Attention Deficit/Hyperactivity Disorder (AD/HD) is a lifelong condition that first emerges during early childhood and can be difficult to diagnose for a few reasons.  For one, many symptoms of AD/HD can be considered typical childhood behaviors, so it can be hard to distinguish what is ADHD-related and what is not.  Most importantly, the presentation of AD/HD symptoms can look very different in different children, so there is not a “one size fits all” approach to diagnosis. ADHD is more than problems with distractibility, impulsivity and disorganization. Children with ADHD may also struggle with symptoms such as emotional sensitivity, relationship problems and difficulty with time management.

There are 3 “official” presentations of AD/HD: Inattentive presentation (this is what used to be called “ADD”), Hyperactive/Impulsive presentation, and Combined presentation.

The symptoms of AD/HD Inattentive presentation can include:

  • Difficulty sustaining attention
  • Does not seem to listen when spoken to
  • Losing things
  • Forgetfulness
  • Being easily distracted

The symptoms of AD/HD Hyperactive/Impulsive presentation can include:

  • Fidgeting
  • Constantly “on the go”
  • Excessive talking
  • Blurting out or interrupting
  • Difficulty waiting one’s turn

If a child shows symptoms from both lists, a Combined presentation type is likely.

Other common symptoms associated with AD/HD include:

  • Difficulty with organization
  • Poor time management and procrastination
  • Difficulty getting started on and following through with tasks
  • Difficulty shifting tasks
  • Difficulty with working memory
  • Poor emotional regulation

These types of skills listed above are sometimes collectively referred to “executive functioning.”

Complications with diagnosis: AD/HD is much more than just not being able to pay attention or inhibit impulses.  AD/HD also shares many symptoms with other diagnoses.  For example, individuals with depression and anxiety often have difficulty concentrating, may be restless, and may have problems with regulating their moods.  Individuals with learning disabilities may appear as though they aren’t listening or are forgetful at times. This is why it is so important to receive an accurate evaluation and diagnosis that will lead to an appropriate treatment plan.

Unfortunately, there is no single objective “test” that can be used to diagnose AD/HD.  A thorough evaluation will use a combination of direct observation, assessments, interviews with teachers and parents, and rating scales from home and school.  This is often difficult for even the most diligent and well-meaning pediatricians to accomplish.  Moreover, pediatricians rarely have expertise in direct assessment and may misinterpret rating scales or not assess for other disorders with similar symptoms that can mimic AD/HD.

By seeking a diagnosis from a trained evaluator, such as a psychologist or school psychologist who has expertise in assessing symptoms, you will be able to differentiate AD/HD from other disorders such as anxiety, learning disability or language/speech disorders. Early assessment and intervention are vital in getting children the skills they need to be successful. Helpful interventions often include behavioral strategies to reduce problem behaviors, social skills training to improve peer relationships, educational interventions to tailor a classroom environment for their success. There is also the potential of dietary and or medication consultation to address physiological processes.

If you think your child may have AD/HD, you’ll want to seek out evaluation options right away.  Dr. Julia Hollinger at Fundamental Psychology provides comprehensive AD/HD testing for children and teens which includes assessment of attention, focus, inhibition, and executive functioning as well as provide recommendations for intervention and treatment.  Dr. Hollinger can also help coordinate any additional services that are needed through the school.

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