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To ensure that children referred for evaluation for ADHD receive the most reliable, thorough assessment possible, the AAP has developed a set of diagnostic and evaluation guidelines, and recommends that pediatricians follow the steps outlined below. Your child’s pediatrician may prefer one variation or another of a particular step (talking in person or on the phone with a teacher, or asking the teacher to write a brief narrative instead of or in addition to requesting written questionnaires), but in general each of these steps should be considered.

  1. Primary care clinicians should initiate an evaluation of ADHD for any child 4 to 18 years of age who has significant academic or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity. Attention-deficit/hyperactivity disorder often becomes apparent when a child enters a structured school setting, but symptoms can emerge prior to kindergarten or may not be recognized until adolescence.
  2. To make a diagnosis of ADHD, primary care clinicians should determine that the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSMIV-TR) criteria have been met (including documentation of impairment in more than one major setting) with information obtained primarily from reports of parents or guardians and teachers. The DSM-IV-TR is a manual published by the American Psychiatric Association that describes all mental health conditions in children and adults. Information obtained from parents, guardians, and caregivers should be the basis for determining if the DSM-IV-TR criteria are met. The latest revision is called DSM-V.
  3. In the evaluation of a child for ADHD, primary care clinicians should include assessment for other conditions that might occur along with ADHD, including emotional or behavioral (eg, anxiety, depressive, oppositional defiant, and conduct disorders), developmental (eg, learning and language disorders), and physical (eg, tics, sleep apnea) conditions.


Last Updated
ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.