Does My Child Have ADHD?

One of my specializations as a child psychologist is the evaluation of Attention-Deficit/Hyperactivity Disorder (ADHD).  As a result, many parents often ask me “Does my child have ADHD?” and “Should they be on medicine?”  For me, those are not quick and easy questions to answer.  Why?  Because before I diagnose any child with ADHD and make recommendations for their treatment, there’s A LOT of information that I need to gather and analyze!

As a parent and a professional, I feel strongly that a thorough evaluation is necessary before making a diagnosis of ADHD (or any disorder) and recommending treatment options.  Think about this analogy.  Imagine your son’s teacher suggests to you that your child might have a vision problem.  Would you go online and take a vision questionnaire and then order a pair of glasses based on the results?  Of course not!  If you’re like me, you would be incredibly appreciative to the teacher for their concern, and then you would make an appointment with an optometrist to have your child’s vision thoroughly evaluated.  IF the results from the testing showed a vision impairment, THEN you would get them glasses from a qualified professional.  Not before!

This same line of thinking applies to ADHD, as well.  If you or your child’s teacher suspects that he or she is having trouble with inattention, hyperactivity, or impulsivity, then a thorough evaluation is necessary to determine the nature of their difficulties before considering medication as a treatment option.  There are many medications that help children with ADHD considerably, but if you’re like me, you probably only want your child to take medication if it is absolutely necessary.

In a my dream world, every child that exhibits symptoms of ADHD would get a thorough evaluation by a licensed child psychologist before being prescribed medication from their physician.  You’d hate to have your child put on medicine for ADHD when a full psychological evaluation might have revealed a Learning Disorder or problems with depression or anxiety.  Or, like many children with ADHD, your child might suffer from multiple conditions which might go undetected without a full assessment.

Unfortunately, there are often factors that get in the way of a child being thoroughly evaluated before receiving treatment.  In my opinion, the most common obstacles are time and money.  A full psychological evaluation can take a lot of time and can be expensive.  Sometimes your health insurance will cover the costs, but sometimes it doesn’t.  So, I’ll concede that there are situations where a full psychological evaluation may not be feasible.

But, back in my dream world where time and money are abundant, here are some things that I like to include when I assess a child for ADHD:

  • A thorough interview with both the parent and child (and ideally their teachers).
  • A review of the child’s psychological, academic, and medical records, including confirmation of a recent exam by their physician to rule out any medical issues or hearing or vision impairments that could be contributing to their symptoms.
  • A mental status examination.
  • An intelligence test.
  • A test of academic achievement.
  • Rating scales about behavioral and emotional problems completed by the child, their parents, and their teachers.
  • Rating scales about ADHD symptoms completed by the parents and teachers.
  • A continuous performance task.
  • Behavioral observations of the child in the clinic and in their school environment.  If a school observation isn’t feasible, then structured clinic observations of the child completing academic work.
  • And last but not least, any other test or measure that appears warranted given the child’s specific situation, symptoms, or test results.

If you’re worried that your child may have ADHD, get in contact with your child’s pediatrician for a full physical evaluation (including vision and hearing screenings).  Then locate a child psychologist in your area to obtain a full psychological evaluation for your child.  Some school systems even have psychologists available to assist with the evaluation.  Your child’s psychologist will help select the best assessment for your child and get you on the right track to answering your question, “Does my child have ADHD?”

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About Dr. Polly Dunn

Child clinical psychologist, wife, and mom of four blogging about her 'Perfectly Imperfect' parenting solutions.

Comments

  1. This is a great article! My youngest has been having some issues adjusting to Kindergarten. Many times I have wondered silently to myself if she may have ADHD. Thank you for providing some much needed guidance on how to proceed.

    • Glad you found it helpful! Being a mom of a kindergarten girl myself, I can truly relate. Sometimes it’s hard to know what’s normal and what’s not. Just having a plan in mind for what to do in case she needs help is a great first step! Best of luck, and thanks for reading.

  2. Stopping by from the SITS forum. What a great article, I want to be a teacher and I know we have talked about ADHD a lot. I know I would be glad to help any child in my class who might have a problem that is affecting their learning.

    • Love your Perfectly Flawed blog! Glad you stopped by. I so admire teachers and love working with them to help the children in their classes. Good luck with your studies!

  3. Great post! As a mom of two girls with adhd who are on medication, I still wrestle with the thought of giving it to them. I feel like it’s neglectful to send them to school without it but worry about the long term effects. What are your thoughts on chiropractic measures as treatment or do you know of any articles you could refer me to?

    • Thanks for your comment Dani! I bet you have your hands full! Research has shown that the most effective treatment of ADHD is a combination of medication and behavior management therapy. Of course, adding parent and teacher involvement in treatment makes it even more effective! WebMD has a great online guide at http://www.webmd.com/add-adhd/guide/default.htm It includes information on treatment options for ADHD, including home remedies. Best of luck in your efforts and thanks again for reading!

  4. Hello,

    I currently have a 2nd grader who I have been advised by the teacher to have tested for ADHD. He is the youngest child in his class and a about 40% of the boys were held back a year. I am told that he talks out in class and does not raise his hand in class. He also has poor handwriting. The other side is that he is a VERY determined and bright child. He is currently reading at a near 6th grade level, math skill at near 5th grade level, and has straight A’s with only one B for the entire academic school year. While he does interrupt at home, he completes his homework quickly and rarely forgets anything.

    I also have a 15 yr old who was diagnosed with ADHD at the same age and attended my son’s school which is K-8. My daughter has a significant dose of both inattentive and hyperactive disorder and has received medical treatment, counseling, home modfications, and ongoing medical care since diagnosis. She also has an axiety disorder which is also treated.

    I consider myself extremely well read on the subject due to my daughter living with the disorder. I have reviewed the dignostic criteria and can only honestly say he exhibits 1-2 inattentive traits and only 3-4 hyperactive traits “often”. I have also reviewed the symptoms numerous times in “How to Reach and Teach Children with ADD/ADHD. ” The school he attends is a small private school and is becoming an issue due to my disagreement with the assessment. I personally feel they do not have the resources to make the “diagnosis.” I am to the point of undergoing a thorugh evaluation to put an end to the topic. Do you have any recommendations on how to handle the problem?

    BTW-Thank you for recommending parents seek a child psychiatrist when seeking a diagnosis. I am often asked my opinion and recommend seeing a psychiatrist due to my own experiences.

    • I agree with you. I think I would seek an evaluation (independent of the school system) just to put the issue to rest. Then you will have documentation to support your point of view, as well as a child psychologist on your side who can serve as another advocate for your son. Keep up the good work and thanks for commenting!

  5. Hi there,
    I currently have an 8 year old daughter who has a lovely character and quite happy overall. Although of late I have started to question could she have some kind of ADHD? After reading your article I am a little concerned and not quite sure how to tackle this. I am not sure if we have any family history of this. Although I have always suspected one of my brothers to having a problem but it has never been diagnosed. Our daughter is first born and has always been a bit of a handful. We have had many issues with having too much energy and not listening when told to do something. We have 2 other kids and quite often I feel that I have to spend more time with her than the others as she can be quite demanding. I am finding that I am screaming so much more at her lately and it is making me quite upset and her too. She does not go to sleep so well and I think that is half the problem. If she could just relax I think it would help. I am starting to worry and I think we really do need some help but not sure what to do. Her teacher has recently commented that she talks a lot in class and does not sit still when working, ie shaking the leg when trying to concentrate. Although she might show some tendancies to have have ADHD or ADD I am finding it hard to think she might because of her loving nature. We have had her vision checked lately as we thought it might have been an issue and she is wearing glasses for reading although it is more because she over stresses her eyes than can’t read the letters. I would really love some advice on what to do as I am getting quite emotional about the whole thing and worry the impact this might be having on her and the rest of the family. If you are able to help or even give me some links to websites as a start, it would be appreciated.

    • Try talking to her teacher, pediatrician, or a child psychologist to determine if she needs to be evaluated for ADHD. They will provide you guidance and the help that you need to see if she does have ADHD or not. Education.com offers lots of great resources for ADHD (and other topics). Check out their ADHD section for more information. Best of luck!

  6. Rebecca says:

    Hello,
    my son is 6 and has always been hyperactive, although he can be a handful we have never sought medical advice. Recently my son’s school teacher gave me a special education needs form as his hyperactivity and his lack of concentration is affecting his school work, he is receiving one to one help at school at the moment and this is to be reviewed in 6 months time. Obviously this has concerned me a great deal and I went to visit my GP about getting my son assessed for ADHD he was really unhelpful he said that maybe my son was not that clever and that’s why he was getting bored at school and he would not refer us until he had a letter from the school. I feel like I’m going round in circles. I don’t want to wait 6 months in limbo and with my son getting further and further behind at school.
    Any help or advice would be greatly appreciated.

    Becky

    • I would try talking to the school counselor at your son’s school to see if they can conduct his evaluation for ADHD. Otherwise, a child psychologist in your area would be able to help or try making an appointment with your son’s pediatrician. I understand your frustration, but don’t give up. It might take talking to a few different people before you feel like you’re making any headway, but you’re doing the right thing by trying to have his symptoms checked out by a professional early on. For more on ADHD, check out Education.com’s ADHD section. Best of luck!

  7. my son is 7yrs old the teacher has told me that my son has symtoms of adhd so i went to see my doctor who also agreed wit me and referred me to cams but they wont see me to i seen a parent support worker which i am doing but everytime i try talk to her bout finding out if my son had adhd she tells me that it wont change his behaiviour and that is what she is helping me with i do not know where to go from here because untill she does a report for me i cant get to see cams i feel stuck and do not know where to try next

    • Try going back to your child’s doctor and explain your situation. It sounds like you need your doctor to help get the ball rolling. Just don’t give up. It might take talking to a few different people before you feel like you’re making any headway, but you’re doing the right thing by trying to have his symptoms checked out by a professional early on. For more on ADHD, check out Education.com’s ADHD section. Best of luck!

  8. My child has been struggling in school for the past few years, he is in the 5th grade. On all of his progress reports and report cards state “does not pay attention in class, shows disruptive behavior, always fooling around, now he is at the point of failing. He cannot stay focused with small tasks and sometimes has an I don’t care attitude. None of his teachers have ever mentioned the possibility of having ADHD, but I am starting to believe that he just may. Should I have him evaluated, I am at my wits end and just don’t know what to do.

    Thank You For Any Help

    • I would absolutely have him evaluated by a licensed child psychologist in your area. He may have ADHD or he may not, but at least you’ll find some answers to why he has been struggling and what you can best do to help him! Best of luck!

  9. We brought our son to 2 different neuroligists. The first one spent 20 minutes with us, asked for no additional information (connors, vanderbuilt,report cards) and said that he has some anxiety and handed us a list of psychologists. The second neurologist asked for everything (connors, vanderbuilt, report cards, info regarding his social interactions , spent nearly 3 hours with us and concluded with a diagnosis of ADHD combined type. Our schools child study team did an eval and along with the diagnosis, created a 504 plan. We are now bringing our son to a psychologist for CBT and have also seen a nutritionist (he has a great diet). The neurologist prescribed a med but we are so hesitant to go down this path. Our son also bright FSIQ 129, but marked deficiencies in his digit span and coding 25 and 50 percentile, respectively. We keep coming back to the same question. Is he really ADHD? Should we go for yet another opinion?

    • You may not need another opinion, but I’d suggest considering a re-evaluation every one to three years for any child with ADHD. As your child develops some of his symptoms may improve, while others may get worse. Regular monitoring and re-evaluation will help you to know what his current strengths and weaknesses are. Your psychologist should be able to provide the re-evaluation and give you advice about alternatives to medication. For great tips try the book Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (Revised Edition) by Russell Barkley. Best of luck!

      Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (Revised Edition)

  10. Meredith says:

    My 5 year old son has been diagnosed with ADHD… and after a year of struggling on whether or not to try meds… we started this summer. First with Ritalin, but he had horrible side effects. Now, he’s been on Adderall XR for almost a month… starting the first 10 days on 5mg, and now taking 10mg a day. It seems to help a little bit within the first few hours. But after 3-4 hours on it, he gets REALLY “sped up” and intense. It’s like we’re giving him speed. He has a little appetite loss too (some days worse than others) and mood swings/hysterical crying some days, but not every day. It’s just not doing what I thought it would do. My hubby and I both thought that it would calm him down, relax him, and make him be able to sit still better in Kindergarten, which he starts in 2 weeks. It DOES seem to help with some of his wild/destructive/impulsive behavior. Yet, it seems like we are trading one sort of behavior for another. Instead of the wild/impulsiveness, we now have a super-sped up hyper & intense child… who sometimes gets really upset/has a bad reaction & mood swing over little things that would not normally upset him. I thought that if a child has ADHD, that stimulant medications would calm them down/relax their brains… whereas, so far with our son, both Ritalin and now the Adderall seem to be speeding him up.
    I’ve talked to the doctor about his experience on the Adderall… and she wants me to continue watching him and seeing how he does in school in a few weeks. As a mom though, I hate to see him with ANY negative side effects of a medicaiton… esp since he is so young.
    Yet, every morning when we give him the Adderall, he seems to do better within a half hour… and settles his wild/impulsiveness. Then, when we get to the afternoon/evening, is where we run into all of the negative side effects… “being sped up” too fast/too intense/mood swings/hysterical crying, etc.
    What do you think about this?

  11. Very insightful article. We are about to embark on an evaluation for my Kindergarten-aged daughter, who has been struggling with some emotional and behavioral issues since she was about 2 and a half. Because she has always had a great attention span, none of her pre-school teachers ever considered ADHD before. Everyone assumes that if a child can pay attention, then they don’t have ADHD.

    However, my daughter is clearly hyperactive/impulsive. We cannot take her anywhere that requires her to sit still….not to the movies, not out to dinner, etc. And, even when she is doing a “quiet” task, like coloring or playing on the computer, she is not sitting, she is marching in place. Her K teacher noticed quite a bit of foot stomping and hand banging…something she was misinterpreting as possible sensory disorder. That was quickly ruled out by the school’s OT, and we are now realizing those symptoms are the result of a child who is knows she is supposed to sit still and is desperately trying to do so, but needs to release that energy somehow.

    She also finds it extremely difficult to follow instructions and obey rules. Her teacher and I don’t believe she is being deliberately defiant….she is never hostile or angry when she fails to comply with a request. For example, if I tell her to stop jumping on the couch (which happens all the time, no matter how many times I have told her it is forbidden) she will agree and stop. Then 5 minutes later she is right back doing it again. And so it goes until I finally send her to time out.

    But, perhaps her most obvious symptom is a lack of coping skills and an inability to regulate her emotions. She will cry inconsolably, for extended periods of time, over the smallest things….losing a hair clip, when a kid cuts her in line for the swing, and other easily-fixable problems. Here’s an example, she frequently leaves her lunch box in her locker at school. The school is right around the corner, so we just hop in the car to get it. No problem, right? Yet still, each and every time she gets home and realizes she forgot it again, she has a meltdown.

    Meltdowns are also quite frequent in the classroom and during homework. She is fine until she makes a small mistake, or gets to a question she can’t answer. Then, her frustration level goes through the roof and she has a meltdown. So, needless to say, she is starting to fall a bit behind.

    I finally called her pediatrician, who spent over an hour on the phone asking me a bunch of questions. We had joked about her being a “handful” at prior well visits, but I never went into too much detail with him. He was the first one to ever throw the idea of ADHD out there, and said now that he knows all the facts, this sounds like a classic case. And, we were referred to a pediatric developmental/behavioral specialist for an assessment.

    On the one hand, I am thankful that we are finally going to get some answers. On the other hand, I have to wonder why none of those who have been put in charge of her care have ever considered this option? She went to pre-school for 3 years, with 3 different teachers, and has been in K since early September. Shouldn’t those who work with young children be better informed about the possible “red flags” for ADHD?

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