ADHD Testing Facts
- Testing for ADHD involves a number of screening tools, full history and physical, self-tests, observations, and other neurocognitive evaluations.
- There is no currently accepted blood test or radiologic test for the disorder, though it is probable that there will be in the not too distant future.
Symptoms and Signs of ADHD
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder associated with difficulties with attentiveness, impulsivity, and hyperactivity. There are several subtypes of the disorder that include varying expressions of the symptoms. Attention deficit disorder (ADD) is considered an inattentive predominant subtype. There is a high frequency (>50%) of comorbid psychiatric disorders in children and adults with ADHD, including bipolar disorder, mood disorders, anxiety disorders, and others. The diagnosis and treatment of ADHD is well established and is based on observations and subjective reports by the affected children, parents, teachers, and physicians.
Specific Rating Scales Used to Diagnose ADHD in Children
There are a number of assessments that are completed by physicians, parents, and teachers. No single scale or source should be used to make the diagnosis of ADHD. It requires information from multiple sources. These include the following:
The Vanderbilt Assessment Scale is a tool which reviews symptoms associated with ADHD and other psychiatric diagnoses. This is generally completed by a teacher and a parent. This is primarily used for children in elementary school.
Conners Scale is a symptom rating tool that can be used for children aged 2-18 years and is completed by teachers, parents, and even self-administered by adolescents.
The child behavior checklist is also called the Achenbach Checklist and is completed by parents, teachers, and the child and is a subjective evaluation of behaviors consistent with ADHD.
When to Be Evaluated for ADHD
According to the American Academy of Pediatrics, any school-aged child who has a history of academic or behavioral problems who also has symptoms of inattention, hyperactivity, or impulsivity should be evaluated for ADHD. More specifically, symptoms which may suggest ADHD include being unable to sit still, having poor ability to concentrate, poor listening skills, daydreaming excessively, acting without thinking, and poor school performance. These symptoms can prompt the child's health-care professional to consider the diagnosis of ADHD.
How to Find a Specialist Who Can Diagnose ADHD
All pediatricians are trained to screen for ADHD using readily available screening tools mentioned above. In addition to the screening, there are also developmental specialists, psychiatrists, psychologists, and other behavioral specialists who are trained to evaluate for other learning differences and associated mental-health problems. The pediatrician can refer the child to a specialist if needed.
Screening for ADHD in Adults
Although the hyperactive and impulsive symptoms usually improve as children age, at least one-third of all children with ADHD continue to exhibit some symptoms into adulthood. Often adults can also be diagnosed with ADHD and ADD. That means that there are probably quite a few adults who haven't yet been diagnosed with ADHD who might benefit from evaluation and treatment. The evaluation of adults with ADHD is not as well established as it is in children but has matured over the last 10 years. In general, it involves a complete developmental history, symptom review, objective assessment of intentional deficits, medication review, and evaluation of other mental-health disorders. Some of these tools include the Childhood Symptom Scale, the Wender Utah Rating Scale, the Adult ADHD Rating Scale and Symptom Checklist, and the Connors Adult ADHD Rating Scale. If this initial evaluation is unclear, patients should be referred to a psychiatrist or psychologist for more complete study. There are a number of medical conditions that can mimic ADHD symptoms in adults, including thyroid disease, liver disease, and some drug interactions, each of which is considered when evaluating an adult for ADHD.
ADHD Testing and Diagnosis
Physicians and parents should be aware that schools are federally mandated to perform an appropriate evaluation if a child is suspected of having a disability that impairs academic functioning. This policy was strengthened by regulations implementing the 1997 reauthorization of the Individuals With Disabilities Act (IDEA), which guarantees appropriate services and a free, appropriate public education to children with disabilities from ages 3 to 21.
After an ADHD Diagnosis
If someone is diagnosed with ADHD or ADD, his or her health-care professional will make a recommendation regarding treatment. Typically this involves the use of a medication, such as a stimulant (methylphenidate [Ritalin, Concerta], amphetamine and dextroamphetamine [Adderall], lisdexamfetamine [Vyvanse]) or a nonstimulant (atomoxetine [Strattera]), and often some level of cognitive behavioral therapy as well. A health-care professional will then intermittently evaluate the patient's symptoms using modified (shortened) screening and rating scales and will adjust the therapy accordingly.