ADHD Diagnosis in Kids

Guidelines for Pediatricians Diagnosing ADHD

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

Pediatrician giving a lollipop to a little girl at her office after evaluating for Tourette Syndrome and sharing some basic facts.
Pediatrician giving a lollipop to a little girl at her office after evaluating for ADHD diagnosis.

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

Many children with 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 steps to address this problem. The doctors’ group updated their clinical practice guidelines for diagnosing and treating ADHD again in 2011 to help pediatricians better diagnose ADHD in children. These guidelines address public concerns about rampant misdiagnosis. Eleven 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 updated guidelines, designed to help assess ADHD in children age 4 to 18, 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 in the Diagnostic and Statistical Manual of Mental Disorders (DSM–V). 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. More than two-thirds of children with ADHD also have co-existing conditions.

More information is available from the American Academy of Pediatrics on their website.