How is ADHD diagnosed?

There aren't any special DNA tests, blood tests or other laboratory tests for ADHD. Determining if a child has AD/HD takes many steps. There is no single test to diagnose the disorder. As a result, a comprehensive evaluation is necessary to establish the diagnosis, rule out other causes, and determine the presence or absence of coexisting conditions. Such an evaluation requires time and effort. It should include a clinical assessment of the child’s school, social, and emotional functioning and developmental level. A careful history should be taken from parents, teachers, and the child when appropriate.

It will often be appropriate for other professionals such as psychologists, speech therapists, teachers and health visitors to contribute their observations to the assessment of a child with possible ADHD. Different sorts of information needs to be gathered, such as the following:

History of symptoms
The precise nature of the difficulties, when they were first noticed, in what situations they occur, factors that exacerbate or relieve them.

Medical history
Risk factors that could predispose the child to ADHD include difficulties and risks in pregnancy and during birth, for example if the mother was in poor health, very young or drank alcohol or smoked or had an extended or complicated labour.

Several medical conditions are known to be associated with ADHD. These include fragile-X syndrome, fetal alcohol syndrome, G6PD deficiency, phenylketonuria and generalised resistance to thyroid hormone.

Accidents, operations and chronic medical conditions such as epilepsy, asthma and heart, liver and kidney disorders all need to be taken in to account. Also of possible relevance is any medication the child is taking, as well as any adverse reactions they have had to medication in the past.

Past psychiatric history
Enquiring about any mental health problems the child has had can help rule out depression or anxiety being behind the symptoms.

Educational history
This means the level of their ability and what specific difficulties they have, how they function within their peer group and get on with teachers, and any behaviour difficulties such as suspensions or exclusions. A more detailed evaluation of the child's learning by a psychologist may be necessary.

Evaluation of the child's temperament and personality
The child's temperament and personality, those of other family members and the nature of relationships within the family may need to be assessed. This will include discussion of the methods used by the parents to manage the child's behaviour and how successful they have been. Although this seems intrusive, the assessor will remain neutral and parents should not feel the disorder is 'their fault'.

Family history
The mental and physical health of the child's parents and other family members can be relevant, particularly regarding the incidence of ADHD or depression.

Social assessment
The family's social circumstances, such as housing, poverty, and social support may all have an impact on the child's behaviour.

Only a child mental health expert (a child psychiatrist, an educational psychologist or a pediatrician) can make the diagnosis, based on the DSM-IV (the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders), or the ICD-10 (its European counterpart). One aim is to rule out any other possible causes for your child's behaviour, such as language or hearing difficulties, dyslexia, autism, Asperger's syndrome, epilepsy or depression.

The DSM-IV-TR provides criteria for diagnosing ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities will help determine the public health impact of ADHD.

Sources:
www.mind.org.uk
www.netdoctor.co.uk
www.chadd.org