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How do I know if my child has attention deficit hyperactivity disorder?

Your child's doctor may make a diagnosis. Or sometimes the doctor may refer you to a mental health specialist who is more experienced with ADHD to make a diagnosis. There is no single test that can tell if your child has ADHD.

It can take months for a doctor or specialist to know if your child has ADHD. He or she needs time to watch your child and check for other problems. The specialist may want to talk to you, your family, your child's teachers, and others.

Sometimes it can be hard to diagnose a child with ADHD because symptoms may look like other problems. For example, a child may seem quiet and well-behaved, but in fact he or she is having a hard time paying attention and is often distracted. Or, a child may act badly in school, but teachers don't realize that the child has ADHD.

If your child is having trouble at school or at home and has been for a long time, ask his or her doctor about ADHD.

This answer is based on source information from National Institute of Mental Health.

Dr. Karyn  Purvis, PhD
Psychology Specialist
It is important in considering ADHD to rule out other causes for the behavior. In our work with children who have experienced trauma we see hypervigilance frequently mistaken for ADHD. If your child has experienced trauma or if you are adopting or fostering a child who has a history of neglect or abuse it will be important to inform your health care provider about their history. Hypervigilance occurs when the child is on constant alert about potential danger and can easily be mistaken for ADHD. If you believe there is a chance that your child's behavior is hypervigilance you may want to consider reading Disarming the Fear Response, which is Chapter 4 of our book The Connected Child and is freely available to download at this link http://www.child.tcu.edu/Book/The%20Connected%20Child%20Chapter%20Four.pdf.
Dr. Lara Honos-Webb, PhD
Psychology Specialist

If your child has symptoms of difficulty concentrating, impulsiveness and hyperactivity, it is likely she or he will be referred for an evaluation. The diagnosis of ADHD can be unreliable. A minimum gold standard evaluation would include:

  • rating forms filled out by both parents and teachers
  • medical exam ruling out vision/hearing other health problems
  • thorough interview ruling out alternative explanations
  • Determination of "clinically significant" impairment in functioning

A child who doesn't get enough sleep would have many of the same symptoms of ADHD. A child who has major stressors such as parents divorcing would also predictably see changes in attention and behavior. If your child is going through puberty - that would also explain changes in attention in behavior!

In addition, it has to be shown that your child has an impairment in functioning. This means that if your kids is getting B's in school and has an average IQ, they are doing quite well and would not be considered to have an impairment in functioning. Sometimes parents think if a child is not getting A's that should be an impairment -- but it is not.

In some cases, I recommend that families and children get 12 sessions of psychotherapy BEFORE getting an evaluation. This allows a therapist to separate the "signal" from the "noise". This means that if poor attention is caused by stress, or lack of sleep or other causes that could be solved, you might prevent your child from getting a miss-diagnosis. After the therapy, the evaluation should be completed by someone other than the therapist.

Remember, many kids have some of the problems of ADHD some of the time. Remember also, that the diagnosis of ADHD is a mental disorder. It is not a trait, a learning style, a temperament. I often conduct evaluations to find that a child or adult has many symptoms of ADHD, but that these symptoms are caused by other factors and do not result in a clinically significant impairment in functioning. It might be helpful to think of ADHD type symptoms as existing on a continuum.

Donna Hill Howes, RN
Family Practitioner

The only way to know that your child has attention deficit hyperactivity disorder (ADHD) is to have him see a medical doctor or other ADHD expert. Some of the primary symptoms of ADHD are pretty obvious. Is your child hyperactive? Does he have trouble paying attention? Does he act impulsively? These are some of the major signs of ADHD. However, ADHD manifests itself in many ways. Some lesser-known symptoms of ADHD include the following:

  • trouble with schoolwork
  • anxiety, especially during school or other activities
  • nightmares, stomachaches, headaches, or other physical maladies
  • behavior problems
  • aggression, mood swings, poor coping skills

Know that boys and girls display different symptoms of ADHD. Girls tend to internalize their problems. That is why some girls with ADHD end up with substance abuse or mental health problems. ADHD is often easier to spot in boys. If you are concerned about your child, don't hesitate to seek help.

Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Another part of the process may include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.

Dr. Michele Borba
Psychology Specialist

Typical behaviors—such as not listening, difficulty settling down and uninterested in paper tasks can easily be confused with true attention deficits but are common with preschoolers. Doctors generally won’t diagnose ADD because most preschoolers can be forgetful, lose their belongings and be easily distracted to some degree and are unable (especially boys) to sustain attention for long periods. So don’t jump to conclusions that your child has a disorder. Pay attention instead to extreme behavior patterns: your child is noticeably more distracted than other kids; constantly in trouble with friends; repeatedly must be asked to listen.

Dr. Heather Wittenberg, PhD
Psychology Specialist

If you're concerned that your child has problems with attention, concentration, or behavior, it's important that he or she is given a complete evaluation by an experienced clinician. I've seen too many children who are "diagnosed" simply because of school problems, or because of a high activity level. There are many possible reasons for these difficulties. Some—but not all—are because of an underlying diagnosis. But many other problems can masquerade as ADHD.

Sometimes, schools suggest a child has ADHD, but instead there may be problems with learning, mood, anxiety, or sensory processing. Even chronic sleep deprivation—often caused by sleep apnea—can cause inattentiveness and hyperactivity. A good clinician will gather information from home and school, as well as from getting to know your child, before determining if there is a diagnosis of some kind. Of course, make sure you allow the clinician to gather health history from your pediatrician as well.

If your child does have ADHD, there are lots of effective treatments and strategies to help. ADHD is thought to be a neurological condition—your child shouldn't be blamed for it. But the whole family can help to help him or her stay "on task", organized, and doing well socially. An experienced child/family therapist can help guide you through the process.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.