Diagnosing ADD or ADHD: a Pediatrician’s Perspective

Last updated on September 13th, 2015 at 01:10 am

Visiting the doctorWe have all been exposed to ADD or some form of it for many years now. It is a very common “diagnosis” and it is usually the teacher, parent or physician who initially brings up the subject about your child. ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder) is suggested and even diagnosed based on clinical (observational) criteria. This is to be distinguished from other medical issues for which one can run specific tests. It, however, is not the only diagnosis which describes children who are very impulsive, hyperactive, unable to concentrate on any topic, and are underachievers in school in spite of being very bright beginning under seven years of age and who is seen to have these same issues in different social settings such as school, home, groups (church, scouts, etc.) consistently.

You may recognize these “symptoms” as very common observations in children in general, but when it becomes an issue significant enough to disrupt the family and school function it is something that should be evaluated. There are many issues for which these symptoms apply to children; learning disabilities, emotional disorders, mental retardation, psychological illnesses, and these can all be confused within the same child. To make matters worse, two or more of these can exist at the same time in the same child.

A suspicion of ADD or ADHD is the first step in determining the problem. There are many questionnaires that parents and teachers are asked to fill out that can point in the direction of this problem. First though, is a complete exam by your child’s primary care physician. His/her input is very important as it is up to him or her to coordinate the further evaluation and treatment (if necessary) of this problem.

A very careful and thorough evaluation should be done because of the variety of other problems (see above) that can mimic this disorder. Your Doctor will probably require certain testing to be done, up to and including a full, and expensive neuropsychological evaluation. This kind of evaluation can help pinpoint some of the more pertinent issues and rule out some symptoms that could point in the wrong direction. Therefore, this is not usually a diagnosis that is made on your first or even second visit to your Doctor.

Many feel that this disorder is becoming much more prevalent; I really don’t feel this is the case. Many conditions that were passed over in the past are now recognized as part of an attentional deficit subgroup. The level of awareness in the general population and in teachers and Physicians particularly has been raised, and what was considered something that children would just “grow out of” is now recognized more often as early attentional problems. There have also been an explosion of testing materials (questionaires, etc) and medication for treatment.

When the issue is thoroughly evaluated, the methods of “treatment” usually are condensed to educational, psychological, and/or medication. All are important if the situation points in this direction in order to grasp the concept and use all means to help these children get through this very frustrating problem.

In one of the next several posts I will try to delve into the three approaches as mentioned above.

About the Author

Dr. Joseph Skoloff received his undergraduate degree from the University of Pennsylvania and his medical degree from The Jefferson Medical College in Philadelphia. He is a past Vice Chairman of the Department of Pediatrics, a past Chairman of the Infection Control Committee at the Loudoun Hospital Center and a Fellow of the American Academy of Pediatrics. In his 41 years as a practicing pediatrician he has kept hundreds of kids and families healthy and safe and plans to continue to do so for years to come. Dr. Joe believes strongly in the combined power of parent and physician working together for the health of their children. He is an advocate for children everywhere and and adheres strongly to the principles of the American Academy of Pediatrics. Dr Joe is a member of the PedSafe Expert team


4 Responses to “Diagnosing ADD or ADHD: a Pediatrician’s Perspective”

  1. My doc suggested one or the other might be prevalent in my six year old but my husband said “What is it with insisting everyone has a disorder? He’s a kid!” and we just left it at that. I’ll see if his attention improves as he goes into first grade and beyond but for now he’s just my kooky little monster!

    • Dr Joe Joseph Skoloff,MD says:

      He certainly is your special little guy and will always be that, but try not to overlook the obvious as early intervention is the name of the game.


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