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How To Get An Accurate Diagnosis For A Child Who May Have ADHD

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If you have a child or teen who seems to be struggling more with low motivation, keeping up with school work, and organizing things from clothes to projects to chores than at the beginning of the school year? The winter doldrums are no joke for many students, especially those who may have ADHD or live with neurodivergence. This is a good time of year to look under the hood and investigate what’s going on for them and why they are wrestling with productivity and performance.

While this process can seem daunting, investigating what is happening will offer information about their cognitive and emotional functioning.

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Here's how to get an accurate diagnosis for a child who may have ADHD.

1. An accurate diagnosis is complex.

For children and teens up to age 18, receiving an accurate diagnosis of ADHD can be a complicated, confusing, and even affirming experience. Often, parents receive contradictory or inadequate information about the process, and navigating the maze toward diagnosis and treatment can be perplexing. In particular, the tween and teen years are development stages when trouble with attention, organization, and distractibility come to the forefront.

As kids advance in school, confront more complex academic work, cope with social dynamics, and pursue extracurricular activities, their lives demand they develop and apply more sophisticated executive functioning skills. So, it’s common to see challenges, anxiety, and even depression when they struggle to keep up.

2. Different ways to get a diagnosis

Typically, there are three ways to obtain a diagnosis of ADHD, and quite honestly, TikTok is not one of those paths. While social media may alert your adolescent that some of their difficulties might meet the criteria for ADHD, it is not a reliable source of a diagnosis.

Your options include primary care providers (nurse practitioners, pediatricians, medical staff), mental health professionals (including psychiatrists), or using school resources. Whichever route you choose, make sure the person understands and has significant experience with ADHD. They should also conduct a thorough individual and family history with you and your child and listen openly to your concerns.

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Let’s look at each option to get an accurate ADHD diagnosis for a child.

1. Primary care providers

If you think your child’s issues might be related to attention, you may have already started researching ADHD on your own. Start by talking with your primary care provider or pediatrician because they have likely known your child for years and have been advising you all along. They will probably give you some forms to fill out with rating scales (and take you to the school) to get a sense of daily functioning and trouble spots and talk with each of you about behavioral, emotional, and cognitive issues. If the forms indicate ADHD, they may refer you for counseling, coaching, or a psychoeducational evaluation (private or through the school district), discuss medication options with you, or give you the name of a local psychiatrist.

2. Mental health professionals

Whether your child or teen is already in therapy or has just been referred, your licensed counselor, social worker, or therapist will want to evaluate their primary concerns and symptoms to determine a diagnosis and create a treatment plan. Like your pediatrician, this provider will usually conduct a thorough developmental and family history and give you forms similar to the ones a pediatrician uses before making a diagnosis.

Often, they will consult with your pediatrician, your child’s teachers, and other school personnel. If a mental health professional has additional concerns and needs more data, they may recommend testing to rule out any learning issues or for clarification of what’s going on. Some psychiatrists offer therapy in addition to prescribing medication, and others only focus on medication management. All of these folks are capable of diagnosing ADHD.

However, only psychologists and neuropsychologists are trained to do formal psychoeducational evaluations, although speech and language pathologists (SLP) and special education teachers can conduct smaller specific tests. These evaluations include cognitive functioning (verbal, visual-motor, working memory, and processing speed), other visual, verbal, math, and written skills, grade-level competencies, and emotional issues. These evaluations can be extremely informative to you and your teen because they provide a glimpse into how your child’s brain works and its strengths and challenges.

When you choose a private evaluation (as opposed to testing through the school), you have more control over the person who does it. But be sure the evaluator takes the necessary time to explain the results thoroughly to you. These reports can be dense, confusing, and overwhelming. Ask all of your questions and request a follow-up meeting if you need it.

   

   

3. School resources

Many parents first learn about their child’s challenges with concentration and focus from a teacher, school counselor, or principal. These conversations can be painful, yet the information educators share is a crucial piece of the puzzle for why your child struggles at school. Public schools in the USA are allowed to name issues related to attention, concentration, and memory but they cannot legally diagnose ADHD since it is considered a health issue.

However, they are mandated under IDEA (Individuals with Disabilities Education Act) to check students for possible learning disabilities, including ADHD, and, if there are conditions that interfere with learning, to provide accommodations. To begin this process, start with a parent meeting with a guidance counselor or vice-principal who knows your child.

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Discuss your concerns and see what they advise. Often, they might suggest teachers can make some minor changes in the room. If the changes are unsatisfactory or your child needs more support, you have the right to request a formal evaluation., which includes a team meeting. This request can be made at the school or the district office.

What typically follows is the beginning of a thorough evaluation that is similar to private testing but may also include additional information about speech and language skills and occupational functioning. These are similar to private testing because they offer rich information about your child and the additional benefit of direct contact with their educational environment.

Photo: sergey causelove via Shutterstock

Some school districts prefer to do their evaluations but may need to wait longer than you want. You also have the right to present your report. Regardless, schools can’t diagnose ADHD because it is a health disorder, so you will need to share the report with your primary care provider, psychiatrist, or mental health professional to get an official diagnosis.

Following the completion of this evaluation, a team meeting will be convened to determine the type(s) of special needs your child may have and whether they are eligible for mandated services. If your youngster qualifies, then the team will make recommendations and create an IEP plan or design the 504 at a later time.

Since many kids with ADHD also have reading, writing, or mathematics difficulties which qualify as learning disabilities, these actually can be diagnosed by the schools and, if they are blocking academic progress, support services will be provided.

You can see how complex this process can be. Take a deep breath, stick to what you know is true about your child, and don’t get intimidated by anyone who may dismiss your concerns. You know your kiddo better than anyone else. Collaborate on creating a plan that offers the help your student needs. Stay curious, ask questions, listen with an open mind, know your rights, and advocate fiercely.

   

   

If you need more support, seek it. You’ve got this!

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Sharon Saline, Psy.D., is an international lecturer and workshop facilitator. She has focused her work on ADHD, anxiety, learning differences, and mental health challenges and their impact on the school and family dynamics for more than 30 years.