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Assessment Strategies for ADHD

People with Attention Deficit Hyperactivity Disorder, or ADHD, have trouble paying attention, controlling impulses, taking turns, setting priorities, following instructions and/or sitting still. No single psychological, medical or neurological test can determine presence of ADHD. Instead, a doctor must arrive at a diagnosis through a combination of several assessment strategies. These strategies require input and data collection from parents, teachers and, sometimes, an independent observer.

  1. Rating scales and checklists

    • Clinicians give parents and teachers a rating scale or checklist to keep track of the occurrence, frequency and impact of ADHD-type behaviors. Clinicians then use the data to help diagnose or dismiss a diagnosis of ADHD. Two popular rating scales include the Vanderbilt Scale and the Conner's Scale. In addition to a diagnosis of ADHD, these scales help determine the ADHD subtype: predominantly inattentive, predominantly hyperactive/impulsive or combined inattentive/hyper. Clinicians also use this information to help develop a treatment plan for the child with ADHD.

    Interviews

    • Experts recommend that doctors interview the parents and teacher(s) of the child suspected to have ADHD, according to the Journal of Clinical and Child Adolescent Psychology. Interviews are a good supplement to the rating scales because they provide the clinician with the details and nuance often lost in a checklist. Doctors may also find it helpful to look over a sample of the child's schoolwork. Questions regarding the child's approach or reaction to school assignments, household chores and other tasks may also be relevant.

    Observations

    • Sometimes, clinicians will have an independent observer evaluate the behavior of a child suspected to have ADHD. The observer takes note of behaviors such as time on-task, disruptiveness and talking out of turn. These observations can be done in an artificial (clinical) setting or in natural setting (classroom, playground, home). The information from a disinterested observer may provide further clues on the child's condition or may provide further insight on how to best help the child.

    DSM-IV Criteria

    • Clinicians use data collected from a variety of sources, including parents, teachers, interviews and observations, to determine if a child meets the criteria for ADHD as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or DSM-IV. In addition to meeting the DSM-IV criteria, the child must exhibit the symptoms in more than one setting; he must, for example, exhibit symptoms at school and at home, not just at school. The symptoms must also significantly impair the child's social or academic performance, and they must occur to a greater degree than observed in other children of the same age. What counts as ADHD behavior in a 9 year old, for example, may be perfectly normal for a 4 year old.

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