ADHD Screening

What is ADHD screening?

If you or your child has symptoms of attention-deficit/hyperactivity disorder (ADHD), a healthcare provider may recommend an ADHD screening. An ADHD screening is also called an ADHD assessment. An ADHD screening is an evaluation that can diagnose ADHD; it’s not a test.

What is ADHD?

ADHD is a neurodevelopmental condition that often begins at a young age. ADHD without the hyperactivity was formerly known as ADD (attention-deficit disorder), but this is now also considered a type of ADHD. People with ADHD might have trouble with:

• Impulsivity.
• Hyperactivity.
• Distractedness.
• Following instructions.
• Completing tasks.

When is an ADHD evaluation performed?

An ADHD evaluation is often done when a parent, teacher or pediatrician notices ADHD symptoms in a child that are interfering with their ability to function at home and in school.

ADHD is often diagnosed first in children. The American Academy of Pediatrics (AAP) recommends that healthcare providers regularly ask parents, teachers and other caregivers about their child’s behavior in various settings, including at home and at school.

If you notice behavioral changes in your child or experience ADHD symptoms as an adult, your healthcare provider may order an ADHD assessment. There’s no cure for ADHD. But having an ADHD evaluation and early diagnosis can improve quality of life sooner since this condition can be accompanied by learning and behavioral problems.

How can I get my child screened for ADHD?

The first step is to talk to your child’s pediatrician if you think:

• Your child has a problem with attention, hyperactivity or impulsivity.
• Their behavior impacts their performance at home and in school.

If symptoms affect your child’s ability to learn, the pediatrician will likely recommend that you contact the school and request a learning evaluation. Be as specific as possible about the type of learning or behavioral difficulties your child has, such as reversing letters or numbers or having difficulty writing them.

Schools must screen children (ages 3 to 21) for evidence of a disability that affects learning. This assessment is free and (by law) must include appropriate standardized tests.

The school can’t diagnose ADHD, but they can note the symptoms and assign a designation of “Other Health Impaired” (OHI) to your child. You bring a copy of this report to the pediatrician’s ADHD screening appointment. The school assessment helps your pediatrician when they evaluate your child.

Is ADHD screening only for children?

No. Adults can have ADHD screening and a diagnosis at any age. About 4% of Americans older than 18 experience ADHD behaviors regularly. Usually, they had those behaviors since childhood but were never diagnosed. If you experience ADHD symptoms, talk to your healthcare provider about an ADHD screening.

Who performs an ADHD evaluation?

In most cases, a pediatrician or primary care provider does the evaluation for ADHD. In some cases, the provider may recommend taking your child to someone who specializes in ADHD and other developmental, behavioral or mental health disorders.

How does the ADHD screening work?

Medical providers use a series of steps to make a diagnosis. Part of the screening includes the guidelines in the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition Text Revision (DSM-5-TR™).

Diagnosing ADHD is a three-step process:

1. Identify whether the symptoms of ADHD are present and impairing daily functioning.
2. Rule out the presence of alternative causes for the symptoms’ presence, such as sleep disturbances, social problems, adjustment disorders and depression.
3. Identify comorbidity, such as the presence of a learning disability, anxiety disorder, intellectual disability or mood disorder.

Here’s what you can expect for a typical ADHD evaluation:

• A medical, physical or neurodevelopmental exam identifies if you or your child meets the criteria for ADHD symptoms, including hyperactivity, inattention or impulsivity.
• Recording symptoms using rating scales and other sources of information ensures you or your child meets standardized criteria.
• An interview includes questions about your child’s behavior at various places, such as home and school.

To make an ADHD diagnosis, providers look for these conditions:

1. For children, six or more symptoms in one of the two main categories (or both) over the last six months — inattention and hyperactivity/impulsivity.
2. For adults, at least five established ADHD behaviors in one category (inattention or hyperactivity/impulsivity) for six months.
3. Adults or children must have symptomatic behavior in two or more settings, like at home, school or on the job, usually as identified by two or more observers.
4. The symptoms are debilitating and interfere with daily functioning.
5. Symptomatic behavior started in childhood, usually before age 12.
6. Symptoms aren’t due to another disorder. For example, the symptoms can’t be caused by anxiety or depression.

What are examples of ADHD screening questions?

During the interview, your provider discusses your or your child’s development, health, and family and lifestyle history. They may interview other people like family members, friends, teachers or coaches.

Your provider might ask questions like:

• How often do you or your child have trouble finishing a project or task once you complete the challenging parts?
• Are there any immediate family members (parents, brothers or sisters) who you think may have or have had ADHD, whether or not they were diagnosed or treated?
• How often do you or your child fidget or squirm with your hands or feet when sitting for a long time?
• How often are you or your child distracted by activity or noise around you?
• How often do you or your child have difficulty waiting your turn in situations when taking turns is required?

What other conditions can cause ADHD symptoms?

To make an accurate ADHD diagnosis, your provider must rule out other conditions that might cause ADHD symptoms. These include:

• Anxiety.
• Depression.
• Learning disabilities.
• Autism.
• Undetected seizures.
• Medical disorders that affect brain functioning, such as thyroid disorders.
• Lead toxicity (poisoning).
• Sleep problems.

Is every ADHD screening the same?

Healthcare providers use the same guidelines from the DSM-5-TR. This ensures they’re diagnosing and treating people for ADHD using appropriate standards. They may, however, use different measures to identify symptom criteria for this condition.

Your provider may customize the rest of the screening process based on your unique symptoms. For example, if you have trouble paying attention in learning environments, you may need a different screening process than someone who has difficulty managing their emotions.

Beyond the initial ADHD criteria, your provider can focus on your symptoms and use an individualized screening to determine what’s causing them — whether it’s ADHD or something else.

How long does an ADHD evaluation take?

You can expect the ADHD test to take at least one to three hours, depending on what’s involved (and the age of your child, if you have one). A full evaluation usually takes longer since your provider needs to gather information from multiple sources. Further testing could take days or weeks if your healthcare provider needs to rule out other medical conditions.

How do I prepare for an ADHD screening?

When you come to the screening, bring a list of all medications that you (or your child) currently take. Be prepared to answer questions about family health history, personal health history, environment, school or work performance and behavior. There may be a physical exam, so wear comfortable clothing with minimal jewelry.

What should I expect during the ADHD screening?

Things to expect during your appointment with your healthcare provider include:

• Answering questions: Expect to talk to your provider about your or your child’s health history, symptoms and behavior.
• A questionnaire: You may have to fill out a questionnaire or multiple questionnaires. Your provider might ask other people — like family, friends or teachers — to fill out a questionnaire, as well.
• A physical exam: A general physical exam can help rule out other conditions.
• Child observation: If your child’s having the screening, your healthcare provider will spend time with your child to observe their behavior.

What should I expect after the test?

If your provider doesn’t request other testing and confirms an ADHD diagnosis, they may prescribe treatment, like medication. They may also want to schedule a follow-up appointment for a few weeks later to discuss how the treatment is going.

In some cases, your provider may determine that you or your child doesn’t have ADHD and may recommend other tests. Follow your provider’s directions for scheduling necessary follow-up appointments.

What are the risks of ADHD screening?

There are no risks associated with an ADHD evaluation. Talk to your provider about any risks associated with other tests that you may need to rule out other medical conditions.

Can I take an ADHD screening test online?

While there are online ADHD questionnaires, only trained healthcare providers can diagnose or treat ADHD. If you think you or a loved one has debilitating ADHD symptoms, visit your provider for a full evaluation and diagnosis.

What type of results do you get from an ADHD screening?

Since an ADHD screening involves many steps, results can vary. For example, you may find out that you or your child has a different condition — like anxiety or depression — instead of ADHD.

If you or your child meets the ADHD diagnostic criteria set by the American Psychiatric Association, your provider may diagnose one of four types of ADHD:

• Predominately hyperactive/impulsive type: Children or adults have had hyperactive/impulsive behaviors for at least six months, but their symptoms can’t be diagnosed as “inattention.”
• Predominately inattentive type (formerly known as attention deficit disorder or ADD): Children or adults have had problems with inattention for at least six months but can’t be diagnosed as hyperactive/impulsive.
• Combined type (inattentive and hyperactive/impulsive): People have symptoms from both types of ADHD for at least six months. Children with ADHD usually have this type.
• Other specified/unspecified ADHD: Children or adults have problems with inattention but don’t meet the criteria to receive an ADHD diagnosis.

When should I know the results of the ADHD screening?

The timing of the screening results depends on how many additional tests, screenings or appointments your healthcare provider recommends before making a diagnosis. Ask your healthcare provider how long it’ll take to reach a diagnosis.

A note from Cleveland Clinic

If the thought of having an ADHD screening makes you nervous, remember that the condition is common and treatable. Quality of life can improve dramatically with a proper diagnosis and treatment. The ADHD screening itself is a process of discovery — beyond the standardized criteria, your healthcare provider will work with you to customize the screening for exactly what you need. If you think you or your child has ADHD symptoms and would benefit from a diagnosis, talk to your pediatrician or primary care provider today. They’re here to help.