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Attention-deficit hyperactivity disorder (ADHD), or hyperkinetic disorder (HKD), can have a significant impact on patients’ lives, and is generally considered to have three component features – inattention, hyperactivity and impulsivity – with the severity and combination of symptoms varying between patients and across a patient’s lifespan.1 These factors, combined with the frequent presence of psychiatric comorbidities,2-5 make the assessment and diagnosis of ADHD challenging.

 

Assessment

The assessment process involves the comprehensive evaluation of information gathered from a number of sources, including: clinical examination; clinical interviews with patients, and parents/teachers for children and adolescents or partners for adults with ADHD; and use of assessment tools and rating scales.2-5

Please indicate which of the below steps you use in the assessment of childhood ADHD.

Diagnosis

Following assessment, the National Institute for Health and Care Excellence (NICE) guidelines state that a diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD based upon a full clinical and psychosocial assessment, a full developmental and psychiatric history and observer reports of the individual’s mental state. For a diagnosis of ADHD, symptoms of hyperactivity-impulsivity and/or inattention should meet the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5TM) for ADHD; and the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) for HKD.2

Rating scales

Rating scales are an essential part of the full assessment process for ADHD, they vary in format and scope and recognise the need for multidisciplinary input on a patient’s condition and symptomatology.2-5

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2013.
  2. NICE guideline 2018. Attention deficit hyperactivity disorder: diagnosis and management. Available at: https://www.nice.org.uk/guidance/ng87. Accessed December 2018.
  3. Canadian ADHD Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines. Fourth Edition. Toronto, ON; CADDRA, 2018.
  4. Banaschewski T, Hohmann S, Millenet S. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Kindes-, Jugend- und Erwachsenenalter. DGKJP, DGPPN and DGSPJ German guidelines. 2018.
  5. Guías de Práctica Clínica en el SNS. Grupo de trabajo de la Guía de Práctica Clínica sobre las Intervenciones Terapéuticas en el Trastorno por Déficit de Atención con Hiperactividad (TDAH). 2017.
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