The diagnosis of ADHD requires specific and significant symptoms. These include inattention, impulsivity and hyperactivity. These symptoms are present more days than not, beginning in early childhood. Significant impairment is noted in at least two settings--home, school or job. The symptoms are also not consistent with the child’s age or developmental levels.
The vast majority of children with ADHD have an unremarkable medical history. There are only a few medical conditions which masquerade as ADHD.
Children who have had a head injury may develop a kind of ADHD, usually of the inattentive type. This will become apparent as the parent sees the child’s academics and style of learning after the injury. Furthermore, a child who presents with an encephalopathy may demonstrate some symptoms similar to ADHD. However, there are also other medical issues present. Hyperthyroidism may present with hyperactivity. But, again there are other specific symptoms of hyperthyroidism present, as well.
Lead exposure also may cause learning problems in the child. This seems to be more prevalent in children from inner-city environments where there may be more exposure to older paint and lead plumbing.
Additionally, children with symptoms of fetal alcohol syndrome or other exposure to drugs or toxic substances also appear to have a higher prevalence of ADHD symptoms.
EEG, MRE, PET or SPECT scanning is not routinely indicated for the diagnosis of ADHD. The exception would be if there is strong medical evidence that would warrant such studies. In fact, the Council on Children, Adolescent and Their Families of the American Psychiatric Association has warned against the exposure of children to intravenous radioactive nucleotides as part of the diagnosis or treatment of childhood psychiatric disorders, citing both a lack of evidence of validity and safety issues.
Speak to your child’s doctor regarding specifics on the need for medical testing in the workup for ADHD.