The Full Library of ADHD Tests and Assessments for Related Conditions
What medical ADHD tests help doctors diagnose symptoms of attention deficit hyperactivity disorder? Diagnosing ADHD is a nuanced and time-intensive process, when 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.
ADHD Tests: Symptom Assessments for Diagnosis
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.
Many 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 Test for Children
- Inattentive ADHD Symptom Test for Children
- Hyperactive Impulsive ADHD Symptom Test for Children
- ADHD Symptom Test for Girls
- More Symptom Tests for Children
ADHD Symptom Tests for Adults
- ADHD Test for Adults
- Inattentive ADHD Symptom Test for Adults
- Hyperactive Impulsive ADHD Symptom Test for Children
- ADHD Symptom Test for Women
- More Symptom Tests for Adults
A proper ADHD evaluation begins with a critical analysis not just the results of these ADHD tests, but also other aspects of the patient’s daily life, such as learning, memory, cognitive functioning, executive functioning, reasoning, social functioning, verbal and non-verbal communication.
ADHD comorbidity must be taken into account. There are many non-ADHD conditions that frequently co-exist with ADHD — for example, learning disabilities, sensory processing disorder, speech/language delays, and autism spectrum disorder. The initial evaluation usually includes screening for these comorbid conditions. 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
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the key symptoms of ADHD and explains criteria for a diagnosis. Your child’s physician uses the following assessments to determine if a child meets these criteria.
- Clinical interview: The provider completes an extensive discussion with both the child and parents or guardians about family and developmental history and current symptoms or concerns. During the interview, parents might be asked about specific symptoms, when they first noticed them, and whether they occur in more than one setting, such as at home and at school. They might also be asked to describe steps they have taken to correct symptoms and behaviors and how those strategies worked. A good clinical interview takes two to three hours.
- Normed rating scales: Patients and caregivers, including parents, teachers, and family members, fill out questionnaires to evaluate symptoms in different settings. Common rating scales include the Conners Comprehensive Behavior Rating Scales as well as Barkley Home and School Situations questionnaires.
- Physical exam: Sometimes ADHD-like symptoms are caused by a medical problem, such as a thyroid condition. A thorough physical exam, which can include laboratory tests, is used to rule out these conditions and evaluate whether a person can safely take ADHD medication. During the physical exam, the provider notes temperament, mental status and behaviors. Your doctor might ask to observe your child in a play session to observe potential concerning behaviors.
- Emotional assessment: Some emotional disorders, such as depression, generalized anxiety disorder, obsessive compulsive disorder (OCD), or oppositional defiant disorder (ODD), often accompany ADHD. When a child shows signs of one of these conditions, an emotional assessment, completed by a mental health professional may be required. ADHD treatment can be hampered when there are untreated emotional issues. For example, a child with depression may not respond well to treatment until the symptoms of depression have been addressed.
Many children with ADHD have learning problems. Neuropsychological testing is not required for an ADHD diagnosis but might 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 areas.
[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 disability2. 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 can perform the educational assessment, either through the school or a 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. Children are not usually subjected to all of the following assessments. The professional chooses which tests are appropriate based on the child’s specific difficulties.
Tests used to evaluate educational functioning and the potential for learning disabilities include:
- Weschler Individual Achievement Test for overall academic strengths and weaknesses
- Woodcock-Johnson Test of Achievement (WJ-IV) for a wide variety of cognitive skills
- Predictive Assessment of Reading (PAR) for predicting a child’s future reading skills
- Dynamic Indicators of Basic Early Literacy Skills (DIBELS) for assessing the learning of early literacy skills K-6th grade
- Scholastic Reading Inventory (SRI) to assess how well students read at different levels
- Woodcock Reading Mastery Test (WRMT III) for assessing reading readiness and achievement
- Gray Oral Reading Test (GORT-5) for oral reading fluency and comprehension
- Comprehensive Test of Phonological Processing for reading and phonological processing
- Rapid Automatized Naming Tasks for predicting future reading skills
- Dr. Brian Butterworth’s Dyscalculia Screener for the math disability known as dyscalculia
- Neuropsychological Test Battery for Number Processing and Calculation in Children (NUCALC) for assessing how a child’s brain makes sense of math
- Key Math-3 Diagnostic Assessment for assessing and determining strategies for improving math skills
- Test of Mathematical Abilities (TOMA 3) for identifying, describing, and quantifying mathematical deficits in school age children
- Detailed Assessment of Speed of Handwriting (DASH) for identifying children with handwriting difficulties and determining appropriate interventions
- Test of Handwriting Skills, Revised (THS-R) for assessing neurosensory integration skills in handwriting
- Rey-Osterrieth Complex Figure Drawing for spatial perception and visual memory
- Beery-Buktenica Developmental Test of Visual Motor Integration for identifying visual-motor deficits that can lead to learning, neuropsychological, and behavior problems
- Children’s Memory Scale for comparing memory and learning to ability and achievement to identify learning disabilities and attention deficit
- NEPSY Developmental Neuropsychological Assessment–II for executive function and attention, language, memory and learning, visuospatial processing, sensorimotor, and social perception
- Peabody Picture Vocabulary Test–IV for vocabulary assessment
- Test of Written Language, Fourth Edition (TOWL-4) for comprehensively assessing written language
- Kaufman Test of Educational Achievement, Third Edition (KTEA-III) for key academic skills
- Oral and Written Language Scales (OWLS) for a global approach to assessing language difficulties
*Note: IQ tests are not always included in assessments for ADHD and learning disabilities because these conditions are not a result of intellectual ability but are a result of brain functioning or processing.
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 could choose to break up testing into several separate sessions.
When testing is complete, the evaluator scores the assessments, analyzes the information gathered, and writes 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 can 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 identify treatment strategies.
An occupational therapy evaluation includes an inventory of the patient’s history — 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 for the occupational therapy evaluation. The actual time required for this assessment depends on the practitioner and the number of areas he or she needs to evaluate.
When the evaluation is complete, the occupational therapist scores the assessments, analyzes the information gathered, and writes 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. These are different than language learning disabilities, though some symptoms can be similar. If your child is significantly behind in developing language and communication skills when compared to developmental milestones, a speech-language evaluation might be necessary. Some schools complete this type of evaluation, if not, you might need to pursue this evaluation privately. Your child’s doctor or therapist might refer you to a specialist for further evaluation and assessment, or, if you have concerns, you can 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 begins 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
- 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
When the evaluation is complete, the SLP scores the assessments, analyzes the information gathered, and writes 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-5) allows for an individual to 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 also have symptoms of ADHD, and estimates suggest that up to 60 percent of individuals with ADHD have 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 in children.
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:
- Screening Tool for Autism in Toddlers and Young Children (STAT) for interactively screening kids 24 to 36 months old for autism
- Modified Checklist for Autism in Toddlers (M-CHAT) for assessing children 16 to 30 months of age for autism through parent reporting
- Ages and Stages Questionnaires (ASQ) for assessing developmental progress in children between the ages of one month and 5 ½ years
- Autism Diagnostic Observation Schedule (ADOS) for assessing communication, social interaction, and play in children suspected of having autism
- Social Communication Questionnaire (SCQ) for screening for autism and social communication disorder
- Autism Diagnostic Interview-Revised (ADI-R) for assessing children and adults for autism through caregiver interview and standardized scoring
- Childhood Autism Rating Scale (CARS) for diagnosing and identifying autism symptom severity for children over the age of 2
- Pervasive Developmental Disorders Screening Test—Stage 3 for screening children as young as 18 months for autism spectrum disorders
- Gilliam Autism Rating Scale for identifying the probability and severity of autism
The Time Required
The time required to conduct an ASD evaluation can 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.
Once the evaluation is complete, the clinician who performed the assessment provides 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]
The Clinicians’ Guide to Differential Diagnosis of ADHD from Medscape and ADDitude
- How can I better understand ADHD, its causes, and its manifestations?
- What do I need to understand about ADHD that is not fully represented in the DSM?
- How can I avoid the barriers and biases that impair ADHD diagnosis for underserved populations?
- How can I best consider psychiatric comorbidities when evaluating a patient for ADHD?
- How can I differentiate ADHD from the comorbidities most likely to present at school and/or work?
- How can I best consider trauma and personality disorders through the lens of ADHD?
- What diagnostic criteria and tests are recommended for performing a differential diagnosis of ADHD?
View Article 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