How to Diagnose and Treat ADHD in Children

A parent's guide to ADHD in children: recognizing symptoms, finding a doctor, evaluating medications, and helping your child thrive.

The ADHD Road Map, Part 2

How is ADHD diagnosed?

To diagnose a child with ADHD, a doctor must complete several different assessments:

  • Behavioral history. Your initial meeting with the doctor (pediatrician or specialist) should focus on your child's behavioral symptoms. Leave your child at home, and bring along written or verbal descriptions of your child's behavior from current or former teachers, as well as copies of any psychological test results you might have.

You'll be asked where and when your child's symptoms occur and when you first noticed them. In addition, the doctor may ask you (and your child's teachers) to complete the Conners' Rating Scale, a questionnaire that helps determine the nature and severity of your child's symptoms. And don't be surprised if the doctor asks about family or marital stresses that could be making your child anxious.

  • Medical history and exam. If your answers convince the doctor that your child's symptoms are chronic and pervasive, he or she will probably take a detailed medical history of your child. The goal here is to rule out anxiety, depression, sleep problems, seizure disorders, vision or hearing problems, and other medical conditions that can mimic ADHD. Certain medications can also cause symptoms of hyperactivity or distractibility in some children.Some of this history may be taken in the initial parent-doctor interview, but the doctor will also schedule an appointment to examine your child.
  • Review of records. The doctor should review relevant school reports and medical records. (If you didn't bring copies of the records to your initial appointment, call the school and have them sent to your doctor.) The doctor will want to have at least one phone conversation with your child's teacher(s) or school psychologist.

Awaiting the diagnosis

At this point, you want the answer to one big question: "Does my child have ADHD?" But don't expect an answer overnight. The diagnostic process typically takes a week or two.

As you await the diagnosis, inform your child's teachers and any other school officials that your child is being evaluated for ADHD. Ask for a meeting with the school psychologist or special education teacher to discuss having your child evaluated for learning disabilities (which affect 30 to 50 percent of ADHD kids).

If your school is unable or unwilling to administer the appropriate testing, you may have it done by a private educational psychologist - typically at a cost of several hundred dollars.

"I always tell parents to work both the medical and the school tracks in parallel," says Barkley. "If you wait to do one after the other, you're stalling."

The treatment plan

A month or so into your journey, your child's diagnosis should be complete. Now, you, your child, and your doctor are ready for the treatment phase.

If your child has been evaluated by a specialist, he or she will likely take the lead in formulating a treatment plan (which should be communicated to your pediatrician and other caregivers). If your child was evaluated by a psychologist, he or she will probably need to confer with your pediatrician about starting your child on one of the many ADHD medications available.

Studies show that ADHD medications are generally safe and effective for about 80 percent of the children who take them. Many experts feel that treatment with medication is essential: "If your child had a cavity, wouldn't you treat it?" asks Joseph Biederman, M.D., head of pediatric psychopharmacology at Massachusetts General Hospital in Boston. "Medication management represents the most important component of the treatment of ADHD."

Dr. Silver agrees. "Sometimes medication is all it takes to solve the problem," he says. "Even if it isn't, it's important to evaluate how the child is doing on medication before you start dealing with other psychosocial issues."

This article appears in the Winter issue of ADDitude.
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