Attention Deficit Hyperactivity Disorder (ADHD) - Exams and Tests

Exams and Tests

The American Psychiatric Association (APA) has established criteria for diagnosing attention deficit hyperactivity disorder (ADHD). These criteria divide the condition into three basic types based upon major symptoms:

• ADHD, predominantly inattentive type
• ADHD, predominantly hyperactive-impulsive type
• ADHD, combined type

In addition, some people are diagnosed with "ADHD, not otherwise specified" when symptoms of inattention, hyperactivity, and/or impulsivity are present but do not fit into one of the three types.

A health professional will use criteria for diagnosing attention deficit hyperactivity disorders to determine whether a child has ADHD. Information used to diagnose the condition includes:

• An interview with the child.
• Medical history, to include asking a parent about the social, emotional, educational, and behavioral history of the child.
• Physical examination.
• Behavior rating scales or checklists for ADHD given to parents and teachers to evaluate the child's symptoms.

It can be difficult to determine whether a child's behavior problems are caused by ADHD, other conditions with similar symptoms, or a combination of ADHD and another condition. Several verbal and written tests for associated disorders are used to help with this determination.

In addition, children with ADHD may have difficulty learning to read, write, or do math problems. Testing for learning disabilities will help teachers develop the best educational plan for a child with these difficulties.

Additional tests may be done to identify other medical problems that might explain the child's symptoms, such as:

• Hearing or vision impairment. This type of disability often interferes with school achievement.
• Lead exposure. Children who have even small amounts of lead in their bodies can have symptoms similar to ADHD.
• Low red blood cell counts (anemia). This condition can cause low energy and poor concentration. It can be diagnosed with results from a complete blood count (CBC).
• Thyroid disease. Blood tests can help determine whether a person has too much or too little thyroid hormone, which also can affect energy and attention. This is more common in adults than children.
• Seizures. Seizures can affect brain function and result in unusual behavior. Rarely, a person with ADHD symptoms may have an electroencephalogram (EEG) to determine whether seizures are occurring.

Parents often question whether ADHD is overdiagnosed. Many health professionals and researchers believe that the increase in ADHD diagnoses results from improved detection techniques, especially the standardization of assessment criteria. Current and future research should help in answering this question.

Many adults with ADHD have never been diagnosed or treated. ADHD is a lifelong condition that, left untreated, can lead to low self-esteem, frustration, educational or job failure, drug abuse, and depression. To diagnose ADHD in an adult, a health professional may use the Wender Utah Rating Scale (WURS), a written test that consists of 25 questions about childhood difficulties that are often seen with the condition. The scale evaluates the presence and severity of ADHD symptoms during childhood.

Adults with untreated ADHD are at an increased risk of abusing drugs or alcohol.⁵ If an adult is suspected of having or is diagnosed with ADHD, he or she may also be screened for alcohol and drug abuse.

Early Detection

The American Academy of Pediatrics (AAP) guidelines recommend that health professionals ask parents about behavior and school performance during regularly scheduled well child visits. This helps identify early signs of attention deficit hyperactivity disorder (ADHD). If you are concerned about how your child's temperament, learning skills, or behavior is developing, talk with your health professional during your next visit.

Before meeting with your health professional, think about at what age your child's symptoms began. In addition, you and other caregivers should record when the behavior occurs and how long it lasts. An important component of evaluation for ADHD is considering the kinds of problems that result from the behaviors and to what extent they affect academic performance and social behavior.

Some adults do not recognize their own symptoms of ADHD until their child is diagnosed with the condition. If your child is diagnosed with ADHD or you think you have symptoms, talk with your health professional about being screened for ADHD.