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Mark Hutten, M.A.
Re: Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)

How is ADHD diagnosed?

Kids mature at different rates and have different personalities, temperaments, and energy levels. Most kids get
distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may
be mistaken for ADHD. ADHD symptoms usually appear early in life, often between the ages of 3 and 6, and because
symptoms vary from person to person, the disorder can be hard to diagnose. Moms and dads may first notice that
their youngster loses interest in things sooner than other kids, or seems constantly "out of control." Often, teachers
notice the symptoms first, when a youngster has trouble following rules, or frequently "spaces out" in the classroom or
on the playground.
No single test can diagnose a youngster as having
ADHD. Instead, a licensed health professional needs to
gather information about the youngster, and his or her
behavior and environment. A family may want to first talk
with the youngster's pediatrician.

Some pediatricians can assess the youngster
themselves, but many will refer the family to a mental
health specialist with experience in childhood mental
disorders such as ADHD. The pediatrician or mental
health specialist will first try to rule out other possibilities
for the symptoms.

For example, certain situations, events, or health
conditions may cause temporary behaviors in a
youngster that seem like ADHD.
Between them, the referring pediatrician and specialist will determine if a youngster:

• Has a middle ear infection that is causing hearing problems
• Has anxiety or depression, or other psychiatric problems that might cause ADHD-like symptoms
• Has any learning disabilities
• Has any medical problems that affect thinking and behavior
• Has any undetected hearing or vision problems
• Has been affected by a significant and sudden change, such as the death of a family member, a divorce, or parent's
job loss
• Is experiencing undetected seizures that could be associated with other medical conditions
A specialist will also check school and medical records
for clues, to see if the youngster's home or school
settings appear unusually stressful or disrupted, and
gather information from the youngster's moms and dads
and teachers. Coaches, babysitters, and other adults
who know the youngster well also may be consulted.
The specialist also will ask:
• Are the behaviors a continuous problem or a response
to a temporary situation?
• Are the behaviors excessive and long-term, and do
they affect all aspects of the youngster's life?
• Do the behaviors occur in several settings or only in
one place, such as the playground, classroom, or home?
• Do they happen more often in this youngster
compared with the youngster's peers?
The specialist pays close attention to the youngster's behavior during different situations. Some situations are highly
structured, some have less structure. Others would require the youngster to keep paying attention. Most kids with
ADHD are better able to control their behaviors in situations where they are getting individual attention and when they
are free to focus on enjoyable activities. These types of situations are less important in the assessment. A youngster
also may be evaluated to see how he or she acts in social situations, and may be given tests of intellectual ability and
academic achievement to see if he or she has a learning disability.

Finally, if after gathering all this information the youngster meets the criteria for ADHD, he or she will be diagnosed with
the disorder.