Diagnosing Attention-Deficit Hyperactivity Disorder (ADHD) is not only complex, but also is controversial among health professionals.

In an attempt to ease the controversy, researchers at the Munroe-Meyer Institute (MMI) have been testing a "best practice" approach involving multi-disciplinary, multi-method assessment for diagnosis and treatment programming of children with ADHD.

"The number of children diagnosed with ADHD has increased dramatically because parents are now paying attention to this disorder," said Joseph Evans, Ph.D., associate professor and director of pediatric psychology at MMI.

"Some parents overreact. Their child gets his first below-average grade and all of a sudden he’s got ADHD. In turn, the number of prescriptions written for Ritalin has increased 300 percent in the past seven years," he said. Ritalin is one of the common drugs prescribed for this disorder.

Dr. Evans and a team from MMI conducted a multi-disciplinary diagnostic clinic for children with ADHD to provide accurate initial diagnoses. Team members included Brett Kuhn, Ph.D., assistant professor, pediatrics, and Tim Riley, Ph.D., assistant professor, pediatrics.

Initial clinical data collection was from evaluations of 223 males and 52 females, between ages 4 and 18, who were referred to the ADHD Diagnostic Clinic. Individual diagnoses were made after reviewing data from measures collected from parents, teachers, clinic-based tests and direct observations of behavior.

In addition to an initial interview and medical history questionnaire, each child was evaluated through eight rating scale measures and observation of behavior.

"Emphasis was placed on determining the presence of ADHD symptoms across development, settings and caregivers, while ruling out other problems which could better account for the children’s problems, such as a learning disability, conduct disorder or oppositional behavior," Dr. Evans said.

Of the children seen in the clinic, the team diagnosed 53 percent with ADHD. The team decided against an ADHD-related diagnosis for 21 percent of the children who had entered the clinic with a "prior" ADHD diagnosis. Nineteen children who were taking medication for ADHD symptoms when they entered the clinic, did not receive an ADHD-related diagnosis.

Between 3 to 5 percent, or 2.5 to 3 million, of all school-aged children (70 percent in relatives of ADHD children) are affected by this disorder.

Its base characteristics — inattentiveness, impulsivity and hyperactivity — must appear in a child before the age of seven. Boys with ADHD tend to outnumber girls by 4-1, although ADHD in girls is under-identified, he said.

Some common symptoms of ADHD are fidgeting or squirming excessively, having difficulty remaining seated, being easily distracted, having difficulty awaiting turn in games, blurting out answers to questions, having difficulty following instructions and sustaining attention, shifting from one activity to another, having difficulty playing quietly, and often talksing excessively, interrupting, failing to listen, losing things and impulsively engaging in dangerous activities.