How Pediatricians Make an ADHD Diagnosis

New guidelines for pediatricians aim to curb the rampant increase in ADHD misdiagnoses for children.

Diagnosing attention deficit disorder (ADD ADHD) is an inexact science not because it's unsupported, but because of who is doing the diagnosing.

Many children with ADD ADHD are diagnosed and treated by pediatricians and may never see a psychiatrist specially trained to understand the disorder. Surveys of pediatricians have shown wide variations in the criteria they use to establish the diagnosis, as well as their methods for treating ADHD.

The American Academy of Pediatrics has taken the first step in addressing this problem. The doctors' group has issued new guidelines to help pediatricians better diagnose ADHD. These guidelines address public concerns about rampant misdiagnosis. Between 4 and 12 percent of schoolchildren are believed to have ADHD; many who have it never get diagnosed, while others without it may be diagnosed and treated inappropriately.

The new guidelines, designed to help assess ADHD in children age 6 to 12, include the following components:

• ADHD evaluations should be initiated by the primary care clinician (such as a pediatrician) for children who show signs of school difficulties, academic underachievement, troublesome relationships, and behavior problems.
• To make the diagnosis, doctors should rely on guidelines established by the American Psychiatric Association. These guidelines require that the child's symptoms be present in two or more environments, and that the child's ability to function academically and socially must have been impaired for at least six months.
• Children with suspected ADHD should be screened for co-existing conditions such as learning and language problems, aggression, disruptive behavior, depression or anxiety. As many as a third of ADHD children also have co-existing conditions.

The group is in the process of developing comprehensive treatment guidelines for primary care physicians.

More information is available from the American Academy of Pediatrics website in the article Clinical Practice Guideline: Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder . You may access the full text and reprint (PDF) versions of this article from the AAP for 30 days from the computer you are currently using for US$5.00 for certain uses. For US$20.00 you may access (from the computer you are currently using) all content on the AAP for 30 days. Note: This link will open a new browser window. Close the new window to return to ADDitudemag.com.