ADD / ADHD Tests and Diagnosis

Diagnosing ADD / ADHD: What you need to know

There is no single medical, physical, or other test for diagnosing ADD/ADHD. To determine if you or your child has ADD/ADHD, a doctor or other health professional will need to be involved, and you can expect him or her to use a number of different tools: a checklist of symptoms, answers to questions about past and present problems, or a medical exam to rule out other causes for symptoms. Keep in mind that the symptoms of ADD/ADHD, such as concentration problems and hyperactivity, can be confused with other disorders and medical problems. Just because it looks like ADD/ADHD doesn’t mean it is, so getting a thorough assessment and diagnosis is important.

Finding out that you or your child has been diagnosed with something—whether it’s an ear infection, a learning disability, or ADD/ADHD—may feel at first scary or intimidating. In fact, an ADD/ADHD diagnosis can be the first step toward making life better: you can seek treatment immediately, and that means managing symptoms and feeling more confident in every area of life.

Making the ADD / ADHD diagnosis

ADD/ADHD looks different in every person, so there is a wide array of criteria—or measures for testing—to help health professionals reach a diagnosis. It is important to be open and honest with the specialist conducting your evaluation so that he or she can come to the most accurate conclusion.

Important factors

To be diagnosed with ADD/ADHD, you or your child must display a combination of strong ADD/ADHD hallmark symptoms, namely hyperactivity, impulsivity, or inattention. The mental health professional assessing the problem will also look at other factors. This set of criteria may include:

• Severity of symptoms. To be diagnosed with ADD/ADHD, symptoms must have a negative impact on the person’s education, career, relationships, or social life.
• When symptoms started. Since ADD/ADHD starts in childhood, the doctor or therapist will look at how early the symptoms appeared.
• How long symptoms have been present. Symptoms must have been going on for at least 6 months before ADD/ADHD can be diagnosed.
• When and where symptoms appear. The symptoms of ADD/ADHD must be present in multiple settings, such as at home and school. If the problem only appears in one environment, it is unlikely to be caused by ADD/ADHD.

Finding a specialist who can diagnose ADD / ADHD

Qualified professionals trained in diagnosing ADD/ADHD can include clinical psychologists, physicians, or clinical social workers. Choosing a specialist can seem confusing at first. The following are steps you can take toward finding the right person to evaluate you or your child.

• Get recommendations. Doctors, therapists, and friends you trust may like a particular specialist. Ask them questions about their choice and try out their recommendation.
• Do your homework. Find out the professional certification and academic degrees of the specialists you are looking into. If possible, talk to former patients and clients, and find out what their experience was.
• Feel at ease. Feeling comfortable with the specialist is an important part of picking someone right to evaluate you. Try to be yourself, ask questions, and be honest with the professional. You may need to speak with a few specialists before choosing the person that is best for you.
• Check price and insurance. Find out how much the specialist will charge and if your health insurance will cover part or all of the ADD/ADHD evaluation. Some insurance policies cover evaluation for ADHD from one kind of specialist, but not from another.

Diagnosing ADD / ADHD in adults

Many people only learn that they have ADD/ADHD when they become adults. Some find out after their children receive the diagnosis; as they become educated about the condition, they realize that they also have it. For others, the symptoms finally outpace their coping skills, causing significant enough problems in their daily life that they seek help. If you recognize the signs and symptoms of ADD/ADHD in yourself, schedule a visit with a mental health professional for an assessment. Once you make that important appointment, being somewhat nervous about it is normal.

If you know what to expect, the process for evaluating ADD/ADHD isn’t confusing or scary. Many professionals will start by asking you to fill out and return questionnaires before an evaluation. You'll probably be asked to name someone close to you who will also take part in some of the evaluation. To determine if you have ADD/ADHD, you can expect the specialist conducting the evaluation to do any or all of the following:

• Ask you about your symptoms, including how long they’ve been bothering you.
• Administer ADD/ADHD tests, such as symptom checklists and attention-span tests.
• Ask you about problems your symptoms are causing or have caused in the past.
• Talk to family members or someone close to you about your symptoms.
• Give you a medical exam to rule out other physical causes for the symptoms.

Diagnosing ADD / ADHD in children

When seeking a diagnosis for your child, it can be helpful to have a team mentality; you are not alone and with the help of others, you can get to the bottom of your child’s struggles. Together with specialists trained in diagnosing ADD/ADHD, you can help bring about a swift and accurate assessment that leads to treatment.

Your role as a parent

When seeking a diagnosis for your child, you are your child’s best advocate and most important source of support. As a parent in this process, your roles are both emotional and practical. You can provide or ensure:

• Emotional support for your child during the diagnostic process.
• The right choice of specialist for your child.
• Unique and helpful information for doctors/specialists.
• Open and honest answers to questions about your child’s history and current adjustment.
• Speed and accuracy of evaluation, and a second opinion if necessary.

The doctors’ or specialists’ role

Usually, more than one professional is typically involved in the assessment process for ADD/ADHD in children. Physicians, clinical psychologists, school psychologists, clinical social workers, speech-language pathologists, learning specialists, and educators may each play an important role in the ADD/ADHD evaluation.

As with adults, there are no laboratory or imaging tests available to determine a diagnosis; instead, clinicians base their conclusions on the observable symptoms and by ruling out other disorders. The specialist who conducts your child’s evaluation will ask you a range of questions that you should open honestly and openly. He or she may also:

• Obtain a thorough medical and family history.
• Order or conduct a general physical and/or neurological exam.
• Lead a comprehensive interview with you, your child, and the child’s teacher(s).
• Use standardized screening tools for ADD / ADHD.
• Observe your child at play or school.
• Use psychological tests in order to measure IQ and social and emotional adjustment.

Understanding an ADD / ADHD diagnosis

It’s normal to feel nervous or disappointed by a diagnosis of ADD/ADHD. Understanding what the diagnosis really means can make you feel a whole lot better—it may even lead to feelings of relief, as you can finally put a name to the symptoms you or your child has been suffering. A diagnosis can be the first step toward taking control of your ADD/ADHD symptoms.

What does an ADD / ADHD diagnosis mean?

An ADD/ADHD diagnosis may feel like a label, but it can be more helpful to think of it as an explanation. The diagnosis explains why you may have struggled with things like paying attention, following directions, listening closely, organization—things that seem to come easily to unaffected peers. You can rest better knowing that it wasn’t laziness or a lack of intelligence standing in your way—or your child’s—but rather a disorder that you can do something about.

An ADD/ADHD diagnosis means that you or your child has a common disorder of the brain—one that is different for each individual. Some people have mild ADD/ADHD with only a few symptoms or problems. Others have more serious ADD/ADHD with more or worse symptoms. It runs in some families, so it may be inherited, but anyone can have it. An ADD/ADHD diagnosis does not mean you are in for a lifetime of suffering. Although the disorder lacks one guaranteed cure, there is actually a lot you can do to reduce the symptoms of ADD/ADHD.

Co-existing conditions and ADD / ADHD

It is important to understand that an ADD/ADHD diagnosis does not rule out other mental health conditions. The following disorders are not part of an ADD/ADHD diagnosis but sometimes co-occur with ADD/ADHD:

• Anxiety – Excessive worry that occurs frequently and is difficult to control. Symptoms include feeling restless or on edge, easily fatigued, panic attacks, irritability, muscle tension, and insomnia.
• Depression – Symptoms include feelings of hopelessness, helpless, and self-loathing, as well as changes in sleep and eating habits and a loss of interest in activities you used to enjoy.
• Learning disabilities – Problems with reading, writing, or mathematics. When given standardized tests, the student's ability or intelligence is substantially higher than his or her achievement.
• Substance abuse – The impulsivity and behavioral issues that often go along with ADD/ADHD can lead to alcohol and drug problems.

After an ADD / ADHD diagnosis: Getting help

A diagnosis of ADD/ADHD can be a great wake up call—it can give you the extra push you need to seek help for the symptoms that are getting in the way of your happiness and success. If you or your child is diagnosed with ADD/ADHD, don’t wait to start treatment. The earlier you begin treating the symptoms, the better.

Managing ADD/ADHD takes work. Finding the right treatments for you or your child is a process—one that takes time, persistence, and trial and error. But you can help yourself along the way by keeping the following concepts in mind: much as you can about ADD/ADHD, getting plenty of support, and adopting healthy lifestyle habits.

• ADD/ADHD is treatable. Don’t give up hope. With the right treatment and support, you or your child will be able to get the symptoms of ADD/ADHD under control and build the life that you want.
• Treatment is your own responsibility. It’s up to you to take action to manage the symptoms of ADD/ADHD. Health professionals can help, but ultimately, the responsibility lies in your own hands.
• Learning all you can about ADD/ADHD is key. Understanding the disorder will help you make informed decisions about all aspects of your or your child’s life and treatment.
• Support makes all the difference. While treatment is up to you, support from others can help you stay motivated and get you through tough times.

Related articles

Related links for ADD / ADHD diagnosis

Diagnosing ADD / ADHD

Identifying and Treating ADHD: A Resource for School and Home (PDF) – In-depth guide to the diagnosis and treatment of ADD / ADHD in children. (U.S. Department of Education)

ADHD: Diagnosis Dilemma – Explore the complexities of diagnosing ADD / ADHD in adults. (Psychology Today)

Defining and Diagnosing ADHD – Offers several brief, informative articles describing the diagnostic criteria for ADHD, how children are diagnosed, and the challenges of diagnosing and treating ADD / ADHD. (PBS.org)

Getting a Diagnosis– See “AAP Guidelines,” “Getting a diagnosis through the school system,” and “Specialists for diagnosing ADHD.” (MyADHD.com)

Finding professional help for ADD / ADHD

CHADD Professional Directory – Once you accept the CHADD agreement, choose a type of professional from the dropdown menu beginning with Any Category. (Children and Adults with Attention-Deficit/Hyperactivity Disorder)

Attention Deficit Disorder Resources – A directory of providers for professional help with ADD / ADHD. Broaden your search if you don’t get enough providers in your initial search. (Attention Deficit Disorder Resources)

Melinda Smith M.A., Jocelyn Block, M.A., and Jeanne Segal, Ph.D., contributed to this article. Last reviewed: February 2010.