Whether or not a child has ADHD can be confusing. That’s because the symptoms of ADHD are behaviors you see in all children occasionally: being distracted, being unable to sit still or wait for their turn, being disorganized and prone to losing things, being impulsive and unable to manage their emotions without outbursts or tantrums.
The difference with ADHD is that these behaviors are so frequent and so intense they are cause problems for the child. If you think your child might have the disorder, or your child’s teacher has expressed concern about how they are functioning in school, you need an expert diagnosis.
An expert diagnosing your child will consider ADHD only if the behaviors associated with the disorder — inattention, hyperactivity and impulsivity — occur:
- More often than is typical for children their age
- Over an extended period of time
- In more than one setting — both at home and at school, for instance
Because the symptoms of ADHD can also be the result of other issues, such as anxiety, depression or trauma, a professional diagnosing your child should carefully rule out other possible reasons for their behavior.
Who can diagnose ADHD?
ADHD can be diagnosed by any doctor or mental health professional, including:
- Primary care doctors
- Clinical psychologists
- Social workers
Most school psychologists are also qualified to diagnose ADHD, but in most cases they’re not authorized by their school districts to do so. Instead, school psychologists will often help identify that a child is showing symptoms of ADHD, determine if their symptoms hinder their school functioning, and make recommendations for needed academic supports. They can also often refer families to an outside mental health professional for the diagnosis.
In most places, only medical doctors — like pediatricians, primary care doctors and psychiatrists — can prescribe medication to treat ADHD. (Some states allow psychologists to prescribe, and nurse practitioners and physician’s assistants often can, as well.)
The overwhelming majority of ADHD diagnoses are made by pediatricians, though parents should keep in mind that many pediatricians don’t have advanced training in psychiatric disorders.
An ADHD diagnosis should not be made in a quick office visit, based solely on a report that a child is having trouble concentrating in school. There is a risk of misdiagnosis if the doctor doesn’t take the time to rule out other possible causes for the child’s behavior. And giving a child ADHD medication won’t help if they don’t have ADHD.
If you think your child may have been misdiagnosed, you can ask for a referral to a psychiatrist or another mental health professional who has expertise in kids with ADHD.
Is there a test for ADHD? How is it diagnosed?
There is no blood test or scan that tells whether a child has ADHD. The clinician diagnosing ADHD relies on information about the child’s behavior, including:
- Reports from parents and other adults who are very familiar with the child’s behavior
- Tools that measure the frequency of certain behaviors or a child’s ability to perform tasks
To make an accurate ADHD diagnosis, a clinician should collect information from several people who have observed your child, including parents, other caregivers and teachers.
Parents and teachers should be asked to fill out a rating scale to measure the frequency of the child’s symptoms over a period of time. Common rating scales include the SNAP, the Child Behavior Checklist, and Connor’s Checklist. A child may be given a test called a Continuous Performance Test, which rates their ability to complete a repetitive task over a period of time.
A child should not be diagnosed with ADHD just based on a parent’s or teacher’s report that they are overly active or distracted.
How old does a child have to be to be diagnosed with ADHD?
It’s not unusual for parents to notice that a child is unusually active in the toddler years — they describe kids as running around nonstop or “bouncing off the walls.” But because there is a wide range of normal toddler behavior, it’s hard to distinguish ADHD before about age four.
ADHD usually isn’t diagnosed until kids are in elementary school. That’s when it often becomes noticeable that their ADHD symptoms make it hard for them to settle down, concentrate, follow directions, wait their turn, etc.
Sometimes children who are younger than most of their classmates get diagnosed with ADHD when they’re really just less mature, so it’s especially important for those kids to get a careful evaluation if they’re showing possible symptoms.