How is ADHD assessed/ diagnosed?
Usually a paediatrician or child psychiatrist conducts an initial assessment or diagnosis of ADHD. A psychologist can focus on how the disorder affects behaviour and learning, and what can be done to improve this.
There are various ways to measure ADHD. Psychologists use rating scales, questionnaires and other tests for collecting information from the children themselves, their parents/caregivers and their teachers. Children are observed at home and school.
To assess whether a person has ADHD, we can consider several critical questions:
* Is the behaviour excessive, long-term?
* Do they occur more often than in people the same age?
* Is it a continuous problem and not just a response to a temporary situation?
* Do the behaviours occur in several settings or only in specific places like the playground?
The person’s pattern of behaviour is then compared against a set of criteria and characteristics of the disorder. The universal criteria referred to for diagnosing ADHD is DSM-IV (diagnostic and statistical manual of mental disorders version IV) where there are three sub-types of ADHD.
Caution: As everyone shows some of the behaviours mentioned in the above table at times, the DSM-IV contains very specific guidelines for determining when a patient is indicated with ADHD. Such guidelines include:
* Behaviours appear early in life, before 7 years and continue for at least 6 months.
* Behaviours must be more frequent or severe than in others of the same age group
Above all the behaviour creates a real handicap in at least two areas of the person’s life such as school, home, work or social settings.
Behaviours that are not necessarily ADHD
The following conditions listed do not qualify for diagnosis of ADHD as some of these conditions are either temporary or chronic:
o Attention lapses during absence seizures.
o Underachievement at school due to a learning disability.
o A middle ear infection or grommets that may reduce hearing sensitivity.
o Central Auditory Processing Disorder
o Visual Processing Disorder
o Disruptive or unresponsive behaviors due to childhood depression or anxiety.
o Anxiety, chronic fears and childhood depression can make a child seem overactive, quarrelsome, impulsive, or inattentive.
o Overactive or under active thyroid.
o Undiagnosed diabetes.
o A child who becomes overactive and easily distracted after the death of a family member or friend or after some traumatic loss or fearful experience may be dealing with unresolved grief and/or emotional problems.
o A chronic middle ear infection or mild asthma, often the result of dairy intolerance, can also make a child seem distracted and uncooperative and lead to Learning Difficulties.
o A child who is emotionally unstable and therefore cannot focus due to living with a family member who is physically or emotionally abusive or neglectful.