By Regina Bussing, MD

Health professionals who suspect ADHD hunt for the presence of a spectrum of characteristic behaviors and base their assessments on a battery of exams. They compare the results to the criteria set forth by the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These behaviors must be considered excessive and inappropriate for the child’s age.

These assessments can be time-consuming and costly, but they help rule out other disorders and highlight the presence of any conditions that might occur simultaneously. Doctors choose which types of examinations to conduct based on the types of problems found in an initial evaluation. Some children may not need full psychological IQ or achievement testing, while others may benefit from it. Likewise, brain scans or electroencephalograms (EEGs)—a recording of the brain’s activity—may help pinpoint the proper diagnosis in some patients.

Assessments may include:

• vision, hearing and speech tests
• a medical examination that includes a neurological evaluation
• a developmental history that evaluates a child’s motor skills, cognitive abilities and social behavior
• a thorough family history of psychiatric, medical, learning or developmental problems
• comprehensive interviews with parents, teachers and the children themselves to assess academic performance and behavior patterns. Report cards or achievement test scores can be valuable tools as pieces of the diagnostic puzzle are put together
• intelligence testing
• standardized behavioral rating scales such as the Child Behavior Checklist Scale (Achenbach and Edelbrook) and the Connors Rating Scale
• a discussion of current strategies to address problems

Practitioners also may ask these and other questions:

• What problems, if any, occurred during pregnancy? Did the mother or baby contract any infections? What about medication use? ...