Assessment

There is no independent valid test to determine that a child has ADHD. The diagnosis can only be obtained reliably by using well-established diagnostic assessment methods. This involves using the standardized diagnostic criteria of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; Box 24-2), rather than the clinical description of the World Health Organization's International Classification of Diseases (ICD-9) (AHCPR, 1999). Unfortunately, only 30% of family physicians routinely use the DSM criteria (Rushton et al., 2004). This must be part of a comprehensive diagnostic evaluation that involves obtaining information from the parents, child, and teacher. The baseline assessment of target ADHD symptoms can be assisted by using standardized behavior reports, such as the Conners Rating Scales (1997 revision), NICHQ Vanderbilt forms, or the SNAP checklist. Broadband behavioral rating scales, such as the Child Behavior Check List (CBCL, Achenbach), do not effectively discriminate between ADHD and non-ADHD children but do assist in identifying comorbid disorders (AAP, 2000). Because of the significant prevalence of comorbid psychiatric disorders, the assessment should include inquiring about these conditions (AHCPR, 1999). In addition to psychiatric symptoms, the ability of the child to function normally in different domains must also be assessed. These domains include family relationships with adults, sibling relationships, peer social relationships, community behavior, school academic performance, school behavior, interests and play activities, and subjective psychological distress.

The physician should conduct a medical screening examination, including hearing and vision tests, if this has not already been done. Other diagnostic tests, including laboratory screening tests for lead intoxication, abnormal thyroid function, neuroimaging for brain tumor, or seizure disorder, should be conducted when indicated by the history and physical examination (AHCPR, 1999). Computerized continuous performance tests should not be used as a clinical screening or diagnostic tool for ADHD.

ADHD Helping Your Anxious Child Audio

ADHD Helping Your Anxious Child Audio

Has Your Child Been Diagnosed With ADHD Is Coping With Your Child's Behavior Wearing You Out Are You Tired of Searching For Answers An ADHD child does not have to have a dark cloud over his or her head. If You've Got Burning Questions About ADHD, I've Got Answers.

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