ADHD testing: Everything parents need to know

Children's Health

by Arti Lal, MD

Oct 6, 2021

If your child’s brain tried to communicate that it had a problem, would anyone notice?

In my office, kids’ brains sometimes ask for help by displaying symptoms of attention deficit hyperactivity disorder (ADHD). My job is to work with you, the child’s parent or caregiver, to determine whether ADHD is causing the emotional, social and behavioral issues that prompt the office visit.

Until recently, children with ADHD were often misdiagnosed or mislabeled. Many of them missed out on the stabilizing treatment that could have made all the difference. But in the 1990’s, parents became more aware of the condition, diagnoses were verified and treatment options improved. These developments changed thousands of lives and turned the tide for future generations.

Today, ADHD testing is still fraught with misconceptions. But that’s okay—we’re here to clear them up.

What is ADHD?

ADHD is a mental disorder that affects about 8.4% of children and 2.5% adults. This neurobiologic condition could be caused by a number of factors:

  • Brain anatomy
  • Heredity
  • Head injuries
  • Premature birth
  • Prenatal exposure to substances
  • Environmental toxins

Some parents ask me whether sugar, too much screen time, or even immunizations can cause ADHD. There is no evidence any of these theories hold any weight whatsoever.

ADHD is marked by inattentiveness, impulsivity, or often, both. These symptoms can be expressed in many different ways, as you may have seen for yourself.

Living with and loving a youngster with suspected ADHD can be confusing. Here’s what you need to know about ADHD testing.

How ADHD usually starts and how it typically goes

No one looks at their kid and on-the-spot declares they likely have ADHD. No, this disorder is diagnosed by a combination of events that add up to a wholistic picture.

Concerns usually arise at home in early childhood. Caregivers and parents often tell me about a child’s wild or stubborn personality. Then, suspicions are validated when the child enters daycare or the classroom, where other children are nearby as a benchmark for social and emotional behavior.

At these ages, all educators and parents acknowledge the busy, fidgety nature of kids in general. But they can also usually recognize if a particular child shows an extreme degree of inattentiveness or impulsivity. The CDC’s organization, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), has published a list of ADHD symptoms and signs that indicate a child may need to be tested for ADHD.

Left untreated, ADHD can sabotage a youngster’s academic performance as they enter elementary school and middle school, even though their intelligence matches that of their peers. The underperformance further frustrates the child, exacerbating the impulsivity and/or inattentive behavior.

And come high school, untreated kids with ADHD can start to show a lack of motivation or perseverance. Each child shows the disorder very differently, making it extremely difficult for parents to pin down.

As the brain continues to develop, the condition tends to become more cerebral. It exposes itself less in outward expressions, and instead presents as anxiety and inner emotional tension. These changes can further confuse both child and caregiver. Thankfully, a simple visit to the doctor for ADHD testing can help.

What to expect at your child’s ADHD testing appointment

When you plan a visit to your primary care provider, you want to know what you’re walking into. My team takes a three-pronged approach to ADHD testing.

Clinical interview

We start with a list of questions that covers a range of aspects of the child’s life. Some of the things we cover include:

  • What are some other events happening in your child’s life right now? For example, maybe mom has just had a baby and the older sibling, a five-year-old, is acting out. Or perhaps there’s been a recent move or other major transition.
  • What physiological symptoms is your child experiencing, if any? I saw a 14-year-old who suddenly lost weight and became very irritable, hyperactive and inattentive. Based on his physical symptoms, I could rule out ADHD. Turns out he actually had high thyroid levels. Today, he’s being treated properly for that and doing very well.
  • Was there any trauma in the past? Young brains cannot process abuse. Often, as they develop, the turmoil emerges as behavioral and academic problems.
  • What’s the degree of dysfunction? Sometimes young people are slightly inattentive and somewhat impulsive. We don’t want to medicate a child just because of a personality quirk, so it’s critical we assess the degree of dysfunction in our clinical interview.
  • Does the child’s lifestyle support healthy mental and emotional development? Kids who don’t get enough sleep, affection, nutrition, socialization and exercise can easily develop the kinds of issues that appear to be ADHD. When they’re “multitasking” between social media, video games, streaming movies and messaging apps, they’re training their brain to be unfocused and inattentive. This is a possibility we explore in our clinical interview, as well.

Our clinical interview is my chance to be your child’s advocate—and detective. The open, honest conversation allows me to take a wholistic look at what could be contributing to the reason for the office visit, and what we can do about the problem.

Rating scales

ADHD is nothing if not nuanced. That’s where our rating scales come in handy. Rating scales are an opportunity for the young person to answer “somewhat yes” and “somewhat no” to a variety of scenario questions. This way, they can self-report how emphatically they struggle or succeed in different areas of life.

A computerized test

The third is a computerized test, which is an objective measure of your attention, impulsivity and activity level.

The reliability of this three-pronged approach is truly sealed with the impartial, substantive results of the computerized test. In the clinical interview, I get to ask the questions based on my knowledge. Then, during the rating scales portion, the child or teen gets to contribute their input. And finally, the computerized assessment is something completely outside the two of us. It’s completely objective. And it confirms or allays our hypothesis so that we can begin discussing treatment options for your child.

How to get started

ADHD is a disorder that can be disabling to different extents. It presents differently at different ages and in different kids. But families who come to see me are in the right place. And if we find that your child does not have ADHD, then we will definitely still try to find solutions in some other way.

As a parent, it’s only natural to worry about your child’s well-being. The good news is this: there is a variety of helpful treatment options in terms of medication, classroom accommodations and—for older kids and young adults—life coaching. We’re here to help you navigate the uncertainties of ADHD and team up together to help your child thrive.

Is your child showing symptoms of ADHD? Connect with an expert today.

About the Author

Arti Lal, MD, FAAP, is a pediatrician on the medical staff at Baylor Scott & White Clinic – Austin Northwest. She specializes in caring for the mental health of children and teens. Schedule an appointment with Dr. Lal today.

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