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Understanding ADHD
Understanding ADHD

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1.3.3 The diagnostic process

Diagnosing any condition does not simply require identification of symptoms. The whole process of diagnosis is complex and will often begin with a trip to see a GP, who may make a referral to a specialist. In the case of ADHD, the type of specialist someone is referred to depends on their age and the services available locally. This means that some people will be referred to a psychiatrist while others may see a learning disability specialist. When a specialist sees an individual, they will then work through a series of steps to establish a diagnosis as you will see in Activity 3.

Activity 3 Diagnosing ADHD

Timing: Allow about 15 minutes

The diagnostic process includes several different stages as shown in Figure 4.

The diagram shows six panels, three are pink and three are blue. The pink panels are smaller then the blue panels. The first pink panel at the top reads ‘psychological assessment’ and the blue panel positioned next to it is bullet pointed with the following: Clinical interview to determine symptoms with child or parent; Medical history of individual collected; Family history collected; Psychological testing conducted. The second pink panel lower down reads ‘Differential diagnosis’ and the blue panel positioned next to it bullet points the following: Details of any signs and symptoms are collated and all possible diagnoses are noted; The probability of each of the diagnoses are considered and the most likely one taken forward. The pink panel towards the bottom of the diagram reads ‘Co-mobidity analysis’ and the blue panel adjacent bullet points the following: The possibility of multiple conditions is considered; Additional diagnoses are made if needed.
Figure 4 The typical steps required when diagnosing ADHD in children and adolescents
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The diagram shows six panels, three are pink and three are blue. The pink panels are smaller then the blue panels. The first pink panel at the top reads ‘psychological assessment’ and the blue panel positioned next to it is bullet pointed with the following: Clinical interview to determine symptoms with child or parent; Medical history of individual collected; Family history collected; Psychological testing conducted. The second pink panel lower down reads ‘Differential diagnosis’ and the blue panel positioned next to it bullet points the following: Details of any signs and symptoms are collated and all possible diagnoses are noted; The probability of each of the diagnoses are considered and the most likely one taken forward. The pink panel towards the bottom of the diagram reads ‘Co-mobidity analysis’ and the blue panel adjacent bullet points the following: The possibility of multiple conditions is considered; Additional diagnoses are made if needed.

Figure 4 The typical steps required when diagnosing ADHD in children and adolescents

Watch Video 3 How is ADHD diagnosed [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] in which Thomas E Brown briefly discusses the difficulty in diagnosing ADHD. As you watch the video make notes of the challenges he mentions. You may like to use the box provided.

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Discussion

Dr Brown notes that there is no one test to determine ADHD. No medical imaging of the brain, no blood test, no EEG, no computer test. Clinical interview is used where a medical professional who understands ADHD obtains a variety of information from various sources e.g. the child, the parents, teachers. The aim is to understand functioning at school and home. Focus questions are: What is life like? What stressors are there in life? Any other health problems? Is there any known family history of ADHD?

You saw in Section 1.1 that variation in prevalence is found according to culture and gender. The next section will explore briefly how these factors impact on diagnosis.