There Are Currently No Medical Tests for ADHD
ADHD is diagnosed by the observation of behavioural symptoms. If you’re concerned about your child’s behaviour, your GP is a good place to start. They might refer your child to a paediatrician, a psychologist, or a child psychiatrist for a diagnosis of ADHD or another condition.
The diagnostic process may include:
- Interviews with parents and carers
- An interview with your child
- Behaviour checklists completed by parents, carers, and teachers
- Discussions with teachers or other caregivers
Your child may also undergo further assessments, such as:
- Developmental, learning, or IQ tests
- Language, speech, and motor development checks
- General health checks
- Vision and hearing tests
ADHD Diagnosis Information
Diagnostic Criteria
The DSM-V and ADHD Diagnosis
The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is produced by the American Psychiatric Association (APA) and is used by clinicians and researchers to diagnose and classify mental disorders, including ADHD.
The APA is a national medical specialty society with more than 36,000 physician members specialising in the diagnosis, treatment, prevention and research of mental illnesses.
The DSM-V is the guide used by doctors, mental health professionals, and other qualified clinicians when making a diagnosis of ADHD in Australia and the USA. The 5th edition was released in 2013.
ADHD in DSM-V
According to the DSM-V, ADHD is listed under the category of Neurodevelopmental Disorders and described as:
“a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with development, has symptoms presenting in two or more settings (e.g. at home, school, or work), and negatively impacts directly on social, academic or occupational functioning”.
Symptom Categories
ADHD symptoms are divided into two categories:
- Inattention
- Hyperactivity and Impulsivity
Children must present with at least six symptoms from either or both categories. Older adolescents and adults (over age 17) must present with five symptoms. Symptoms must have been present before age 12 (previously age 6 in DSM-IV).
Diagnostic Criteria
Because everyone shows some of these behaviours at times, the DSM-V includes specific guidelines to determine when they indicate ADHD:
- Behaviours must appear before age 12 and continue for at least six months
- In children, behaviours must be more frequent or severe than in others of the same age
- Behaviours must create a real hindrance in at least two areas of life (e.g. school, home, work, or social settings)
- Someone whose work or friendships are not impaired by these behaviours would not be diagnosed
- Symptoms must not occur exclusively during schizophrenia or another psychotic disorder
- Symptoms must not be better explained by another mental disorder (e.g. depression, bipolar disorder, anxiety, personality disorder, or substance use/withdrawal)
Changes from DSM-IV
The DSM-V updates reflect a more accurate understanding of ADHD in adults. Although ADHD begins in childhood, it can continue into adulthood for many people.
- Guidance provided for diagnosing adults
- No exclusion criteria for people with autism spectrum disorder (ADHD and autism can now be diagnosed together)
- Recognition that a person’s presentation can change over their lifetime
- Severity ratings added — mild, moderate, or severe — based on symptom count and impact on daily life
Ongoing Care
The DSM-V ensures that children diagnosed with ADHD can continue to access care into adulthood if needed. It supports clinicians in providing accurate, lifelong management for those affected.
What Symptoms Must a Person Have for a Diagnosis of ADHD?
To confirm a diagnosis, children should have six or more symptoms of the disorder.
In older teens and adults, the DSM-V states they should have at least five of those symptoms listed in What is ADHD?
Each child with an ADHD diagnosis is unique. With hundreds of possible combinations of symptoms and co-morbidities, ADHD can present in many different ways.
The DSM-V diagnosis is a label indicating that the observed behaviours are considered outside the normal range. However, the label does not tell us why this might be the case or identify possible underlying causes.
Co-morbid Conditions
ADHD often occurs alongside other conditions. See co-morbid conditions for more information.
Brain Mapping (qEEG)
Some professionals utilise Quantitative Electroencephalography (qEEG) as part of the diagnostic process.
ADHD Diagnosis with qEEG
Some professionals utilise Quantitative Electroencephalography (qEEG) as part of the diagnostic process.
An EEG measures the electrical patterns at the surface of the head, which reflect cortical activity. These patterns are commonly referred to as “brainwaves”.
Quantitative EEG (qEEG) analyses these patterns from a multi-electrode recording. This EEG data is processed using various algorithms, statistically analysed, and compared to a normative database — that is, the brainwaves of children or adults of similar age who are considered neurotypical. The data is then converted into colour maps of brain function, sometimes called “brain mapping”.
qEEG processing techniques, combined with highly technical software, allow us to view the dynamic changes taking place throughout the brain during specific neuropsychological or cognitive tasks. This type of assessment can help identify which brain areas are engaged and processing efficiently, and which are somewhat dysregulated or inefficient.
Experts can interpret this information as a clinical tool to evaluate brain function and track changes resulting from interventions such as neurofeedback.
Other Brain Imaging Techniques
Several brain-imaging techniques, such as Single-Photon Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) and Functional Magnetic Resonance Imaging (fMRI), allow researchers to study how the brain operates and functions. However, most professionals who use brain-imaging techniques for ADHD diagnosis rely on qEEG.
Next Steps
If you think your child might have ADHD, first read Conditions that Mimic ADHD. Then use the ADHD Directory to find a practitioner who can guide you through the next steps.