ADHD Screening

Your child may need screening if you, a teacher, or another caregiver thinks your child has symptoms of ADHD.

Adults who have had challenges since childhood (before age 12) with focusing, impulsive behavior, restlessness, and/or being organized can ask their providers if they need to be screened for ADHD. The symptoms depend on the type of ADHD a person has.

People with symptoms of attention problems may often:

• Miss details or make careless mistakes in schoolwork, at work, or in other activities
• Have trouble staying focused on play activities or work tasks
• Not seem to listen when spoken to directly
• Find it hard to follow instructions or finish tasks, or may start but get easily sidetracked
• Have trouble being organized, keeping belongings in order, and managing time
• Avoid doing tasks that require long periods of mental effort
• Lose important items, such as books, wallets, keys, eyeglasses, and cellphones
• Forget about doing daily activities

People with symptoms of hyperactivity-impulsivity may often:

• Fidget and squirm while seated
• Get up when staying seated is expected, such as at school or work
• Run around or climb when it’s not appropriate (children) or feel restless (teens and adults)
• Have trouble doing quiet activities
• Be constantly moving or “on the go”
• Talk much more than is normal
• Blurt out answers before questions are completed
• Have trouble waiting for their turn
• Interrupt others for example during conversations or games

People with combined ADHD show a mix of inattention and hyperactivity-impulsivity symptoms.

The general screening process is similar for people of all ages. It involves several steps. A primary care provider may do the entire screening or refer the person to a mental health provider. A mental health provider is a health care professional who specializes in diagnosing and treating mental health problems.

During an ADHD screening, the provider will:

• Do a physical exam. An exam by a primary care provider checks for certain health conditions that can cause symptoms similar to ADHD. The exam may include vision and hearing tests (for children and adults), thyroid tests, and other tests.
• Review medical history, family health history, and other records. The cause of ADHD isn’t known, but it often runs in families. So, family history is important. The results of any past tests and school reports provide valuable information, too. For adults, old school records can help a provider find out if symptoms began in childhood.
• Gather information using standardized ADHD symptom checklists, questionnaires, and/or interview questions. A provider will use one or more tools to gather, organize, and evaluate information during an ADHD screening. These tools have rating scales (scoring systems) that help the provider see if a person’s symptoms and history fit a diagnosis of ADHD. The provider will use these tools to:
  • Interview the person about their symptoms. For children, questions and activities are geared toward their age. Parents are usually interviewed, too.
  • Gather information from others. To make a diagnosis, it’s necessary to know how the person acts during different activities and situations. So, the provider may request permission to ask others for information. These people may include:
    • For children and teens: Teachers, babysitters, coaches, and other family members who spend time with the child. Parents may also complete checklists and/or questionnaires.
    • For adults: Family members who know the person from childhood, and spouses, friends, and co-workers.
• Screen for other mental health disorders. People who have ADHD often have other mental health disorders. It’s also possible that another disorder, and not ADHD, is causing symptoms. So, mental health screening tests are often done as needed to check for conditions such as, anxiety, depression, and bipolar disorder. Children and may also be tested for learning disabilities, autism spectrum disorder, or behavior disorders.

The provider will usually write up the results of an ADHD screening in a report that includes a diagnosis. To diagnose ADHD, the screening must find all of these things:

• Several symptoms of ADHD that began before age 12.
• Several symptoms of inattention and/or hyperactivity-impulsivity that have lasted for at least 6 months and cause serious problems. To be diagnosed with ADHD:
  • Children up to age 16 must have at least 6 ongoing symptoms.
  • People 17 and older must have at least 5 ongoing symptoms.
• Symptoms that happen in 2 or more settings, for example, at home and at work or school.
• Symptoms that clearly get in the way of functioning well at school, work, and/or in social situations.
• Symptoms aren’t caused by another mental health disorder.

If there is a diagnosis of ADHD, the report will include the type of ADHD (inattentive, hyperactive-impulsive, or combined). It will also say whether ADHD is mild, moderate, or severe. Any other disorders that may have been found will be included in the report.

There’s no cure for ADHD, but treatment may help reduce symptoms. Treatment may include medicine, talk therapy, behavioral therapy, and lifestyle changes. Usually, two or more treatments are combined. Parents of children with ADHD may also receive training to help their children manage ADHD.