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What are the symptoms of Attention Deficit Hyperactivity Disorder (ADHD)?
Wide arrays of symptoms indicate the presence of ADHD. A common ADHD symptom is the difficulty or inability to sustain attention. Other symptoms include the failure to follow directions, frequent careless mistakes, inability to organize activities, and distractibility. Bossiness, stubbornness, extreme mood swings, and low or poor self-esteem are also ADHD symptoms.
How is Attention Deficit Hyperactivity Disorder (ADHD) diagnosed or evaluated?
The evaluation of children with possible ADHD may be performed by a variety of health care and mental health professionals, including child and adult psychiatrists, neurologists, and psychologists and neuropsychologists. It is most often the primary care physician, however, whom the parent or school first approaches about making the diagnosis. There is currently no single reliable diagnostic test for ADHD. Diagnosis is based on a comprehensive clinical assessment that should include the following:
- History of the problem-including onset, type, and severity of ADHD symptoms.
- Assessment of common co-morbid conditions-including symptoms of depression or anxiety, oppositional behaviors and conduct problems.
- School history-including previous and current academic and behavioral difficulties, history of grade retention, recent report card results, academic strengths and weaknesses, homework management, and peer relationships.
- Assessment for learning disabilities-including review of any previous educational or achievement test results and neuropsychological (e.g., IQ, language, cognitive, processing abilities) evaluation results.
- Family history-including other family members with ADHD, academic problems or learning disabilities, mood or anxiety disorders, substance or alcohol abuse, thyroid disease.
- Social history-including educational level of parents and siblings, family constellation, marital history, history of domestic violence or sexual or physical abuse, recent or ongoing stressors in the home, family response to the child's behavior and/or academic problems.
- Developmental history-including major milestones, results of previous developmental evaluations.
- Medical history-including significant or chronic illnesses, lead poisoning, significant head trauma, allergies, medications.
- Physical examination-including growth parameters, baseline vital signs, brief neurologic examination.
- Sleep history-including sleep onset difficulties, night waking, quality and duration of sleep (restless), early awakening, and bed wetting.
- Child interview-including observation of ADHD target symptoms in the office setting, general cognitive and language level, child's understanding of behavioral concerns, parent-child interactions.
- Standard ADHD questionnaires-including validated instruments such as the Conners' Parent and Teacher's questionnaire, which provides information about pretreatment baseline functioning and later allows a standardized measure of treatment efficacy. The Achenbach Child Behavior Checklist (CBCL), which has parent, teacher, and self-report forms, is also an excellent screening tool for many behavioral problems, including ADHD.
Diagnosing an adult with ADHD is not easy. Many times, when a child is diagnosed with the disorder, a parent will recognize that he or she has many of the same symptoms the child has and, for the first time, will begin to understand some of the traits that have given him or her trouble for years. Other adults will seek professional help for depression or anxiety and will find out that the root cause of some of their emotional problems is ADHD.
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