD for a diagnosis to occur. Teachers and parents may notice ADHD symptoms in kids, but only a medical or mental health professional can provide a diagnosis.

Recommended reading: How to Tell Your Child About Their ADHD Diagnosis

Teenagers

Those aged 17 or above must display five or more symptoms of ADHD for a diagnosis to occur. This differs from the 6+ symptoms needed for a diagnosis in kids. Although ADHD symptoms may change or present differently in teens, it doesn't necessarily mean that they "go away." Teens may need additional support in varying areas, such as their social lives.

Regardless of a person's age at the time of diagnosis, symptoms must have started before the age of 12 for a medical or mental health provider to diagnose ADHD. A child or teen's history will be taken into account during the diagnostic process, and other conditions will be ruled out if needed. 

Note, however, that it's possible for a child, teen, or adult to have a comorbid or co-occurring diagnosis, such as an anxiety disorder, depression, or autism spectrum disorder, in addition to ADHD. In fact, it's not only possible but common. 

According to the Center for Disease Control, 6 out of every 10 kids who live with ADHD experience another mental, behavioral, or emotional disorder. 3 out of every 10 kids with ADHD experience an anxiety disorder specifically. A child or teen's treatment can be adjusted to tend to these concerns as well and provide whole-person support for your child based on their unique needs.

Recognizing ADHD means that a child or teen will have tools they can use in their lives, including tools that can help them cope with the emotions that can come with ADHD symptoms.  Here's what you should expect after an ADHD diagnosis.

It isn't uncommon for kids to experience high levels of frustration in their school, their social life, in feeling misunderstood, and so on. Therapies and other tools can help a child or teen healthily express and address these feelings.

Where Can I Find an ADHD Test?

Who can diagnose or test for ADHD in a child? A pediatrician may be able to diagnose the condition, and if not, they should be able to refer you to someone who can. If you are looking for ADHD testing for your child or teen and aren't sure where to find it, there are resources that can help, such as the provider directory on the CHADD website.

While you may see ADHD "tests" online, it's vital to note that they aren't diagnostic tools, and while they may offer insight into symptoms, they cannot replace a professional diagnosis. Some providers, such as psychologists, specializing in the diagnosis and treatment of ADHD. 

This can also be true for social workers, neurologists, psychiatrists, and various other professionals. A specialist will have designated training in ADHD and will know more about ADHD, including how to detect it and the strategies that can help someone with it, than someone who does not.

ADHD Treatment 

The goal of ADHD treatment can range based on a person's age and other factors. Commonly, ADHD treatment goals for kids include lower levels of frustration, increased confidence, heightened levels of motivation, and improved functioning in school. 

ADHD can also impact kids and teens socially. As a result, many kids and teens work on concerns related to their social life in therapy. 

If you're nervous about your child or teen receiving treatment for ADHD post-diagnosis, don't let it prevent you from seeking help; know that there are different treatment options and ways to support a child, including behavioral, psychosocial, and educational strategies. Often, kids and teens will benefit from a combination of different strategies.

ADHD treatment may include but isn't limited to:

●   A customized education plan and/or accommodations at school.

●   Games and game-based digital therapeutic devices.

●   Behavioral therapy.

●   Medication.

Treatment will be tailored to the individual needs of you, your child, or your teenager, and you are allowed to opt out of or change treatments you find unhelpful. 

ADHD can affect all areas of life regardless of a person's age, and getting a formal evaluation and/or diagnosis can open the door that allows people to access the tools they need to succeed. It can also help you as a parent or caregiver better understand and support your child.

Receiving an Evaluation for ADHD

What can you expect when your child or teenager receives an evaluation for ADHD? An ADHD evaluation will typically entail:

●   A review of your child or teen's symptoms and behavior. The provider (whether that's a psychologist who works with ADHD or another professional) will typically ask you (the parent) about your child's history, including how long these symptoms have persisted and how they impact your child in areas of their life, such as school. If your child is older (IE, a pre-teen or teenager), they may be able to answer more questions themselves or have a higher level of involvement.

●   Any necessary exams to rule out other possible diagnoses or explanations for symptoms. If needed, these can include screenings for mental health conditions, like anxiety, or physical health concerns that could be the cause of certain symptoms.

●   Some providers will use additional diagnostic tools, such as tasks, questionnaires, and games, to observe the way that symptoms present. For example, a psychologist who specializes in ADHD and is testing your child for ADHD might have them engage in a pen and paper task or computer activity to gauge their attention and other ADHD symptoms like fidgeting.

The length of time and the ADHD evaluation costs may vary, partially depending on who conducts the testing and/or evaluation and other factors. 

If you feel that a provider's conclusion for diagnosis is inaccurate, it’s worth it to ask for a second option from another medical or mental health professional - preferably one who specializes in ADHD, such as a psychologist who specializes in ADHD. 

Although some primary care physicians/pediatricians will be able to diagnose ADHD and may have special training in ADHD, this isn't always the case. If they don't, it may be wise to seek or ask for a referral to a specialist with an extensive background and training in ADHD.

Conclusion

A diagnosis is worthwhile for people living with ADHD for accommodations and other purposes. Many kids, teens, and adults find their ADHD diagnosis life-changing because it provides clarity and validation for their life experiences as well as new routes to navigate symptoms.