Practice Guidelines

Clinical Practice Guideline: Treatment of the School-Aged Child With Attention-Deficit/Hyperactivity Disorder
American Academy of Pediatrics

Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults with Attention-Deficit/Hyperactivity Disorder
American Academy of Child and Adolescent Psychiatry

Practice Parameter for the Use of Stimulant Medications in the Treatment of Children, Adolescents, and Adults
American Academy of Child and Adolescent Psychiatry

Clinical Assessment Tools

When assessing ADHD it is important to establish that symptoms represent a pattern of behaviors that have occurred across time and contexts (e.g. home and school) for a period of at least six months. 1It is important to note that children are generally more inattentive and hyperactive than adults. Also, there is normal variability among children: some are normally more hyperactive, inattentive, and impulsive than others. In all cases it is important to consider whether or not a child is exhibiting behavior appropriate to his or her age. Also it is normal for kids to appear inattentive when things they are not naturally interested in are occurring (a geography lecture). Finally, many children enjoy activity and sometimes adults regiment their day so that there are long periods of sitting or other structured activities. This structure can make some children appear "hyperactive" or "impulsive" when "bored" and "restless" would be more accurate terms.  Remember, hyperactivity or impulsive behavior should always be judged by developmental norms.

It is important to obtain information from parents and teachers about ADHD symptoms. Information provided by children is less useful.1

Self-Report Measures

The following measures assess symptoms in accordance with DSM-IV diagnostic criteria:1

Disruptive Behaviour Disorder Rating Scale

Swanson Nolan and Pelham-IV (SWAN-IV)

ADHD Rating Scale

Vanderbilt Rating Scale

Clinician-Administered Assessments

Pelham and Waschbusch note that structured clinical interviews can also be used to assess ADHD symptoms. However, structured interviews require more time on the part of the assessor and informants, and do not necessarily better inform diagnosis.1

Diagnostic Interview Schedule for Children

1Pelham, W. E., & Waschbusch, D. A. (in press). Attention-deficit hyperactivity disorder (ADHD). In J. E. Fisher & W. O’Donohue (Eds.). Practitioner’s guidelines for evidence based psychotherapy. New York: Kluwer.