Investigations
1st investigations to order
no formal laboratory or imaging studies
Test
Behaviour rating scales can be used to aid with the diagnosis.[90] In the author's experience, a brief scale is the preferred choice, as it reduces the burden on parents and teachers. The same scale can be used to follow response to treatment. Commonly used scales include:
The ADHD Rating Scale: an 18-item scale based on the DSM criteria for ADHD. It is useful both for diagnosing ADHD in children and adolescents and for measuring improvements with treatment.
The Vanderbilt Scale: a scale that assesses ADHD, comorbid conditions (including oppositional defiant disorder, conduct disorder, anxiety, and depression), and performance. There are both parent and teacher forms as well as initial and follow-up forms. Vanderbilt ADHD diagnostic scales Opens in new window
SNAP-IV is included in many research trials, including the Multimodal Treatment Study of AD/HD (MTA). It is a 26-item scale that screens for hyperactive and inattentive types of ADHD and for oppositional defiant disorder (ODD). SNAP-IV 26 - teacher and parent rating scale Opens in new window
The Child Behavior Checklist (CBCL) can be used to assess a wide range of child behavioural problems, with the CBCL-Attention Problem (CBCL-AP) sub-scale used as a diagnostic tool for ADHD.[94] However, this scale does not include all the criteria to establish a diagnosis.
Conners rating scales: Includes a long and short version. There are three forms, to be completed by parents, teachers, and the child, respectively.
DuPaul ADHD Rating Scale: Includes both teacher and parent forms.
Result
diagnosis is clinical
Investigations to consider
neuropsychological testing
Test
Because ADHD is considered a behavioural disorder and is diagnosed by clinical history, neuropsychological testing is neither necessary nor sufficient for the diagnosis.[90] However, testing should be considered by a neuropsychologist when it is important to differentiate between ADHD and learning disabilities. Failing to recognise a learning disability can result in inadequate response to medication, academic failures, and low self-esteem.
Result
normal cognitive ability and academic achievement but will often have deficits in executive functions (those required to plan, prioritise, attend to, and inhibit behaviours) including working memory and processing speed
Use of this content is subject to our disclaimer