Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders experienced during childhood. The condition can persist into adulthood. Diagnosis often involves several tests to help determine whether a child or adult has ADHD.
If a person suspects that they or a child has ADHD, it is best to contact a doctor for advice. The doctor may then refer them to a specialist, who will ask more questions about the person’s symptoms and perform tests.
This article reviews the tests for ADHD in children and adults, where assessments take place, who makes the diagnosis, and what the next steps are. It also discusses some of the symptoms that may prompt an ADHD assessment.
ADHD diagnosis involves several steps and potential tests and assessments. A doctor, psychiatrist, or other mental health professional can often make a diagnosis through an evaluation of symptoms.
As part of an evaluation, a doctor or other diagnosing professional may:
- interview parents, teachers, and others in close contact with the child
- review school records
- conduct psychological tests
- check hearing and vision
- make observations
- review teacher- or parent-rated behavior scales
- review parenting style self-reports
Evaluations can differ among children. Some individuals may need additional testing, while others will not need as much.
Criteria
In order for a primary care doctor to make a diagnosis, a child needs to demonstrate symptoms and impairments in more than one major setting. Depending on the age of the individual, these settings can include:
- social settings
- academic environments, such as in a school
- occupational or working environments
To assist with the diagnosis, a doctor can use the information they collect from parents, guardians, teachers, mental health workers, and other professionals in direct contact with the child.
During diagnosis, they will need to rule out other possible causes of symptoms and impairment.
Symptoms
Symptoms break down into two categories: inattention and hyperactivity.
A child up to the age of
Inattention symptoms include often doing the following:
- losing focus or getting sidetracked, such as not following through on instructions or not completing tasks such as chores or schoolwork
- having difficulty holding attention
- appearing not to listen when a person speaks directly to them
- making careless mistakes or not paying close attention to detail
- becoming distracted easily
- having difficulty with organization
- avoiding or disliking homework, schoolwork, or other tasks that require mental effort for an extended period of time
- forgetting things during daily activities
- losing important objects, such as school materials, books, paperwork, and keys
Hyperactive-impulsive symptoms include often doing the following:
- having difficulty waiting their turn
- leaving their seat
- fidgeting or squirming
- acting like they are always “on the go”
- running around or climbing on things in unsuitable situations
- talking excessively
- being unable to quietly play or take part in activities
- providing answers before the question is finished
- interrupting other people
In addition, for a doctor to diagnose ADHD in children, they must have multiple inattentive or hyperactive-impulsive symptoms before the age of 12 years.
They must also display clear evidence that the symptoms interfere with, or affect the quality of, daily life, such as at school or work.
During diagnosis, a doctor will determine what category or type of ADHD the person has. They can include:
- combined type ADHD
- primarily inattentive ADHD
- primarily hyperactive ADHD
Similar to with children, there is no single test that can evaluate ADHD in adults. Clinicians use symptom presentation as a means to diagnose ADHD in adults.
Assessments often vary but may include:
- interview
- checklist of symptoms
- standardized behavior rating scales for ADHD
- information from spouses or others in contact with the person
Unlike children, an adult only needs to demonstrate
Some possible differences in symptoms include restlessness and agitation rather than hyperactivity.
If an adult has symptoms that do not cause impairment at work, home, or social settings, they may not receive an ADHD diagnosis.
However, a person may need an evaluation if they experience issues, such as:
- repeated poor job performance
- history of underperformance at work or school
- issues with relationships
- forgetfulness
- chronic stress related to not meeting expectations
An ADHD assessment can take place at a primary care doctor’s office. However, a general practicioner may refer a child or adult to a specialist who is more familiar with the condition.
If a referral is necessary, the assessment will take place in the specialist’s office.
Professionals qualified to diagnose ADHD can include:
- clinical psychologists
- physicians, such as:
- psychiatrists
- neurologists
- family doctors
- clinical social workers
When selecting a specialist, a person should ask about their experience and qualifications. Adults may want to look for professionals with experience working with adult ADHD.
ADHD can present differently in both children and adults.
For children, a parent, caregiver, or teacher may notice signs such as:
- excessive talking
- being more active compared with other children
- impulsivity
- difficulty paying attention or following directions
A parent or guardian may request an evaluation if a child’s behavior is creating an issue at school, home, or both.
Adults may want to seek an evaluation if they experience symptoms such as:
- inconsistent performance at work
- history of underachieving either at work or academically
- intense feelings of guilt or self-blame
- inability to complete tasks, causing relationship issues
- frequently quitting or losing jobs
- poor management of daily tasks or responsibilities
- often worrying or feeling stressed about not meeting expectations or goals
- forgetting things that are important
- feeling upset over things that other people consider to be minor
Following an ADHD diagnosis, the mental health professional who makes the diagnosis will help develop a treatment plan. Treatment plans can vary and are typically individualized to help a child or adult meet their goals.
Treatments
- stimulants or nonstimulant medications to help with focus
- behavioral interventions, which could include cognitive behavioral therapy (CBT)
- educational support,
such as the development of an individualized education plan (IEP) for school-age children
Treatments are not one-size-fits-all. Mental health professionals may need to continually adjust treatment to help ensure the person gets the support they need.
There is no single test that medical professionals use to diagnose ADHD. Evaluations typically consist of reviewing symptoms, interviewing the person and those in close contact with them, and assessing how their symptoms affect their daily life. Criteria can differ for children and adults.
Evaluations typically take place in a clinical setting, such as a doctor’s office. Following diagnosis, the individual will receive a treatment plan. Treatments can include medication, behavioral therapies, and more.
It is best for a person to contact a doctor for advice if they have concerns about ADHD. The doctor will be able to assess the individual’s symptoms, and they may refer them to a specialist.