ADHD DIAGNOSTIC PROCEDURES FOR CHILDREN AND TEENS

“The ‘gold standard’ for [ADHD] diagnosis currently is the use of a structured or semi-structured clinical interview . . . combined with well standardized rating scales of ADHD symptoms, with information being collected from multiple sources (parent, teacher, child).”[1]

I follow “gold standard” procedures in completing a differential diagnosis[2] for childhood or adolescent ADD/ADHD.  These procedures include the following:

 

1.    Parent and teacher completion of objective rating scales that rate the child’s or teen’s behaviors against norms for his or her age group and gender.  Two types of parent and teacher rating scales are used:  broad mental health scales, and ADHD-symptom specific instruments.  Self-rating scales are added for adolescents, ages 11 – 18.  I use the following rating scales of the Achenbach System of Empirically Based Assessment to screen for broad emotional and behavioral issues (including ADHD):

§         Child Behavior Checklist

§         Teacher’s Report Form

§          Youth Self-Report Form

 

The ADHD-specific forms I use are the:

 

§        Conners’ Rating Scale–Revised or ADHD-IV Rating Scale (parent and teacher versions)

§        Home Situations Questionnaire (HSQ)

§        School Situations Questionnaire (SSQ)

§        Issues Checklist (for adolescents)

 

The HSQ and SSQ are used to rate the number and severity of problem situations that kids with ADHD experience at home and in the classroom.

 

2.    Completion of a developmental questionnaire by parents that includes questions about presenting problems, prenatal and birth history, developmental milestones, medical history, academic history, family genetic history, social/emotional/behavioral development, and current relationships.  These forms include the:

 

§        Developmental History Checklist (ages 5 to 12)

§        Personal History Checklist – Adolescent (ages 13 to 17)

 

3.    Completion of a structured ADHD interview developed by Russell Barkley, Ph.D., with the child’s or teen’s parents.

 

4.    Observation and interaction with the child or teen.

 

5.    Consultation with the child’s or teen’s physician to rule out possible neurological or medical causes for ADHD-like symptoms.

 

6.    Consultation with current or former mental health therapists who have treated the child or teen.

 

7.    Input from the child’s or teen’s teacher(s) and other school personnel.

 

8.    A review of educational testing results, Individualized Education Programs (IEPs) or 504 Plans, and school progress reports.

 

On average, the evaluation process requires about three one-hour sessions and is generally completed within one month.

 

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