Doing Life Together

child footballI’ve been in practice for over 20 years and worked in a center for ADHD. One of our goals was to make sure the right kids were correctly diagnosed when it came to ADHD. Great care was taken to do the proper assessments that help make the diagnosis.

So if you have a child whom you think might be ADHD ask, “Who is making the diagnosis? And based on what?” With 10-11% of U.S. children given the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), we need to make sure the diagnosis is correct.

According to a national survey sponsored by the Centers for Disease Control and Prevention’s National Center for Health Statistics, family members are usually the first ones who express concern, but in about a third of the cases, day care workers or schools note the signs.

A third of time, pediatricians make the diagnosis, followed by psychiatrists, and then primary care doctors. Psychologists diagnose about 14.1% of the time and yet their evaluation process is critical, especially with children. The median age of diagnosis is age 7, with one-third of children diagnosed before the age of 6. Overall, 53% of the time, it is the primary care doctor making the diagnosis.

So what does this mean? In my opinion, it means that you need to have a full evaluation by a psychologist or psychiatrist when diagnosing children 6 and younger. I would recommend the same for those over the age of 6 as well. Reports from caretakers, school personnel, family and others who interact with the child are very important. There is an organized and evidenced-based approach that should be followed.

Typically, to make the diagnosis, the child should meet the criteria in the DMS V (Diagnostic and Statistical Manual) that mental health therapists use. The extent of the child’s impairment and distress across multiple settings should be reviewed and multiple informants (parents, teachers, other adults, etc. and the child) should be interviewed or surveyed.

Important to remember is that there is no single test to make the diagnosis. It is process with several steps as information is gathered and signs of the disorder are observed. A checklist of symptoms, answers to questions about past and present problems, psychological tests in order to measure IQ and social and emotional adjustment, and a medical exam to rule out other causes for symptoms are all needed. If you still feel unsure, it’s fine to ask for a second opinion.


References:  Visser SN, Zablotsky B, Holbrook JR, Danielson ML, Bitsko RH
Natl Health Stat Report. 2015;3:1-7

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