Aniesa Schneberger, a licensed mental health counselor at Tampa Life Change, says it’s necessary to observe whether or not a child is routinely acting inattentive or hyperactive – or both – while in a variety of settings. ADHD symptoms, she says, should be prevalent in at least two environments, which is another DSM-5 criterion.
For example, if a child is acting out at school but not at home, then this could indicate an ability to control their behavior. If this is the case, it may not be a sign of ADHD after all.
“This is an important one,” she says, adding that a child with ADHD can’t switch their symptoms on and off depending on the environment. Behavioral consistency across a host of settings is a telltale indication that a child may have this disorder. It’s also the reason why obtaining a diagnosis when a child is under the age of 5 – the traditional age of entering school or a structured learning environment – can be challenging. Without exposure to various environments to serve as a basis for comparison, it’s difficult to accurately assess if a child has ADHD. “Because of this, children are typically diagnosed around the age of 5 or 6, after being involved in these types of environments for a couple of years,” Schneberger says.
Another reason it’s important to observe your child in a variety of settings is to take note of their interaction with others. In particular, look for behaviors that are inconsistent with children their age. “It’s important to take note of how your child is interacting with other children,” Schneberger says. “Often times children diagnosed with ADHD can be intrusive during activities and conversations, don’t respect the space of other children and can’t seem to wind down when playtime is over while other children are resting.”
Additionally, medical exams, which involve vision and hearing screenings, are also part of this assessment, as is involvement of pediatricians, psychiatrists, psychologists and psychotherapists. “The diagnosis will involve information from various sources,” she says.