Asking the Right Questions Before Your Child’s ADHD Evaluation

The diagnostic process for attention deficit hyperactivity disorder (ADHD) in children differs from most other conditions in several ways, particularly in the level of involvement required from parents.

Clinicians rely on parents to describe their child’s symptoms, behaviors, and experiences to make a diagnosis. Additionally, parents are responsible for administering treatment, monitoring symptoms, and making ongoing treatment decisions. In the ADHD evaluation process and beyond, parents become the medical experts on their child.

Contrast this with an eye exam, for example, where an ophthalmologist determines whether a child needs corrective lenses and prescribes the solution without parental input.

As a parent, your central role in the ADHD evaluation process necessitates strong advocacy to ensure the best outcomes for your child. Knowledge of ADHD is key to effective advocacy, along with knowing the right questions to ask yourself and professionals before your child’s ADHD evaluation.

ADHD is a neurodevelopmental disorder that is characterized by persistent symptoms of inattention, hyperactivity, and/or impulsivity. In children, ADHD often affects learning and classroom behavior, though it’s important to note that ADHD is not considered a learning disability.

Understanding ADHD and its symptoms will help you comprehend what professionals will look for during your child’s evaluation.

More Information

Executive functions (EF) are the brain-based skills that all of us need to function in everyday life. EFs allow us to plan, prioritize, organize, think ahead, maintain and juggle information mentally, work toward long-term goals, and more.

Given the nature of ADHD, every child with the condition will have some problem with EF skills. If your child is diagnosed with ADHD, make sure you understand their specific EF areas of weakness. You should also ask your child’s doctor what they recommend to support EF skills.

Next Steps

Children must exhibit a certain number of symptoms of inattention and/or hyperactivity-impulsivity to receive a diagnosis. The symptoms must also be present in two or more settings and significantly impact functioning. Depending on the symptoms a child exhibits, they will receive a diagnosis of combined type ADHD, inattentive ADHD, or hyperactive/impulsive ADHD.

There is no single test for ADHD. From rating scales and clinical interviews to cognitive testing, a variety of tools and methods are used to evaluate patients for ADHD. However, not every professional will use the same tools. Ask the evaluator about their procedure, the tools they will use, and the effectiveness of each tool.

Understanding how ADHD is diagnosed is also significant because it debunks the common question/myth: “Isn’t everyone a little ADHD?” Absolutely not.

Next Steps and Additional Questions

If you have any concerns about your child’s ability to regulate attention or impulsivity, or if their behaviors are interfering with learning and functioning, you should have your child evaluated for ADHD without delay. Age 10 seems to be a pivotal time to have a formal diagnosis.

The American Academy of Pediatrics’ (AAP) guidelines for diagnosing and treating ADHD in children start at age 4, but professionals can detect and diagnose ADHD in children younger than that.

Additional Resources

Several different professionals can diagnose ADHD, including:

Schools can also perform ADHD evaluations on students.

Pediatricians frequently perform ADHD evaluations, as they are often the first professional that parents consult about their child’s behaviors. However, pediatricians may refer patients to other professionals for evaluation.

Additional Information

Understanding the difference between school and private evaluations is crucial, as it has significant consequences on the services and benefits that your child might qualify for if diagnosed with ADHD. You want to understand if a school evaluation will meet your needs and if your child will benefit from an outside evaluation from an independent medical professional.

Ask the school and independent medical provider about their respective ADHD evaluation processes and what you can expect. What data, for example, will the school collect if they perform the evaluation? Remember that different types of medical specialists use distinct processes when conducting ADHD assessments.

Next Steps

Even the most well-meaning teachers might think, “Your child can’t have ADHD; they’re so smart/focused/well behaved.” It may be the case that your child is masking, working extra hard, and undergoing lots of stress — more than their peers — to do well in school.

Regardless of what the school says, if you notice things from your child that don’t look and feel typical, or that resemble symptoms of ADHD even in the slightest, go ahead and pursue an evaluation. In this case, seek an outside evaluation, and start with your pediatrician.

Bottom line: Don’t let any one person determine whether your child gets an ADHD evaluation.

Additional Resources

Many parents are reluctant to pursue an ADHD evaluation because of concerns around medication and treatment. If your child is diagnosed with ADHD, you will, in all likelihood, end the evaluation with a conversation about ADHD medication.

As overwhelming as the topic may be, please know that the science is in 100% agreement that ADHD medication is a well-established and effective treatment for children. The AAP also recommends medication as a first-line treatment for ADHD in children ages 6 and up (along with behavioral parent training and/or educational interventions).1

Still, you will need to follow your own journey and process of learning about ADHD medication and other treatment options. There is no universally right answer.

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “The Right Questions to Ask Before, During, and After an ADHD Diagnosis” [Video Replay & Podcast #421] with Norrine Russell, Ph.D., which was broadcast on September 15, 2022.

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