At what age can your child be diagnosed with ADHD?

Deciding if a child has ADHD is a process with several steps. If you are concerned about whether a child might have ADHD, the first step is to talk with a healthcare provider to find out if the symptoms fit the diagnosis.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. You can’t really tell if a child has ADHD before the age of four years old because, at that age, many children are very hyperactive! However, that does not mean that there are no children under the age of four who do not have severe hyperactive behaviour or disruptive moods, but in the long run, they may end up with other diagnoses. We chat to Paediatrician Professor Andre Venter for more on this often difficult to understand disorder.

When do children get diagnosed with ADHD?

The majority of children are diagnosed with ADHD because of behavioural, social, or developmental issues at or around five years of age, and another group due to educational difficulties at about a grade 3 level.

How does a child get diagnosed?

As far as the diagnosis of ADHD is concerned, consensus criteria for diagnosing this disorder are defined in the Diagnostic and Statistical Manual of Mental Disorders V (DSM V).

In these guidelines, the symptoms of ADHD are divided into two categories:  

  • The first group is the criteria that suggest inattentiveness and distractibility. There are 9 criteria of which more than 6 would be suggestive of a diagnosis.
  • The second group is symptoms and signs of hyperactivity and impulsivity, again 9 criteria. If more than 6 are present, it suggests a diagnosis on this axis.

Good to know: It’s evident that some children may qualify for a diagnosis on one set of criteria but not another.  

Who should make the diagnosis and decide if it is necessary to prescribe medication?

The most practical answer is anyone in your community who is either an expert in the field or has a great deal of experience with children with ADHD. In an ideal world, the diagnosis should be made by child psychiatrists, developmental paediatricians, and trained psychologists.

Unfortunately, those resources are quite scarce. The next level of professionals that may help are paediatricians, psychiatrists, and some general practitioners.

Teachers are not allowed to make a diagnosis, but many of them are very experienced and may ask you to have your child assessed.  That would not be an unreasonable request, but they cannot insist that medication be prescribed.  Therapists also have experience in the field of ADHD. Although they cannot make definitive diagnoses, they could suggest an assessment for a diagnosis and medical intervention and be part of the therapeutic team.

When is my ADHD child supposed to be medicated?

The indication to start a trial of medication is when, despite your child being in the correct school placement, the ADHD symptoms interfere with learning or social development to a significant degree.  If it does not, there is no harm to take a wait-and-see approach (preferably together with a professional that can guide you). But when it does, it is better to trial medication sooner rather than later.


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