The journey to an ADHD diagnosis looks different for everyone – because ADHD symptoms can present differently in different people, and there is no official medical test for it, healthcare professionals must individually assess a person’s behavior over time to make a diagnosis.
ADHD isn’t usually diagnosed before about 4 years of age, because some of the symptoms of ADHD can be considered to be within the range of typical behavior in early childhood. ADHD symptoms can change as people age, and although it is not uncommon for teenagers and adults to reach a diagnosis, the process can sometimes be more complicated, since some of the more outwardly obvious symptoms can become less apparent than in childhood.
Age of diagnosis may also be affected by limitations such as cost and accessibility of care, and as a result, not everyone may be able to or wish to get an official diagnosis for themselves or their child.
Is an ADHD diagnosis necessary?
Some people identify as having ADHD through self-diagnosis, and although not everyone with ADHD requires support, there are options available for undiagnosed or self-diagnosed people with ADHD.
However, there are some benefits that come from getting an official diagnosis. It may help people feel validated in and better understand their own experiences. A diagnosis can also be crucial for gaining access to specific interventions, supports and services.
Step 1: Behavioral monitoring
When we’re young, our parents and the people who spend time with us, both at home and at places like daycare or school, naturally observe our behaviors and how we interact with the environment and others. It’s often by doing this ‘behavioral monitoring’ that people may first notice the signs of ADHD in a child.
During appointments, healthcare professionals may ask parents and guardians questions about any behaviors they might have noticed, to get a sense of whether the child may be showing signs of ADHD. They may even interact and play with the child to assess their behavior.
Behavioral monitoring is not limited to childhood. Teenagers or adults may be observed to be showing signs of ADHD by those close to them, or may even recognize the signs in themselves and choose to monitor their own behavior.
A handy resource
Behavioral monitoring can be hard to keep track of without a record. Human Health is a free mobile app that helps you track symptoms daily and see how they change over time, as well as any treatments or interventions you may be using.
You can download the app here, or by searching for ‘Human Health’ on the App Store or Google Play.
Step 2: Talking to a healthcare professional
If there are concerns that a person has ADHD, a visit to the pediatrician or family medicine doctor is usually the next step. During the appointment, your healthcare professional may discuss the symptoms of ADHD and how they relate to you or your child.
The doctor may also ask for more information about certain behaviours from other people who are close to the patient, such as educators, carers, and other adults who interact frequently with the patient. They may also consider if there are other conditions or factors that could be influencing the patient’s behavior other than ADHD.
Step 3: Moving towards a diagnosis
If the results of behavioral monitoring and assessment by a healthcare professional indicate that a child or adult may be showing signs of ADHD, it may be recommended to proceed with further investigations to determine an official diagnosis.
A primary care provider such as a pediatrician or family medicine doctor can make the diagnosis, but patients are sometimes referred to a specialist such as a psychologist or psychiatrist for diagnosis.
Formally diagnosing someone with ADHD means they have certain traits or symptoms that are known to be associated with the condition. These have been identified and studied over time through scientific and medical research. To diagnose ADHD, healthcare professionals follow standard guidelines from the Diagnostic and Statistical Manual, Fifth Edition (DSM-5). The DSM-5 outlines certain criteria that a patient must meet in order to be diagnosed with the condition, depending on their age.
However, as ADHD often does not present the same way in everyone, it can sometimes be challenging to reach a definitive diagnosis based on a standard criteria. Although ADHD does have some signs that show in a majority of people with the condition, there are also many people who are diagnosed later in life because they did not meet the criteria for an ADHD diagnosis in early childhood.
Whilst specialists trained to diagnose ADHD and other behavioral conditions are aware of this, it is not uncommon for people with ADHD to be misdiagnosed or remain undiagnosed. There is further research being conducted to minimize the occurrence of these cases and improve the diagnostic criteria for ADHD.
Once a formal diagnosis has been made, specific interventions, such as certain therapies, medications, or other supports including individual education plans or workplace accomodations may become accessible.
These supports may be useful in moderating the impact that ADHD traits and symptoms can have on how a person lives and functions.
There are also a wide variety of support groups available for both parents and guardians, as well as people with ADHD, that can be found online. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) has a broad support network which you can browse here.
Diagnostic and Statistical Manual, Fifth Edition (DSM-5), Attention-Deficit/HyperactivityDisorder.