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Tests and diagnosis

By Mayo Clinic staff

In general, a child shouldn't receive a diagnosis of ADHD unless the core symptoms of ADHD start early in life and create significant problems at home and at school on an ongoing basis.

There's no specific test for ADHD, but making a diagnosis will likely include:

• Medical exam, to help rule out other possible causes of symptoms
• Information gathering, such as any current medical issues, personal and family medical history and school records
• Interviews or questionnaires for family members, your child's teachers or other people who know your child well, such as baby sitters and coaches
• ADHD rating scales to help collect and evaluate information about your child

Diagnostic criteria for ADHD
To be diagnosed with ADHD, your child must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. For a diagnosis of ADHD, a child must have six or more signs and symptoms from one or both of the two categories below.

Inattention

• Often fails to give close attention to details or makes careless mistakes in schoolwork and other activities
• Often has difficulty sustaining attention in tasks or play activities
• Often doesn't seem to listen when spoken to directly
• Often doesn't follow through on instructions and fails to finish schoolwork or chores
• Often has difficulty organizing tasks and activities
• Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort, such as schoolwork or homework
• Often loses items necessary for tasks or activities (for example, toys, school assignments, pencils, books)
• Is often easily distracted
• Is often forgetful in daily activities

Hyperactivity and impulsivity

• Often fidgets with hands or feet or squirms in seat
• Often leaves seat in classroom or in other situations when remaining seated is expected
• Often runs about or climbs excessively in situations when it's inappropriate
• Often has difficulty playing or engaging in leisure activities quietly
• Is often "on the go" or often acts as if "driven by a motor"
• Often talks too much
• Often blurts out answers before questions have been completed
• Often has difficulty awaiting turn
• Often interrupts or intrudes on others' conversations or games

In addition to having at least six signs or symptoms from these two categories, a child with ADHD:

• Has inattentive or hyperactive-impulsive signs and symptoms that cause impairment
• Has behaviors that aren't normal for children the same age who don't have ADHD
• Has symptoms for at least six months
• Has symptoms that affect school, home life or relationships in more than one setting (such as at home and at school)

A child diagnosed with ADHD is often given a more specific diagnosis (a subtype), such as:

• Predominantly inattentive type ADHD. A child has at least six signs and symptoms from the inattention list above. This child may sit quietly and appear to get along with others, but he or she is not paying attention.
• Predominantly hyperactive-impulsive type ADHD. A child has at least six signs and symptoms from the hyperactivity and impulsivity list above. This may be misjudged as an emotional or disciplinary problem.
• Combined-type ADHD. A child has six or more signs and symptoms from each of the two lists above.

Other conditions that resemble ADHD
A number of medical conditions or their treatments may cause signs and symptoms similar to those of ADHD, or exist along with ADHD. Examples include:

• Learning or language problems
• Mood disorders (such as depression)
• Anxiety disorders
• Seizure disorders
• Vision or hearing problems
• Tourette syndrome
• Sleep disorders
• Thyroid medication
• Substance abuse
• Brain injury

Diagnosing ADHD in young children
Although signs of ADHD can sometimes appear in preschoolers or children even younger, diagnosing the disorder in very young children is difficult. That's because developmental problems such as language delays can be mistaken for ADHD. For that reason, children preschool age or younger suspected of having ADHD are more likely to need evaluation by a specialist, such as a psychologist or psychiatrist, speech pathologist, or developmental pediatrician.

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