There are currently no medical tests for ADHD

ADHD is diagnosed by the observation of behavioural symptoms.

If you’re concerned about your child’s behaviour, your GP is a good place to start. Your GP might refer your child to a paediatrician, a psychologist or a child psychiatrist for a diagnosis of ADHD (or other condition).

The diagnosis process could include the following:

  • An interview with you and other primary carers of your child
  • An interview with your child
  • Behaviour checklists you and/or your child’s carers and teachers complete
  • Discussions with your child’s teachers or carers

Your child might also have other tests, including:

  • Developmental, learning, educational or IQ checks
  • Language, speech and movement checks
  • General health checks
  • Vision and hearing tests

ADHD Diagnosis Information

The Diagnostic and Statistical Manual of Mental Disorders (DSM V) is the manual used by clinicians and researchers to diagnose and classify mental disorders and is produced by The American Psychiatric Association (APA).

The APA is a national medical specialty society whose more than 36,000 physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including ADHD.

DSM-V is the guide that lays out the criteria to be used by doctors, mental health professionals, and other qualified clinicians when making a diagnosis of ADHD in Australia and the USA.

The 5th edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-V), was released by the APA in 2013.

According to DSM-V, ADHD is now listed in the new category of ‘Neuro-developmental Disorders’ and described as:

“a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with development, has symptoms presenting in two or more settings (e.g. at home, school, or work), and negatively impacts directly on social, academic or occupational functioning”.

ADHD symptoms are divided into two categories:

  • Inattention; and
  • Hyperactivity and Impulsivity

Children must have at least six symptoms from either, or both categories, while older adolescents and adults (over age 17 years) must present with five.

Symptoms must have been present before age 12 (compared to age 6 in DSM-IV).

Because everyone shows some of these behaviours at times, the DSM-V contains very specific guidelines for determining when they indicate ADHD.

The behaviours must appear before age 12, and continue for at least 6 months.

In children, they must be more frequent or severe than in others of the same age. The behaviours must create a real hindrance in at least two areas of a person's life, such as school, home, work, or social settings. Therefore someone whose work or friendships are not impaired by these behaviours would not be diagnosed with ADHD. Nor would a child or adult who seems overly active at school or work but functions well elsewhere.

DSM-V was updated to reflect more accurately the experience of adults with ADHD. Although ADHD is a disorder that commences in childhood, it can continue throughout adulthood for some people.

DSM-V has provided guidance to clinicians in diagnosing adults with the condition and ensuring that children with ADHD will continue to have access to care for the condition throughout their lives if necessary.

DSM-V includes no exclusion criteria for people with autism spectrum disorder, since symptoms of both disorders co-occur, meaning that a person can now have a diagnosis of both ADHD and Autism Spectrum Disorder.

However, ADHD symptoms must not occur exclusively during the course of schizophrenia or another psychotic disorder and must not be better explained by another mental disorder, such as a depressive or bipolar disorder, anxiety disorder, dissociative disorder, personality disorder, or substance intoxication or withdrawal.

A person’s ‘presentations’ can be subject to change during their lifetime which better describes how the disorder affects an individual at different points in their life.

A person can now be diagnosed with mild, moderate or severe ADHD based on how many symptoms a person presents with and how difficult those symptoms make their daily life.
To confirm a diagnosis children should have six or more symptoms of the disorder.

In older teens and adults the DSM-V states they should have at least five of those symptoms listed in What is ADHD?

Each child with an ADHD diagnosis is unique, and with hundreds of possible combinations of these symptoms and co-morbidities it means that each individual’s ADHD will present in many different ways.

The DSM-V diagnosis is a label informing us that the observed behaviours are considered to be outside the normal range.

However, the label does not tell us why that might be so or about any possible underlying causes.

ADHD often has other co-morbid conditions running alongside it. Please look at co-morbid conditions for more information.
Some professionals utilise Quantitative Electroencephalography (qEEG) as part of the diagnostic process.

An EEG measures the electrical patterns at the surface of the head, which reflects cortical activity. These patterns are commonly referred to as “brainwaves”.

Quantitative EEG (qEEG) is the analysis of these patterns from a multi-electrode recording. This EEG data is processed with various algorithms, statistically analysed, and compared to a normative database (comparing the brainwaves to a group of children/adults of similar age who are considered ‘neurotypical’). This data is then converted into color maps of brain functioning sometimes called “Brain mapping”.

QEEG processing techniques and the use of highly technical software to process this data, gives us the ability to view the dynamic changes taking place throughout the brain during specific neuropsychological/cognitive processing tasks, and this type of assessment can be used to assist in determining which areas of the brain are engaged and processing efficiently, versus those which are somewhat dysregulated or inefficient.

The qEEG information can be interpreted and used by experts as a clinical tool to evaluate brain function, and to track the changes in brain function due to various interventions, such as neurofeedback.

Several brain-imaging techniques such as Single-Photon Emission Computer Tomography (SPECT), Positron Emission Tomography (PET) or Functional Magnetic Resonance Imaging (fMRI) allow researchers to study how the brain operates and functions.

Most professionals that use brain-imaging techniques as part of the diagnostic process use qEEG.

If you think you child might have ADHD according the criteria above. Firstly read Conditions that Mimic ADHD then use the ADHD Directory to help you find a practitioner to help you with your next steps.

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