8 Questions to Ask Before Your Child’s ADHD Evaluation

The evaluation process for attention deficit hyperactivity disorder (ADHD) in children stands apart from most other conditions’ diagnostic procedures in a few ways — most notably, in how much it demands from parents.

Clinicians rely on caregivers to describe their child’s symptoms, behaviors, and experiences to make the diagnosis. What’s more, parents are responsible for administering treatment, monitoring symptoms, and driving ongoing treatment decisions. In the ADHD evaluation process (and what follows), parents become the medical expert on the child.

Compare that to, for example, an eye exam, wherein an ophthalmologist determines whether the child needs corrective lenses (with a variety of tools and devices) and prescribes the solution — all without parental input.

As parents, your central role in the ADHD evaluation process requires strong, engaged advocacy to ensure the best outcomes for your child. Knowledge of ADHD is key to effective advocacy, as is knowing the right questions to ask yourself and other professionals before your child’s ADHD evaluation.

At its simplest, ADHD is a neurodevelopmental disorder 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 of inattention, hyperactivity, and impulsivity will help you understand what professionals will look for during your child’s evaluation.

More Information

• An in-depth summary of ADHD and its symptoms
• Understand the ‘three types’ of ADHD
• What is ADD and how does it relate to ADHD?
• Take the ADHD symptom test for children
• Take the ADHD symptom test for girls

Executive functions (EF) refer to the brain-based skills that all of us, including children, 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

• Free Download: Common Executive Function Challenges — and Solutions
• Self-Test: Could Your Child Have an Executive Function Deficit?
• Read: Your Child’s 7 Executive Functions — and How to Boost Them
• Read: Treatments and Strategies for Weak Executive Functions

Children must exhibit a certain number of symptoms of inattention and/or hyperactivity-impulsivity to merit 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 either be diagnosed with 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. But it doesn’t mean that every professional will use those 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 important because it gets to a common question/myth: “Isn’t everyone a little ADHD?” Absolutely not.

Next Steps and Additional Questions

• Read: Full Diagnostic Criteria for ADHD in Children
• Understand: How to Prepare for Your Child’s ADHD Evaluation
• Learn: What Can I Expect During My Child’s ADHD Evaluation?
• Visit our Resource Hub: How ADHD Is Diagnosed

If there is any concern whatsoever about your child’s ability to regulate attention or impulsivity, or if behaviors are interfering with learning and functioning, you should get your child evaluated for ADHD — without delay. Age 10 seems to be a pivotal time to have the diagnosis formalized.

The American Academy of Pediatrics’ (AAP) guidelines for diagnosing and treating ADHD in children start at age 4, but it’s not uncommon for professionals to detect and diagnose ADHD in children younger than that.

Additional Resources

• Read: Is Preschool Too Early to Diagnose ADHD?
• Read: Could My Toddler Really Have ADHD? How Can I Tell?
• Read: Isn’t My 4-Year-Old Too Young to Be Diagnosed With ADHD?

Slightly complicating the evaluation process is the fact that several different professionals can diagnose ADHD, including the following:

• Licensed psychologists
• Pediatricians
• Developmental pediatricians
• Neurologists
• Psychiatrists
• Nurse practitioners

What’s more, schools can also perform ADHD evaluations on students.

Pediatricians most frequently perform ADHD evaluations, as they are often the first professional that parents talk to about their child’s behaviors. But it’s not uncommon for pediatricians to refer patients to other professionals for evaluation.

Additional Information

• Find: ADHD Specialists and Clinics Near You
• Read: Who Can Diagnose ADHD?
• Read: Doctor? Psychologist? Therapist? Someone Else? How to Find the Best ADHD Treatment Professional

Understanding the difference between school and private evaluations is vital, as it has enormous consequences on what services and benefits your child might qualify for should they be diagnosed with ADHD. You want to understand if a school evaluation is going to serve your needs and whether your child will benefit from an outside evaluation from an independent medical professional.

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

Next Steps

• Q: What does the school evaluation process for ADHD and other learning differences look like?
• Read: When Schools Resist Evaluating & Addressing Learning Disabilities

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

• Q&A: Can the School Refuse to Evaluate My Child?
• Q&A: Can the School Reject Documentation from My Doctor?
• Read: How to Stand Up for Your Child’s Educational Rights

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.

Childhood ADHD Evaluation: Next Steps

• Free Download: How Is ADHD Diagnosed? Your Free Guide
• Overview: ADHD in Children — Symptoms, Evaluations & Treatments
• Read: Does My Child Have ADHD? A Parent’s Guide to Symptom Diagnosis & Treatment
• Resource Hub: ADHD Diagnosis in Kids
• Resource Hub: How Should I Treat My Child’s ADHD?

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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Sources

¹ Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & SUBCOMMITTEE ON CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT/HYPERACTIVE DISORDER (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528