Attention deficit hyperactivity disorder (ADHD) - Diagnosis

 If you think you or your child may have attention deficit hyperactivity disorder (ADHD), you might want to consider speaking to your GP about it.

If you are worried about your child, it may help to speak to their teachers before seeing your GP, to find out if they have any concerns about your child's behaviour.

Your GP can't formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment, if necessary.

When you see your GP, they may ask you:

    about your symptoms or those of your child
    when these symptoms started
    where the symptoms occur – for example, at home or in school
    whether the symptoms affect your or your child’s day-to-day life – for example, if they make socialising difficult
    if there have been any recent significant events in your or your child's life, such as a death or divorce in the family
    if there is a family history of ADHD
    about any other problems or symptoms of different health conditions you or your child may have

Next steps

If your GP thinks your child may have ADHD, they may first suggest a period of "watchful waiting" lasting around 10 weeks – to see if your child's symptoms improve, stay the same or get worse. They may also suggest starting a parent training or education programme to teach you ways of helping your child.

If your child's behaviour doesn't improve, and both you and your GP thinks it is seriously affecting their day-to-day life, your GP should refer you and your child to a specialist for a formal assessment (see below).

For adults with possible ADHD, your GP will assess your symptoms and may refer you for an assessment if:

    you were not diagnosed with ADHD as a child, but your symptoms began during childhood and have been ongoing since then
    your symptoms cannot be explained by a mental health condition
    your symptoms have a significant impact on your day-to-day life – for example, if you are underachieving at work or find intimate relationships difficult

You may also be referred to a specialist if you had ADHD as a child or young person, and your symptoms are now causing moderate or severe functional impairment.

Assessment

There are a number of different specialists you or your child may be referred to for a formal assessment, including:

    a child or adult psychiatrist
    a paediatrician (a specialist in children's health)
    a learning disability specialist, social worker or occupational therapist with expertise in ADHD

Who you are referred to will depend on your age and what is available in your local area.

There is no simple test to determine whether you or your child have ADHD, but your specialist can make an accurate diagnosis after a detailed assessment that may include:

    a physical examination, which can help rule out other possible causes for the symptoms
    a series of interviews with you or your child
    interviews or reports from other significant people, such as partners, parents and teachers

The criteria for making a diagnosis of ADHD in children, teenagers and adults are outlined below.

Diagnosis in children and teenagers

Diagnosing ADHD in children depends on a set of strict criteria. To be diagnosed with ADHD, your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness.  

To be diagnosed with ADHD, your child must also have:

    been displaying symptoms continuously for at least six months
    started to show symptoms before the age of 12
    been showing symptoms in at least two different settings – for example, at home and at school, to rule out the possibility that the behaviour is just a reaction to certain teachers or parental control
    symptoms that make their lives considerably more difficult on a social, academic or occupational level
    symptoms that are not just part of a developmental disorder or difficult phase, and are not better accounted for by another condition

Diagnosis in adults

Diagnosing ADHD in adults is more difficult because there is some disagreement about whether the list of symptoms used to diagnose children and teenagers also applies to adults.

In some cases, an adult may be diagnosed with ADHD if they have five or more symptoms of inattentiveness, or five or more symptoms of hyperactivity and impulsiveness, that are listed in diagnostic criteria for children with ADHD.

As part of your assessment, the specialist will ask about your present symptoms although, under current diagnostic guidelines, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood.

If you find it difficult to remember whether you had problems as a child, or you were not diagnosed with ADHD when you were younger, your specialist may wish to see your old school records or talk to your parents, teachers or anyone else who knew you well when you were a child.

For an adult to be diagnosed with ADHD, their symptoms should also have a moderate impact on different areas of their life, such as:

    underachieving at work or in education
    driving dangerously
    difficultly making or keeping friends
    difficulty in relationships with partners

If your problems are recent and did not occur regularly in the past, you are not considered as having ADHD. This is because it is currently not thought that ADHD can develop for the first time in adults.

tags: Attention deficit hyperactivity disorder (ADHD) - Diagnosis, Diagnosis, Attention deficit hyperactivity disorder (ADHD), ADHD, Attention deficit hyperactivity disorder, Diagnosis in adults, Next steps, Assessment, Diagnosis in children and teenagers,  If you think you or your child may have attention deficit hyperactivity disorder (ADHD), you might want to consider speaking to your GP about it.