ADHD is diagnosed using standard guidelines. The DSM-5 diagnostic guidelines are available specifically for children between 4-18 years of age. I generally withhold the diagnosis of ADHD in children younger than 4 years of age. It is often difficult to assess attention span in a child younger than 4 years of age. And intervention is rarely necessarily at this age.
There is no single test available for the diagnosis of ADHD. The diagnostic process requires collection of information from several different sources. I want to see if the child has similar spectrum of symptoms in different situations and locations. It is also important to ascertain whether the severity of symptoms are severe enough to impact his life. The impact on life may occur because of poor academic performance, inability to make friends or if it is impacting quality of life in any other way.
Children’s with ADHD have 3 clusters of symptoms that include inattention, hyperactivity and/or impulsivity. It is important for us to look at the child’s behavior individually and compare to that of other children of similar age. It is also essential that information is provided by primary caregiver as well as other individuals who spend significant time with the child such as teachers, daycare workers, or his/her coaches.
ADHD Diagnostic Symptoms:
Symptoms of Inattention:
- Easily distracted and avoids any task that require sustained attention
- Forgetful and needs constant reminder and redirection
- Loses and misplaces both normal belongings such as gloves or pencils
- Does not seem to respond when spoken directly
- Often fails to pay attention to details and makes careless mistakes
Symptoms of hyperactivity & impulsivity:
- Often fidgets and squirms often on the go and appears to be driven like to motor
- Cannot participate in leisure activities quietly
- Talks excessively
- Cannot wait for his/her turn
- Blurts out answers before question is completed
- Interrupts and intrudes on others
ADHD Diagnostic Criteria:
In order for us to make a diagnosis confidently following criteria must be met:
- The symptoms must occur in 2 or most settings such as home school daycare or other social situations and must be causing some impairment.
- Children ranging between 4-17 years of age should have at least 6 or more symptoms while children 17 years and older must have 5 or more symptoms to qualify for the diagnosis of ADHD.
- Symptoms must have started before the child reaches that 12 years of age however these symptoms may have not been recognized until the child is older.
- Symptoms should have continued for more than 6 months and must impair the child’s ability to function at home or school. It may affect schoolwork or relationship with friends or siblings.
- In addition to looking at your child’s behavior, I do a physical and a thorough neurologic examination. A detailed medical history is necessary to understand the child’s behavior and rule out medical conditions that may affect his/her behavior.
I also like to screen children additionally for anxiety, depression, learning disorder, developmental coordination disorder, aggression, sleep problems etc.
MD, FRCPC, FAAP, Consultant Pediatrician