ADD ADHD: How is it Diagnosed?

Everyone in a private practice setting who works with ADD/ADHD children or adults is going to have their own opinion on how Attention Deficit Hyperactivity Disorder - ADD or ADHD - should be diagnosed. Some clinics take the perspective that “more is good,” and will recommend a large battery of tests, often costing many thousands of dollars. Other clinics, typically with hurried physicians, will simply give a brief rating scales to the parent and then make a quick diagnosis and prescribe treatment. Unfortunately neither of these extremes are in the patient’s best interest. 

Over-diagnosis of ADD ADHD is a big problem. There are some children who are diagnosed as having attention disorder that do not have it. It is not uncommon for someone with depression, or anxiety, specific learning disabilities, early onset bi-polar disorder, or Tourette’s Syndrome, to be diagnosed as ADD/ADHD. This is often the result of a diagnostic “work-up” which is too brief and does not take into account the many reasons why a child might be inattentive, impulsive, or over-active.

Under-diagnosis of attention deficit disorder - ADD ADHD - is also a problem. This happens most often in the school setting where the school psychologist writes his report perfectly describing an ADD individual, then refuses to use the label “Attention Deficit Disorder” in his report anywhere. It also often happens in therapist’s offices where the therapist is not familiar with ADD/ADHD, and only sees the characteristic behaviors as “acting out behaviors” due to family problems, etc. 

Some studies suggest that only one out of three people who have an attention disorder will get help. Two out of three people who have an attention disorder will never receive a diagnosis or treatment. They will never really know what it is that’s bothered them through their life. So we have two problems. One is over-diagnosis and the other is under-diagnosis.

How can you be certain?
What makes a good diangostic work-up?

The unfortunate thing is that there are many kids who have been diagnosed as having attention deficit hyperactivity disorder - ADD ADHD - based on only a parent interview that lasts about four minutes, or a real quick rating sheet taken in the doctor’s office. It’s unfortunate when that’s all that happens and the diagnosis of ADHD is made, because that could lead to real problems.

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