HOW IS ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER) DIAGNOSED? CAN MY CHILD’S PEDIATRICIAN MAKE THE DIAGNOSIS, OR SHOULD I SEE SOMEONE ELSE?
Attention deficit hyperactivity disorder isn’t an easy problem to accurately diagnose. As mentioned earlier, it’s not a disease like the flu or measles, but a collection of common symptoms, not all of which are present in all patients and some of which may also be caused by other disorders. Most children are brought in for evaluation because they exhibit several of the telltale signs of ADHD, such as extreme hyperactivity and inattention, and these problems are causing an adverse effect on their lives at home and at school.Parents and teachers are usually the first to suspect ADHD, and pediatricians are typically the first line of diagnosis. However, not all pediatricians are well versed in the disorder, and they may suggest the child be examined by someone with greater expertise, such as a child psychiatrist who specializes in behavior disorders.It must be stressed that an accurate diagnosis of ADHD cannot be made following a simple fifteen-minute meeting with the child and his parents. If your doctor diagnoses ADHD following such a brief interview and recommends no further testing, you should consider seeking a second opinion, preferably by an ADHD specialist.In most cases, the child must first undergo a thorough and extensive physical examination to ensure that his problems are J not the result of other ailments, such as mental or emotional illness, hearing problems, undetected seizures (known as petite mal), food allergies, poor nutrition, or other medical conditions. The initial diagnostic interview should also include taking a full history of the child’s birth, infancy, and subsequent development, as well as the health history of all related family members.Once the child receives a clean bill of health, the next step is to gather as much information about the child and his environment as possible. This usually includes an examination of all report cards, tests, classwork, and academic and psychological testing, as well as extensive interviews with the child’s parents, siblings, pediatrician, teachers, and others who work closely with him. They may be asked to describe the child’s behavior in a variety of situations and fill out a rating scale to indicate how severe and frequent his behaviors seem to be. The ADHD specialist may visit the child’s school or home to further observe him in his own setting.In addition, the child may undergo a battery of psychological, behavioral, and observational tests to determine the degree of his symptoms and rule out common learning disorders. How extensive is his hyperactivity? What makes him “zone ] out,” and how often does he do it? On which tasks does he find it most difficult to concentrate? Is he prone to bursts of anger or aggression? The answers to these and many other questions help doctors rule out other possible causes and confirm an accurate diagnosis of ADHD based on the criteria listed in the DSM IV.*10\173\2*
