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Assessment and Diagnosis of Attention Deficit/Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is defined by a persistent pattern of inattention (for example, difficulty keeping focus) and/or hyperactivity- impulsivity (for example, difficulty controlling behavior, excessive and inappropriate motor activity). Children with ADHD have difficulty performing well in school, interacting with other children, and following through on tasks. There are three sub-types of this disorder: Predominantly Hyperactive/Impulsive, Predominantly Inattentive, and Combined Inattention & Hyperactive/Impulsive.

Three Overarching Features of ADHD

Inattention: Inattentive children may have trouble paying close attention to details, make careless mistakes in schoolwork, are easily distracted, have difficulty following through on tasks, such as homework assignments, or quickly become bored with a task.

Hyperactivity: Hyperactivity may be defined by fidgeting or squirming, excessive talking, running about, or difficulty sitting still.

Impulsivity: Impulsive children may be impatient, may blurt out answers to questions prematurely, have trouble waiting their turn, may frequently interrupt conversations, or intrude on others' activities.

Special Considerations

  • ADHD is a condition that can affect people of all ages.
  • According to the CDC, ADHD is one of the most common neurobehavioral disorders of childhood.
  • Proper diagnosis relies on comprehensive clinical evaluation, considering member personal history, self-reported symptoms, mental-status testing, and early development problems.
  • The American Academy of Pediatrics recommends every child with ADHD be screened for other disorders and problems, such as:
    • Behavior or conduct problems
    • Learning disorders
    • Anxiety and depression
    • Difficult peer relationships
    • Risk of Injuries
  • Children with ADHD generally experience more injuries due to reduced awareness, impulsivity, or poor decision making.
  • Adults with ADHD are likely to have an anxiety disorder, depression, bipolar disorder, or other comorbid psychiatric disorders.
  • Collaboration with caregivers, behavior therapists, and schools/educators is key in first line approaches for children with ADHD.

 

Interventions and Resources

Behavior Therapy, including Training for Parents

Medications

Parent Education and Support

Support in the Classroom

The following clinical practice guidelines help in the assessment, diagnosis, and treatment of ADHD:

American Academy of Pediatrics. Clinical Practice Guideline: ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics 2011 Oct; 128:5 1007-1022; doi:10.1542/peds.2011-2654.

http://pediatrics.aappublications.org/content/128/5/1007.full

The Centers for Disease Control and Prevention - https://www.cdc.gov/ncbddd/adhd/guidelines.html

American Academy of Family Physicians – https://www.aafp.org/patient-care/clinical-recommendations/all/ADHD.html