From the Guidelines
The diagnosis of ADHD should be made by a primary care clinician, who should determine that Diagnostic and Statistical Manual of Mental Disorders criteria have been met, including documentation of impairment in more than 1 major setting, and rule out any alternative cause 1. The primary care clinician should initiate an evaluation for ADHD for any child 4 through 18 years of age who presents with academic or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity. Key aspects of the diagnostic process include:
- Obtaining information primarily from reports from parents or guardians, teachers, and other school and mental health clinicians involved in the child’s care
- Assessing for other conditions that might coexist with ADHD, including emotional or behavioral, developmental, and physical conditions
- Recognizing ADHD as a chronic condition and considering children and adolescents with ADHD as children and youth with special health care needs. The primary care clinician may also refer patients to specialists, such as pediatricians, child psychiatrists, or psychologists, for further evaluation and treatment. A thorough assessment is crucial to guide appropriate treatment, which may include medication, behavioral therapy, educational interventions, or a combination of approaches, and to improve the patient's quality of life and reduce morbidity and mortality associated with untreated ADHD 1.
From the Research
Diagnosis of ADHD
- The diagnosis of ADHD is typically made by a healthcare professional, such as a pediatrician, psychologist, or psychiatrist, using a combination of clinical evaluation, behavioral observations, and rating scales 2, 3, 4.
- Rating scales, such as the Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) and the Conners Adult ADHD Rating Scales (CAARS), are commonly used to assess ADHD symptoms and diagnose the condition 3, 5, 4, 6.
- These rating scales are designed to evaluate symptoms of inattention, hyperactivity, and impulsivity, as well as other behavioral problems, such as oppositional defiant disorder (ODD) and anxiety/depression 3, 4, 6.
- The VADPRS, in particular, has been shown to have good psychometric properties, including internal consistency, test-retest reliability, and criterion validity, making it a useful tool for diagnosing ADHD in children 4, 6.
- The CAARS, on the other hand, has been found to have some limitations, including questions about its construct validity and the need for further research on its use in adults with ADHD 5.