ADHD Evaluations for Children

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by significant problems with inattention, hyperactivity, impulsivity, and inconsistency that interfere with functioning and development. Individuals with ADHD typically struggle to regulate their focus, self-control, and emotions, as well as to shift from one activity, situation, or strategy to the next. In terms of cognitive processes, skills, and behaviors, ADHD overlaps closely with executive functioning disorder; however, while ADHD is a clinical diagnosis, executive functioning disorder is not.

While ADHD looks different in every child, there are three diagnostic types: predominantly inattentive, predominantly hyperactive, and combined presentations. However, ADHD can look different in everyone. Often, individuals display a unique combination of symptoms that overlap with their abilities, temperament, and educational and life circumstances. 

As Dr. Katen says, “If you’ve seen one child with ADHD, you’ve seen one child with ADHD.” In other words, ADHD looks different in everyone. However, symptoms generally include the following: 

• Being easily distracted
• Making careless mistakes or not paying attention to details
• Difficulty following instructions
• Seemingly not “hearing” information or instructions
• “Daydreams” often or is easily bored
• Losing things and being forgetful in daily activities
• Inconsistent performance
• Not finishing tasks
• Difficulty sustaining effort
• Difficulty organizing tasks, assignments, or projects
• Easily losing track of time or struggling to track progress
• Regulating emotions
• Interrupting or talking over others, blurting out answers
• Fidgeting with hands or feet, struggling to remain seated
• Excessive restlessness, running about, climbing
• Excessive talking 
• Acts as if driven by a motor
• Difficulty waiting or taking turns

An evaluation of ADHD is appropriate for children who are showing difficulty paying attention, recalling information they read, following through on multistep instructions, keeping their room clean, keeping their backpacks organized, turning in work, regulating emotions, and controlling behaviors and choices. 

ADHD can be diagnosed as early as 4 years old (when other areas of development are typical). Symptoms of ADHD must be present before the age of 7 years. 

Ideally, ADHD evaluation and diagnosis is conducted by a psychologist or neuropsychologist who specializes in ADHD and related disorders. Such providers will complete an in-depth assessment that utilizes standardized neuro-measures to fully understand and characterize the unique strengths and struggles of the child. ADHD can also be screened and diagnosed by a psychiatrist, pediatrician, family physician, and therapist/counselor. While teachers, school psychologists, school counselors, language therapists, and occupational therapists may be qualified to identify signs and symptoms of ADHD (or to begin a conversation with parents), they do not issue the clinical diagnosis. 

There is no single test for ADHD, and a diagnosis should not be issued based on one source of information. Ideally, ADHD evaluation includes standardized questionnaires, clinical observation, and neuropsychological measures of inattention, impulsivity, hyperactivity, and consistency. In addition, at Individual Matters we also include measures of development and/or cognitive ability (IQ) because this information is essential to understanding the child’s unique operating system, and it supports differential diagnosis (i.e., teasing out symptoms of ADHD from other disorders or problems).

A school-based identification of ADHD is not a clinical diagnosis; it is based solely on how the child is performing and behaving in the classroom. 

A medical/clinical diagnosis of ADHD is issued by a psychologist, physician, or therapist/counselor and can help parents with getting their child the right supports at school.

If you are concerned that your child is struggling with ADHD, a good first step is to consult with a clinical psychologist who specializes in ADHD evaluation. This consultation should clarify the evaluation purpose and process, outline the scope and cost, and identify goals and potential outcomes. You should feel comfortable with the provider, understand their philosophy about child development and learning, and clearly understand the evaluation process and associated costs. This is also the time to ask questions. If you don’t feel good after the consultation, consider shopping around for other providers and options.

Treatment and intervention for ADHD are unique for each child – this is why individualized evaluation is so important. Every child’s ADHD profile is one-of-a-kind, just like their fingerprints.  When the process begins with a quality evaluation, you can be sure you are on the right track to helping your child.  

Also, an ADHD diagnosis does not automatically mean your child needs to be put on medication. There are many avenues, supports, and interventions available to you, including behavioral therapy, counseling, educational/ADHD coaching, occupational therapy, neurofeedback, school-based intervention, and holistic approaches.