ADHD is a topic of interest to mental health specialists and also general practitioners, parents, and teachers. In this article, we will review what the experts say about ADHD evaluations and how to establish the diagnosis.
American Academy of Pediatrics (AAP)
In the Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents, published in October 2019, it is mentioned that the diagnostic criteria established by the DSM-5 apply to preschoolers (between 4-6 years), therefore, there is no adaptation required to perform the clinical examination in this age group.
The AAP establishes the age range between 4 and 18 for the diagnosis of ADHD by pediatricians.
This guide affirms that the interview, clinical evaluation, and observation of the symptoms described in the DSM-5 constitute the gold standard for the diagnosis. It is very important to rely on the information provided by parents, representatives, and teachers.
Canadian ADHD (CADDRA) Practice Guidelines
Like AAP, CADDRA establishes clinical evaluation as the gold standard for the diagnosis of ADHD.
They state that rating scales are not useful by themselves for the diagnosis of this condition, among other reasons, because each interviewee can interpret the questions differently. However, CADDRA recommends its use to “enrich the evaluation process.”
Additionally, they explain that neuropsychiatric and psycho-educational evaluations are not a first-choice diagnostic method, but a useful resource in uncertain cases and should be interpreted within the framework of a complete clinical evaluation.
EEG and Neuroimaging
In this regard, CADDRA explains the electroencephalographic findings in adolescents and adults with ADHD and how this study provides information that differentiates ADHD at two different vital moments, however, beyond that it is not useful as a diagnostic method for this condition.
Likewise, this society explains that despite the imaging findings in patients with ADHD, these studies have no clinical application in the approach to the condition.
National Health Service (UK)
The UK National Health Service explains that the process of identifying symptoms associated with ADHD can begin with a period called “watchful waiting.” At this stage, parents should watch for signs of impulsivity, hyperactivity, or inattention; how frequent these signs occur; if the conditions improve or worsen; and if they are present in more than one setting of the child’s life. Depending on the findings, the child may be referred to a specialist.
According to the UK National Health Service, specialists suitable for the diagnosis include psychiatrists, pediatricians, social workers, or occupational therapists with experience in ADHD.
In addition to conducting an interview and the clinical evaluation, it is necessary to rule out other conditions and carry out interviews with teachers, parents/partners, colleagues, family members, and spouses to establish the diagnosis. We must remember it is a clinical diagnosis.
To conclude, a specialist criterion with experience in ADHD is sufficient to establish an ADHD diagnosis. It is a process guided by provider observation(s) and interview(s) of patients and must meet established criteria, not necessarily requiring the application of additional scales or tests.
If you suspect your child, you, or someone close to you may have ADHD, do not hesitate to contact us or other specialists to initiate a complete clinical evaluation.