Screening

Screening for ADHD

Screening recommendations vary depending on the clinical setting. The American Academy of Pediatrics recommends that the primary care clinician should initiate an evaluation for ADHD for any child from 4 to 18 years of age who presents with academic or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity.[90]

Clinicians should be aware that:

  • The presenting symptom in preschool children is often hyperactivity, while inattention is more prevalent among adolescents with ADHD.

  • ADHD is likely under-recognized and underdiagnosed in girls.[18]

Screening for comorbidities

The American Academy of Pediatrics recommends that clinicians should screen for comorbid conditions when evaluating a child or adolescent for ADHD (e.g., anxiety, depression, oppositional defiant disorder, conduct disorders, substance use), developmental conditions (e.g., learning and language disorders, autism spectrum disorders), and physical conditions (e.g., tics, sleep apnea).[90]

For substance misuse screening, the 2-question National Institute on Alcohol Abuse and Alcoholism Youth Alcohol Screening Tool is suitable for children as young as 9 years.​[110]​​

Beginning at age 12 years, the Screening to Brief Intervention approach (SBIRT) is preferred.[111]​ Identification of suspected or confirmed substance use disorder requires immediate brief intervention and referral to an addiction or mental health specialist.[110]

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