How is ADHD Diagnosed?

Attention Deficit and Hyperactivity Disorder (ADHD) is a complex condition, and diagnosing ADHD can be difficult. However, the process of evaluating children or adults suspected of having ADHD is fairly straightforward.

As an ADHD psychologist, the process I use to evaluate children for ADHD is a typical one:

Preparation

Before I can evaluate children for ADHD, I need some information. I send packets of questionnaires to parents and teachers. The packets include rating scales for assessing behaviors that are associated with ADHD as well as behaviors that are similar to ADHD but part of other conditions.

I also collect and review records, such as report cards, medical records, individual educational plans, standardized academic test results and psychological testing data.

Parent Interviews

Interviewing parents is an indispensible step in evaluating children and teenagers for ADHD. During these interviews, I gather information about children’s symptoms; parents’ concerns about them; school, family and treatment histories; children’s peer and social relationships and problems in family functioning.

I find out which strategies have been attempted to help children at home and at school, which forms the basis for creating future interventions to help minimize the impact of ADHD.

Interviews with Children

I typically spend two to three sessions meeting with children using a standard interview format to assess the following:

• Do the children understand why they are being evaluated?
• What are their perspectives regarding their functioning at school?
• How do the children think about their peer relationships? Family relationships? Relationships with teachers and other significant people in their lives?
• How do they behave in my office? Children are often well behaved in formal settings, so an ADHD psychologist must guard against drawing diagnostic conclusions during such meetings. However, children’s behavior during an evaluation provides important clues to their functioning in other settings.
• Can an alliance be established and cooperation ensured so that further work will be productive?

Teacher Interviews

Meetings with teachers are essential in order to further clarify children’s problems.

Interviews with teachers focus on the specific nature of children’s problems at school. I am especially interested in knowing what teachers have done in the past to help children with problematic behaviors, which of those interventions have worked and which haven’t.

Since many children with ADHD have associated learning difficulties, the teachers’ assessment of those difficulties and how they are being managed in the school environment helps place an ADHD diagnosis in the context of learning styles and how they can best be handled at school.

Psychological Testing

Psychological testing helps me address the three fundamental questions that are essential for all evaluations of ADHD:

• Is the diagnosis of ADHD justified?
• If the diagnosis of ADHD is not justified, what other explanations can account for the problematic behaviors?
• If the ADHD diagnosis is justified, are there associated conditions that should be identified and treated?

Psychological testing usually involves looking at children’s current achievements in school, potential for achievement, general psychological functioning and neuropsychological functioning, along with observational measures assessing their behavior in the office setting and sometimes at school and at home.

A Comprehensive ADHD Evaluation

As an ADHD psychologist, I put together all relevant information about children into comprehensive, integrated evaluations that speak clearly and thoroughly to the question of whether they have ADHD.

The assessment process takes time and requires the cooperation of many people, but the advantages of an inclusive evaluation are many, not the least of which is knowing that the diagnosis of ADHD, should that result, is accurate. That itself is an invaluable aid in helping children who struggle with challenging behavior.

Dr. Kenneth Roberson is an ADHD psychologist in San Francisco with over 20 years of experience. To schedule a free initial consultation, please call 415-922-1122.