How Is ADHD Diagnosed?

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Mother son and teacher in a conference

Mother son and teacher in a conference

SDI Productions / Getty Images


  • ADHD is a disorder that can affect your thinking, behaviors, and ability to function.
  • There are three main types of ADHD: inattentive, hyperactive-impulsive, and combined ADHD.
  • Yours or your child's healthcare provider can use diagnostic measures and criteria to help you understand what type of ADHD you or your child have.
  • During your appointment, a healthcare provider will take a thorough medical history, perform a physical exam, and conduct various behavioral and educational evaluations to learn more about yours or your child's symptoms.

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder (meaning, it’s a condition that can affect the growth and development of the brain). The condition is commonly seen in children and adolescents, but symptoms can linger into adulthood. ADHD symptoms can affect how your child thinks, behaves, and interacts with others and their environment. 

There is no single test that healthcare providers use to diagnose ADHD. As a result, the diagnosis process involves many steps, including the use of physical exams and a variety of evaluations. 

Typically, people with ADHD receive a diagnosis during childhood—which means that a parent or caregiver is usually involved in the diagnostic and treatment process. That said, your child’s healthcare provider or pediatrician may also seek insight about your child from teachers, coaches, or other important adult figures in your child’s life to make an accurate diagnosis.

If you are concerned that your child might have ADHD, talking with a healthcare provider is an important first step. A primary care provider or mental health professional (e.g., psychologist or behavioral health specialist) can help you evaluate symptoms, make an accurate diagnosis, and work with you to create a treatment plan that is best suited for your child’s needs. 

Diagnosis in Adults

It's important to note that people who begin to experience symptoms as an adult—particularly, adult women—often have a delayed diagnosis. This is because research on ADHD was historically done on young boys. Newer studies have found that symptoms in women and adults can present differently, which can sometimes make it difficult to recognize ADHD symptoms and make an accurate and early diagnosis.

Medical History

Screening for ADHD can begin for children as young as four years old. When taking your child’s medical history, your healthcare provider may ask about:

  • Current symptoms you are noticing 
  • The possibility of any prenatal exposures to tobacco, drugs, or alcohol 
  • Infections or complications that occurred immediately before and after birth
  • Head trauma
  • Recurrent ear infections 

Research shows that there’s a strong genetic component to ADHD. This simply means that ADHD tends to run in families. To assess family history, your child’s healthcare provider will also ask whether you or your immediate family members have experienced symptoms of ADHD or received an ADHD diagnosis.

ADHD symptoms like hyperactivity or inattention can interfere with schoolwork. To get a better sense of school performance and behavior, your healthcare provider may ask you the following questions:

  • Have you, a teacher, or another caregiver noticed any problems with your child’s learning?
  • What emotions do you notice your child feeling at home versus at school? 
  • How does your child behave at home? 
  • Are behaviors different at school or when your child is playing with other children?
  • Does your child experience any challenges completing homework or doing chores?
  • Are there any other emotional, behavioral, or cognitive issues that you’re noticing in your child?

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Physical Exam

Generally, after a provider learns more about your child’s medical history, they will perform a physical exam to help them learn more about symptoms. During the physical exam, the provider will likely:

  • Measure vital signs (e.g., blood pressure, temperature, heart rate)
  • Check height, weight, and head circumference 
  • Screen for vision or hearing problems
  • Assess coordination and movement 
  • Observe behaviors and communication skills during the visit 

Results from the physical exam can help your child’s healthcare provider figure out if your child needs additional testing and rule out other health conditions.

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Developmental and Behavioral Evaluation

A healthcare provider may also want to learn more about your child’s developmental and behavioral history. During the developmental evaluation, the provider may inquire about: 

  • How your child interacts with you, caregivers, or teachers 
  • If your child misses school often 
  • At what age did your child say their first words, when they started communicating in phrases or coherent sentences, or if they picked up other languages 

During a behavioral assessment, a healthcare provider will ask you:

  • At what age your child’s symptoms first began
  • How long have symptoms lasted
  • Whether symptoms occur at school or home or both environments 
  • If there’s been an impact of the ADHD symptom on everyday tasks or interactions 

Your child’s healthcare provider may also ask you to complete a behavior rating scale—a questionnaire that asks about patterns of behaviors in different settings and environments. These scales can better inform your child’s provider to make an accurate ADHD diagnosis.

An ADHD-specific scale is a type of behavior rating scale. There are several ADHD-specific rating scales. Examples of scales include: 

  • Conners Comprehensive Behavior Rating Scales: For preschool-aged children between the age of 4 and 5 years old 
  • ADHD Rating Scale-IV: For preschool-aged children between the age of 4 and 5 years old 
  • ADHD Rating Scale-5: For children between the ages of 5 and 17 years old
  • Vanderbilt Assessment Scales: For children of ages 4 and older

Educational Evaluation

An educational evaluation helps your child’s provider learn about ADHD symptoms in an educational setting. This evaluation is usually completed by a teacher or teacher’s student aid. The evaluation typically includes:

  • Completing an ADHD-specific rating scale
  • Providing copies of report cards and samples of completed schoolwork
  • Offering a summary of classroom behavior and interventions, learning patterns, trouble functioning, or difficulty interacting with others 

For this evaluation to be reliable, teachers must have regular interactions with your child for at least four to six months. This allows teachers to better observe how often ADHD symptoms happen and how symptoms may be affecting your child in a school setting.

DSM-5 Criteria for ADHD

Healthcare providers use agreed-upon criteria to help diagnose health conditions. The DSM-5 is one of several tools that a provider can use to screen for and diagnose ADHD. During the diagnostic process, your child’s healthcare provider will use these criteria to provide an accurate diagnosis for your child and work with you to figure out a treatment plan, if necessary. 

DSM-5

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a set of criteria used to diagnose mental disorders such as ADHD. The most current version used by healthcare providers is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The DSM-5 criteria for an ADHD diagnosis are based on age and the three categories of ADHD symptoms: inattention, hyperactivity, and impulsivity. There are three types of ADHD:

  • Inattentive ADHD
  • Hyperactive-impulsive ADHD
  • Combined ADHD—which includes elements from all three categories of ADHD symptoms

To receive a diagnosis for ADHD, children younger than 17 years old should have either six or more symptoms of ADHD, while people over the age of 17 should have five or more symptoms of ADHD. Additionally, symptoms of ADHD must:

  • Last for at least six months 
  • Occur on most days of the week 
  • Be present in more than one setting (e.g., school and home)
  • Become apparent before the age of 12
  • Impair function in school, work, or social activities

Your child’s healthcare provider will look for the following symptoms:

Inattentive ADHD Criteria
Symptoms of Inattentive ADHD 
Making careless mistakes or lack of attention to detail
Difficulty maintaining attention in school, at home, or during play 
Trouble listening to someone speaking, even when directly addressed
Failing to follow directions or complete assignments and chores  
Avoiding tasks that require consistent or prolonged mental effort
Not being able to organize tasks and activities 
Losing or misplacing objects
Feeling easily distracted
Forgetting things 
To receive a diagnosis for inattentive ADHD, children under 17 must have six or more of these symptoms and people 17 or older must have five or more of these symptoms.
Hyperactive-Impulsive ADHD Criteria
Symptoms of Hyperactive-Impulsive ADHD  
Fidgeting hands or feet and squirming while sitting down
Leaving seat often, even if required to stay seated 
Feeling restless 
Difficulty engaging in activities quietly 
Trouble staying still for extended periods of time
Talking excessively
Blurting out answers or responding to questions before they are fully asked 
Difficulty taking turns with others 
Interrupting or intruding on other people’s activities 
To receive a diagnosis for inattentive ADHD, children under 17 must have six or more of these symptoms and people 17 or older must have five or more of these symptoms.

Some people may experience ADHD symptoms in only one category. But, others can experience an equal amount of symptoms of both inattentive-type and hyperactive-impulsive-type ADHD. If this is the case, your child’s healthcare provider may diagnose your child with combined ADHD—which is the most common type of ADHD in the United States.

Screening for Related Conditions

ADHD symptoms can look like other developmental, emotional, or behavioral disorders. Some disorders may also co-occur with (happen at the same time) ADHD. These are known as comorbid conditions. Comorbid conditions for ADHD include but are not limited to:

  • Learning disabilities
  • Language disorder
  • Autism spectrum disorder (ASD)
  • Sleep disorders
  • Depression
  • Anxiety
  • Oppositional defiant disorder
  • Conduct disorder

During the diagnostic process, the provider may use a variety of evaluations to ensure that your child’s symptoms are due to ADHD and not because of another related condition. If your child’s provider is still unsure about the root cause of your child’s symptoms, they may opt for additional testing and mental health evaluations. 

Remember: while symptoms of ADHD can be frustrating for both your child and you, it’s important to reach out to your child’s provider for testing and care to learn what is causing the symptoms and what you can do to treat the condition.