Last Updated on Thursday, 03 September 2009 17:41

Diagnosis of ADHD

A diagnosis of ADHD can only be made after a range of information is collected. The symptoms must be obvious in most areas of your child's life. There is no single test. General practitioners, paediatricians, child psychologists or child psychiatrists, can make this assessment or arrange a referral. Children with ADHD need to be supported at school with an educational program designed for their specific needs.  

Step 1: The first step of diagnosis is to rule out other causes that may appear like ADHD behaviour such as epilepsy, sudden grief or shock, death in the family, divorce of parents etc.

Step 2: The second step is to gather information regarding your child’s behaviour. As a parent you will be required to answer several questions for example:

What are the undesirable changes in your child’s behaviour?

• How often?

• In which situations?

• How long has the child been doing them?

• How old was the child when the problem started?

• Are the behaviours seriously interfering with the child’s friendships, school activities, and home life?

School and medical records are looked into for any hearing or vision problems in the child. Your child’s teachers may be asked to rate their observations of the child’s behaviour on standardized evaluation forms. Other people, who know the child well, such as coaches or baby-sitters, may also help the specialist in evaluating ADHD.

Talking and observing the child’s behaviour either in the clinic or if possible, in class and other settings, may be done. Tests of intelligence and learning achievement are given to find out if a learning disability exists and whether the disability is in one or more subjects.

Special attention is given to the child’s behaviour during situations that need self-control such as in a noisy environment (e.g. parties) and situations that need concentration (e.g. reading, working math problems, or playing a board game). Free play or individual attention is given less importance in the evaluation because most children with ADHD are able to control their behaviour and perform better in such situations.

Step 3: The third step is making a profile of your child’s behaviour. A doctor then confirms the diagnosis of ADHD by looking at your child's symptoms. ADHD assessment may be done in two different ways:

DSM-IV

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, (DSM-IV-TR) classifies ADHD into two categories: Inattention and hyperactivity-impulsivity. A doctor needs to note how many symptoms your child has in each category and classifies them in the following three types:

• 1. ADHD combined type: In this type, your child has six or more symptoms in each category.

• 2. ADHD predominantly inattentive type: Here your child has six or more inattention symptoms but fewer than six hyperactivity-impulsivity symptoms.

• 3. ADHD predominantly hyperactive-impulsive type: Here your child has six or more hyperactivity-impulsivity symptoms but fewer than six inattention symptoms

ICD-10

The World Health Organisation International Classification of Diseases, 10th Revision 1992 (ICD-10) has the following criteria for 'hyperkinetic disorder'.

• 1. At least 6 out of 9 symptoms of inattention and

• 2. 3 out of 5 symptoms of hyperactivity and

• 3. 1 out of 4 symptoms of impulsivity

This criterion is often used as diagnostic tool in the UK. However, today more UK specialists are using the American DSM-IV-TR definition.