Features
Childhood attention-deficit hyperactivity disorder (ADHD) involves problems with inattention, hyperactivity and impulsivity that significantly interfere with academic and social functioning. Symptoms include difficulties sustaining attention, talking excessively, excessive fidgeting and interrupting others. There are three types of ADHD--combined type, predominantly inattentive type and predominantly hyperactivity-impulsivity type. The combined type involves significant impairment in inattention, hyperactivity and impulsivity. The latter two involve either the predominance of inattention or hyperactivity and impulsivity. The disorder must cause impairment in more than one setting such as both home and school and symptoms must have been present before age 7 years, according to the DSM-IV-TR.
The Process
The disorder is usually diagnosed by a clinical psychologist or school psychologist. A pediatrician can also diagnosis a child with ADHD using diagnostic criteria, but the doctor does not generally have the extensive knowledge and training in testing and psychological disorders that are involved in a psychologist's training, according to FamilyDoctor.org.
A clinical psychologist or school psychologist, who is often also called a diagnostician, uses tests, behavioral observation and interviews with parents and teachers to help determine if a child has ADHD. The diagnostician begins with ensuring that a child has had a full health check-up and neurological examination.
The diagnostician then uses several standardized tests and assessment tools to clarify symptoms and rule out other disorders. The various tests generally measure intelligence, academic performance, neuropsychological impairment and social and emotional functioning, according to HelpGuide.com.
Testing
The diagnostician gives an intelligence test to screen for weaknesses in areas such as working memory and cognitive processing speed. These are the areas of intelligence often impaired in children with ADHD.
The diagnostician may then give an academic test to determine if a child is performing at grade level and to compare a child's intelligence with his actual academic performance. If a child is not performing at grade level or at the level expected given his intelligence, this suggests that something is hindering the child's performance. The hindrance could be ADHD symptoms, social and emotional disturbances or a learning disability. Information from the child's teacher, past academic performance and additional testing assist in determining if the ADHD symptoms are the primary cause of the academic performance and intelligence discrepancy.
Neuropsychological tests are used to measure impairments in attention and in the executive functions of the brain. The executive functions occur in the frontal lobes of the brain and are involved in inhibiting and planning behavior and shifting attention, which are often impaired in children with ADHD.
Children may be administered social and emotional functioning tests to rule out the presence of other mental health concerns. These tests can also help determine the level of psychological impairment caused by the child's ADHD symptoms such as difficulties interpreting social cues, poor self-image or behavior problems.
Interviews and Report
The diagnostician also interviews the child, parents and teachers and observes the child's behavior throughout testing. He may also use symptom checklists that the child, parents and teachers may fill out to determine the type and severity of ADHD symptoms.
The diagnostician generally prepares a report that summaries the child's history of symptoms, psychological diagnoses and testing results. This report also provides treatment recommendations.
