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For detailed information regarding American Academy of Child and Adolescent Psychiatry Practice Parameters for the Assessment and Treatment of Children and Adolescents with ADHD please click on the following link:

http://www.aacap.org/galleries/PracticeParameters/NewADHDParameter.pdf

The diagnosis and treatment of ADHD is determined by a qualified health care professional and may include a psychiatrist, neurologist, pediatrician or primary care physician. All of these physicians are able to prescribe medication for ADHD if needed.

The AACAP recommends that the diagnostic evaluation include:

• In-depth interview with the parents and patient
• Comprehensive medical, social, and family history
• Physical examination
• Evaluation for the presence of comorbid conditions
• Laboratory tests to rule out other medical conditions
• Consultation with teachers, day-care staff, or other on-site professionals to review behavioral checklist or rating scales filled out for the child

Interview with Parents and Patient

The health care provider will try to understand the symptom pattern of the child by asking about several issues, including:

• In-depth review of each of the criteria for ADHD that are listed in the Diagnostic and Statistical Manual (DSM-IV-TR)
• Information regarding the level of academic, social, or employment impairment
• Information regarding where the disruptive behavior or ADHD-type behavior is most observable
• The duration, severity, and frequency of that behavior
• Under what circumstances does it appear to abate?

Comprehensive Medical, Social, and Family History

The health care provider will need to find out about:

• Prenatal and birth history (e.g., birth weight, premature birth, maternal substance abuse, alcohol, or cigarettes)
• Developmental milestones (motor, social, language, etc)
• Sleep habits
• Moods
• Medical history - medications, allergies, history of injuries, etc.
• Emotional health history
• Presence of any situations in the home or school which may be causing stress for the child and lead to disruptive behavior that the child "acts out"
• Social history with friends
• Family history of ADHD or other psychiatric conditions

Physical Examination

The physician may do a thorough examination of the child and check height, weight, vision, and hearing to determine if vision or hearing is impaired and may be a cause of disruptive behavior.

Laboratory Tests

Laboratory tests may be ordered to rule out other conditions which may cause symptoms similar to ADHD, including:

• Anemia
• Lead poisoning
• Abnormal thyroid function

Consultation with Teachers and School Staff

Input of teachers, parents, and child is crucial for the diagnosis of ADHD. There are several standardized behavior assessment scales (such as the National Initiative for Children's Healthcare Quality Vanderbilt Assessment Scale) which provide a checklist of behaviors that the teacher and parents are asked to complete regarding the child's school performance and interpersonal relations. The scoring system of these assessment scales are compatible with the criteria set out by the Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR), published by the American Psychiatric Association for the diagnosis of ADHD. An important but difficult aspect of the school workup is the assessment of overlapping mental health conditions on learning disabilities. Reports by the teachers and staff in school regarding behavior, academics, and friends and may be supplemented by visiting the school and observing the child's behavior and self control in a variety of structured and unstructured settings (e.g., in the classroom, during free time; during various tasks such as reading, school yard, lunch room).