ADHD - Diagnosed!

So what does it take to be diagnosed with ADHD? Actually, diagnosing ADHD is as complicated and controversial as the actual diagnosis. To be clear, there are specific symptoms that point mental health and medical professionals to this particular diagnosis, however there are various ways of documenting and verifying those symptoms as an actual diagnosis of ADHD.
As I can only speak for myself (Michael Whitehead) and not for other mental health or medical professionals, I plan to outline my procedures in diagnosing ADHD. Other professionals may do something similar and/or different from these procedures. However, what should be the same across the board is the following:

1. Symptoms need to be present for longer than six months and are not developmentally appropriate to be considered valid (new AAP guidelines say nine months for children under six years old).
2. The symptoms create considerable impairment in social, academic or occupational functioning.
3. The symptoms are present in more than two different settings (i.e. school, home, daycare).
4. The symptoms can not be better accounted for by other mental health (i.e. Depression, Anxiety) or developmental disorders (i.e. Autism Spectrum Disorders, Developmental Delays).

As can be seen from the above qualifiers, these symptoms really need to be put to the test. Hence, it is not appropriate to diagnose ADHD by simply filling out a form or checking off items on a checklist. Without the proper training and cautions applied, symptoms from several different disorders or issues can match those of ADHD. 

When I receive a call asking me to evaluate a child for ADHD, I generally ask first to meet with the parents. I do so for many reasons. First I want to find out about the families possible history of mental health, developmental, or medical disorders. I then go through a development history of the child with the parents. These histories can take anywhere from one to two hours, sometimes (but rarely) more. After a thorough history with the parents, I then ask the parents and teachers (and other adults who have continual contact with the child) to fill out a psychometric assessment. After getting the appropriate releases of information I contact the school (or other extra domestic agency) in order to observe the child in their 'natural setting'. I generally observe the child using a psychometric coding system for between one to three hours. If I can, I also interview teachers, school counselors and others who have continual contact with the child. This observation, interview with the parents and other adults, and psychometric assessments gives me about 6-8 hours of data to use in the evaluation process. Lastly, I meet with and observe the child in my office for about an hour. After gathering all of this information I am able to give an informed decision regarding a diagnosis. Sometimes it will result in an ADHD diagnosis, sometimes it will be another mental health or developmental disorder.

While this may or may not be the same procedure used by every medical or mental health professional, it is important that the professional you speak with is able to clearly and confidently describe the procedure they use. See this great site for other guidelines regarding ADHD assessment and evaluation.

Next week we will discuss the different treatment options available for ADHD.