What should I do if I think my child might have ADHD? - A step by step guide
ADHD-related symptoms of hyperactivity, impulsivity, and inattention are typically present from birth. However, it often takes a few years to identify the behaviors as excessive and problematic. Distinguishing features include an intense drive to move; difficulty sitting still; struggles to remain focused on quiet activities; frequently making noise; trouble going to sleep; inability to wait his or her turn; frequent interrupting others; forgetfulness; and, reluctance to apply mental effort. For more detailed information about the signs and symptoms of ADHD by age groups please refer to the Section, "What is ADHD?."
For young, pre-school children:
Caregivers are frequently the first to notice hyperactive and impulsive behaviors. Inattentive symptoms are more difficult to notice. If you suspect that your child may have a problem with ADHD, continue to educate yourself about the disorder. At the end of this article, we provide a reference and resource section.
Consider an evaluation if:
- your child's behavior is excessive;
- the concerning behaviors happen in more than one setting;
- your child's short attention span is interfering with learning activities; and/or,
- your child's problem behaviors go beyond what seems typical for that age.
If you can't decide whether or not an evaluation is needed, discuss your concerns with a healthcare professional. They can put you in touch with the right specialists. If you are concerned about having an evaluation performed, keep in mind that it's completely painless. It may yield extremely helpful information because early diagnosis and treatment is key. Ask yourself, which would be worse: 1) Performing an unnecessary evaluation, or 2) Not performing an evaluation and allowing a treatable disorder to go undetected.
As with all treatment professionals, evaluate the qualifications of ADHD professionals. Ask for recommendations. Do not become overly trusting in any one professional. Because ADHD is best treated by a team, make sure your advisor describes this team approach to you. You and your child (depending upon their age) should feel like full members of this team. Your values, questions, and ideas should be treated respectfully. To read more about the team approach to diagnosis and treatment click here.
For school-age children:
1. Get more specific. Go to the CDC and search for ADHD checklist. Fill out the checklist. Evaluate how well your child meets the actual criteria for ADHD.
2. Make an appointment to talk with your child's teacher.
3. If the teacher concurs with your concerns, they may ask you to speak with the school psychologist. Bring your check list and ask questions.
4. If the teacher does not agree that your child displays ADHD related symptoms, you must reevaluate your concerns in light of this new information.
5. Make an appointment with your child's doctor. Discuss your concerns and show the doctor the checklist. The physician will want to conduct a complete physical to rule out other causes of the problems you observe. Depending on the specific circumstance, this might include, an EEG to examine brain wave patterns, or an MRI to check for brain abnormalities.
6. If you both agree to conduct an ADHD evaluation, ask for a referral to a clinical psychologist specializing in children. The diagnostic process is a lengthy one and it is discussed here.
7. Remember no one professional should diagnose ADHD. Evaluation should be performed by a multidisciplinary team. Begin to form your diagnostic team. This resource provides guidelines about how to choose a quality provider: http://www.jointcommission.org/assets/1/18/mktg_bhc_brochure.pdf
8. If you are uncertain whether to proceed with an evaluation, discuss your concerns. The clinical psychologist can guide you to make a decision that is consistent with your needs and values.
9. If the evaluation will proceed, obtain behavior checklists for yourself, teachers, and the child.
10. Discuss the evaluation with your child. Explain the need for it at a level your child can understand. If you are uncertain how to explain this to your child, ask the psychologist for suggestions.
11. Ensure the process is collaborative. Work together with your child to complete checklists, etc.
12. Complete your own behavior checklist.
13. Meet with the school psychologist. Discuss the evaluation process. Provide the names of the clinical psychologist and physician working with your child. If school performance has already been impacted, discuss your concerns. If appropriate, begin the 504 or IEP evaluation process.
14. Meet with the child's teacher(s). Ask for their help to complete the checklists.
15. Return to the clinical psychologist with the completed checklists. Bring the written results of the medical exam. Include input from other involved adults. Review all information. Discuss any additional information necessary to rule out other conditions or to clarify findings.
16. Schedule all appointments and complete all additional testing.
17. Gather the all results. Meet again with the clinical psychologist to discuss the findings. Together decide upon the next course of action.
18. Attend every meeting at the school. Make sure your voice is heard in the decision-making process. You know your child best. You are your child's best advocate. Always remain calm and be sure you understand everything that is discussed. Bring written reports from the clinical psychologist, and other members of your team.
19. If you don't understand something, or are uncertain about the next step, discuss with the clinical psychologist. The psychologist can help manage the overall process. They may also refer you to an educational advocate in your community.
20. Your advocate can attend the school meetings with you. They will help to ensure that the best interests of the child are identified and acted upon.
21. Most health professionals can diagnose ADHD. However, it should be the person who has been gathering all information and coordinating the evaluation. In this scenario, it is the clinical psychologist.
22. A diagnosis from a clinical psychologist can help with the educational evaluation, but it is its own process. The school meetings will determine the child's eligibility for special services at school.
23. Once a diagnosis of ADHD has been determined, continue your active involvement through the treatment planning process.
The evaluation process in the school system is primarily designed to determine if the child is eligible for special services as provided by law. The two key laws that effect the provision of school services, Section 504 and IDEA.
Section 504 guarantees access to a free and public education for every child regardless of disability. This civil rights law requires that schools provide appropriate educational services to disabled students. These services must be comparable to those provided to other students.
IDEA is an educational benefit law. It offers services and protections to students with disabilities that are not offered to other students. Eligibility for these benefits is determined through an Individualized Education Plan process.
Eligibility for services under both laws is determined through meetings of a multidisciplinary team. Parents, or other primary caregivers, have the right to become members of this team. The caregivers' attendance at meetings ensures that the family is included in the decision-making process, and the development of an action plan. Caregivers also have the right to invite an advocate to aid in the discussion, and to represent the child's best interests.