Diagnosis

Symptoms of ADHD fall into three groups:

1. Hyperactivity – increased activity, trouble sitting still or playing quietly

2. Impulsivity – difficulty waiting their turn, interrupting others, intruding on others' games

3. Inattentiveness – inability to finish projects, forgetfulness, misplacing things, makes careless mistakes

These symptoms need to be so serious that they cause difficulties in a variety of settings, such as at school, at home, and with their friends. Some children have primarily inattentiveness symptoms. They are less disruptive in school and are more likely to go undiagnosed.

Sometimes children with behavior problems get labeled with ADHD when they don't have it and children with ADHD never get diagnosed with it. Some experts feel that ADHD is diagnosed too often in children. Because of this, the American Academy of Pediatrics has the following guidelines for diagnosing ADHD:

• Children need to have a minimum of 6 attention, hyperactivity or impulsivity symptoms, several of which have to be present before they turn 7 years old.
• These symptoms need to be present for a minimum of 6 months and have to be seen in at least 2 settings (not just in school).
• They cannot be caused by other physical or mental problems.

If ADHD is suspected, the child should be evaluated by a doctor and the evaluation should include:

• a complete physical examination
• teacher and parent questionnaires
• a developmental and psychosocial history

Watching your child's behavior at home and in the community, as well as talking to other adults who know your child, will give you more information to help the doctor make an accurate diagnosis. Talking to your child's teacher about their behavior at school will also help. Because ADHD symptoms may not be obvious in the doctor's office, you will likely be asked to fill out a questionnaire to learn more about your child's behavior. The doctor may also want to send questionnaires to your child's teachers or other people who know your child well.

Although signs of ADHD can sometimes appear in preschool children, diagnosing the disorder in very young children is difficult. Developmental problems such as language delays can be mistaken for ADHD so very young children suspected of having ADHD are likely to need evaluation by a specialist such as a psychologist or psychiatrist, speech pathologist or developmental pediatrician.

The doctor will want to check for all possible causes of your child's behavior. Some other medical conditions may cause signs and symptoms similar to those of ADHD, including:

• Learning or language problems
• Mood disorders (such depression)
• Anxiety disorders
• Seizure disorders
• Vision or hearing problems
• Tourette syndrome
• Sleep disorders
• Thyroid medication.

Some experts think ADHD is diagnosed too often and it's important to remember that most children are hyperactive or impulsive at times. It's also normal for preschoolers to have short attention spans and be unable to stick with one activity for long. Even older children and adolescents don't pay attention for long if they are not interested in something. Teenagers can talk to their friends or play video games for hours but may be easily distracted when doing homework.

Young children are naturally energetic and often wear their parents out long before they're tired. They also may become even "hyperactive" when they're tired, hungry, upset or with new people. Some children just naturally have a higher activity level than other kids do. Children who have problems one setting, for example school, but get along well in another, such as home or with friends, may have something other than ADHD going on.