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ADHD
— Making the Diagnosis
Your doctor
will determine whether your child has
Attention-Deficit/Hyperactivity Disorder (ADHD) using
standard guidelines developed by the American Academy
of Pediatrics. These diagnosis guidelines are for
children 6 to 12 years of age.
It is difficult to diagnose ADHD in children 5
years of age and younger. This is because many
preschool children have some ADHD symptoms in various
situations. In addition, children change very rapidly
during the preschool years. It is also difficult to
diagnose ADHD once a child becomes a teenager.
There is no single test for ADHD. The process
requires several steps and involves gathering a lot of
information from multiple sources. You, your child,
your child's school, and other caregivers should be
involved in assessing your child's behavior.
Children with ADHD show signs of inattention,
hyperactivity, and/or impulsivity in specific ways.
Your doctor
will look at how your child's behavior compares to
that of other children his own age, based on the
information reported about your child.
To confirm a diagnosis of ADHD these behaviors
must:
- Occur in more than one setting, such as home,
school and social situations.
- Be more severe than in other children the same
age.
- Start before the child reaches 7 years of age.
(However, these may not be recognized as ADHD
symptoms until a child is older.)
- Continue for more than six months.
- Make it difficult to function at school, at
home, and/or in social situations.
In addition to looking at your child's behavior, your doctor
will do a physical examination. A full medical history
will be needed to put your child's behavior in context
and screen for other conditions that may affect your
child's behavior. Your doctor
also will talk to your child about how he acts and
feels.
Your doctor
may refer your child to a specialist if there are
concerns in one of the following areas:
- Mental retardation
- Developmental disorder, such as speech problems,
motor problems or a learning disability
- Chronic illness being treated with a medication
that may interfere with learning
- Trouble seeing and/or hearing
- History of abuse
- Major anxiety or major depression
- Severe aggression
- Possible seizure disorder
As a parent, you will provide crucial information
about your child's behavior and how it affects her
life at home, in school and in other social settings.
Your doctor
will want to know what symptoms your child is showing,
how long the symptoms have occurred, and how the
behavior affects your child and your family. You may
need to fill in checklists or rating scales about your
child's behavior.
In addition, sharing your family history can offer
important clues about your child's condition.
For an accurate diagnosis, your doctor
will need to get information about your child directly
from your child's classroom teacher or another school
professional. Children 6 to 12 years of age spend many
of their waking hours at school. Teachers provide
valuable insights. Your child's teacher may write a
report or discuss the following with your doctor:
- Your child's behavior in the classroom
- Your child's learning patterns
- How long the symptoms have been a problem
- How the symptoms are affecting your child's
progress at school
- Ways the classroom program is being adapted to
help your child
- Whether other conditions may be affecting the
symptoms
In addition, your doctor
may want to see report cards and samples of your
child's schoolwork.
Other caregivers also may provide important
information about your child's behavior. Former
teachers, religious leaders or coaches may have
valuable input. If your child is homeschooled, it is
especially important to assess his behavior in
settings outside of home.
Your child probably does not behave the same way at
home as he does in other settings. Direct information
about the way your child acts in more than one setting
is required. It is important to consider other
possible causes of your child's symptoms in these
settings.
In some cases, other mental health care
professionals also may be involved in gathering
information for the diagnosis.
You may have heard theories about other tests for
ADHD. There are no other proven tests for ADHD at this
time. Many theories have been presented. But studies
have shown that the following tests have little value
in diagnosing an individual child:
- Screening for high lead levels in the blood
- Screening for thyroid problems
- Computerized continuous performance tests
- Brain imaging studies such as CAT scans, MRI's,
etc
- Electroencephalogram (EEG) or brain-wave test
While these tests are not helpful in diagnosing ADHD,
your doctor
may see other signs or symptoms in your child that
warrant blood tests, brain imaging studies or an EEG.
©2001 American Academy of Pediatrics
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