How ADHD Is Diagnosed

The Full Library of Tests and Assessments for ADHD and Common Related Conditions

What ADHD tests help doctors diagnose attention deficit disorder? Diagnosing ADHD is a nuanced and time-intensive process, if done right. It takes patience and many different tools, including these 5 types of assessments administered by practitioners ranging from psychologists to occupational therapists to pediatricians.

A doctor filling out a questionnaire for a patient
Doctor consulting parent and child

Medically Reviewed by William Dodson, M.D., a member of ADDitude’s ADHD Medical Review Panel

How Do Doctors Test for ADHD and Related Disorders?

Unlike diabetes or anemia, attention deficit hyperactivity disorder (ADHD or ADD) can’t be detected with a blood test or scan. “Like other psychiatric diagnoses, the boundaries of ADHD are unclear, so clinician judgment plays a big role,” says Joel Nigg, Ph.D., a professor of psychiatry, pediatrics, and behavioral neuroscience at Oregon Health & Science University.

Most children and adults begin by taking an online test of common ADHD symptoms and then taking the results to an ADHD specialist for review and evaluation. ADDitude offers the following ADHD tests for children and adults:

ADHD Symptom Tests for Children

ADHD Symptom Tests for Adults

Any good ADHD evaluation will begin by critically analyzing not just the results of these tests, but also many aspects of the patient’s daily life, such as learning, memory, cognitive functioning, executive functioning, reasoning, social functioning, verbal and non-verbal communication.

ADHD is a highly comorbid condition and many other non-ADHD conditions can co-exist with ADHD.  These other conditions  are screened for in the initial evaluation.  Then, if there is a high index of suspicion that other conditions are co-existent, one or more of the assessments listed below can be used to explore that co-existing condition further.

Below is a description of 5 types of evaluations for children who exhibit signs of ADHD and related conditions, including learning disabilities.

1. Evaluation for ADHD in Children

A well-rounded evaluation for ADHD  involves several pieces:

  • DSM-VThe physcian will determine if the patient meets the DSM-V criteria for ADHD.
  • Clinical interview: The provider will have an extensive discussion about symptoms to determin their root causes. A good clinical interview will take two to three hours.
  • Normed rating scales: Patients and loved ones including parents, teachers, and family members fill out questionnaires that evaluate symptoms in different settings. Common rating scales include the Conner’s Parent and Teacher Rating Scales as well as Barkley Home and School Situations Questionnaires.
  • Physical exam: Sometimes ADHD-like symptoms can be caused by a medical problem, like a thyroid condition. They physical exam rules out these problems, and evaluates if a person can safely take ADHD medication.

Many children with ADHD have learning problems. Neuropsychological testing is not required for an ADHD diagnosis but may be appropriate in cases where learning disabilities are suspected (see below)1. There are various reading, writing, and math evaluations that schools can administer to find strong and weak points.

[Free Download: What Every Thorough ADHD Diagnosis Should Include]

2. Educational Evaluations in Children

Up to 45 percent of children with ADHD also have one or more learning disabilities2. It’s important to have your child evaluated in any academic areas where he or she is struggling or performing below grade level. A clinical psychologist, educational psychologist, or special education professional may perform the educational assessment, either through the school or via private evaluation.

Educational evaluations vary widely for each student, depending on how many areas require assessment. This type of evaluation includes mostly written tests with some clinical observations.

Tests used to evaluate educational functioning and the potential for learning disabilities include:

*Note: An IQ test may or may not be part of educational testing. It isn’t always required.

The Time Required

It can take 1 to 4 hours or more, depending on the clinician and breadth of assessments. If multiple areas are being tested, the clinician will often break up testing into several separate sessions.

The Outcome

When testing is complete, the evaluator will score the assessments, analyze the information gathered, and write a report. The report should include:

  • A summary of parent and/or teacher concerns
  • The results for each test administered, including the subsection scoring (where applicable)
  • Diagnoses, if any
  • Specific teaching approaches, skill development, special services, and accommodations that will help the student achieve academic success

[Free Guide: How to Prepare for Your ADHD Evaluation]

3. Occupational Therapy Evaluation for Children

Occupational therapy evaluations take an in-depth look at aspects of functioning such as sensory processing, motor coordination, balance, emotional awareness, self-regulation, planning and organization, handwriting, and daily life skills (like tying shoes). An occupational therapy evaluation can provide a great deal of insight into struggles and weaknesses in these areas, as well as treatment of identified difficulties.

An occupational therapy evaluation begins with an inventory of the patient’s history including his or her background and developmental information, a caregiver interview, and clinical assessments and observations.

The Time Required

Plan on devoting at least 2 hours to the occupational therapy evaluation. The actual time required for this assessment will depend on the practitioner and the number of areas he or she needs to evaluate.

The Outcome

When the evaluation is complete, the occupational therapist will score the assessments, analyze the information gathered, and write a report. The report should include:

  • A summary of the information gathered about the patient
  • Clinical impressions regarding level of functioning and areas of weakness
  • Proposed treatment goals and treatment plan

4. Speech-Language Evaluation

Many children with ADHD also have speech-language delays and/or disorders. If your child isn’t developing language and communication skills as developmental milestones dictate, a speech-language evaluation may be necessary. Your child’s school may offer this, or you may have to pursue this evaluation privately. You may be referred for an evaluation by your child’s doctor or therapist, or you may request it yourself.

A speech-language evaluation is performed by a speech-language pathologist, or SLP, who has a master’s level education in the field. The evaluation will begin by gathering patient background and developmental information, conducting a caregiver interview, and performing clinical assessments and observations. The full evaluation typically takes 2 to 4 hours, depending on the clinician and the number of areas being assessed.

Potential areas of evaluation include:

  • Oral motor assessment, including feeding and swallowing
  • Articulation
  • Expressive language
  • Receptive language
  • Speech production and fluency
  • Auditory skills
  • Understanding of grammar and syntax
  • Word retrieval
  • Understanding instructions, especially as they increase in length and difficulty
  • Social language

The Outcome

When the evaluation is complete, the SLP will score the assessments, analyze the information gathered, and write a report. The report should include:

  • A summary of the information gathered about the child’s background and development
  • Clinical impressions of oral motor, communication, and processing functioning
  • Proposed treatment goals and a treatment plan to develop skills for more effective communication and language skills

5. Autism Spectrum Disorder (ASD) Evaluations

The latest Diagnostic and Statistical Manual of Mental Disorders (DSM-V) allows that an individual may be diagnosed with both ADHD and autism spectrum disorder (ASD), which was not previously true. Studies show that 30 to 50 percent of individuals with autism show symptoms of ADHD, and estimates suggest that up to 60 percent of individuals with ADHD show features of autism3. That is a significant overlap, to say the least. A developmental pediatrician, neurologist, psychiatrist, or psychologist can perform an evaluation for autism. Whomever you choose, be sure that the clinician has experience specifically with autism.

The Tests

The evaluation for ASD begins by detailing a patient’s history and developmental information, conducting a caregiver interview, and conducting clinical assessments and observations.

Possible assessment tests include:

The Time Required

The time required to conduct an ASD evaluation may vary significantly. If symptoms are overt, a diagnosis could result from an hour-long meeting with the clinician, or a very comprehensive evaluation could take multiple meetings — each one lasting several hours.

The Outcome

Once the evaluation is complete, the clinician who performed the assessment will deliver a report containing the information gathered on the patient’s history and development, assessment results and scores, the clinician’s findings (a diagnosis of ASD or not), and recommendations for support.

[Everything You Need to Know About ADHD]

Sources

1Pliszka, Steven. “Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder.” Journal of the American Academy of Child & Adolescent Psychiatry, Volume 46, number 7, 2007, pp. 894-921. doi: 10.1097/chi.0b013e318054e724.
2DuPaul, George. “Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment.” Journal of Learning Disabilities, Volume 46, number 1, 2013, pp.43-51. Jan-Feb 2013. doi: 10.1177/0022219412464351
3Leitner, Yael. “The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children – What Do We Know?.” Frontiers in Human Neuroscience, Volume 8, 2014, pp.268. 2014. doi: 10.3389/fnhum.2014.00268

Updated on July 15, 2019

3 Related Links

    1. Agree about the Children’s Memory Scale. Also consider the CHAMP (Child and Adolescent Memory Profile), although recognition memory only – not recall. Also consider using the TEA-Ch 2 (Test of Everyday Attention for Children – 2nd Edition), which examines the differences between sustained and selective attention, switching attention and dual task attention. This generates useful information for teachers and parents and children themselves on where their vulnerabilities are and is useful for recommendations for support.

      Amanda Owen, Developmental Neuropsychologist

  1. Disappointed that you include examples of standardized tests and lists of what kinds of observations are made by every profession except OT. You make it sound like OTs are unprofessional, only asking questions and making observations. Here is a partial list of tests OTs use:
    Bruininks-Oseretsky Test of Motor Proficiency
    Peabody Developmental Motor Scales
    Beery-Buktenica Developmental Test of Visual-Motor Integration
    Sensory Processing Measure
    The Sensory Profile
    Sensory Integration and Praxis Tests (SIPT)
    Motor-Free Visual Perception Test
    Evaluation of Childrens Handwriting (ETCH)
    along with clinical observations, parent/teacher interviews, etc

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