4. Other components to be considered as part of an assessment for ADHD:
- Information about the child's appetite, dietary intake and sleep pattern;
- Physical examination including height, weight, and head circumference. The child's vision and hearing should be also be checked and the child should be screened for co-ordination problems. Other medical causes which might account for the presenting symptoms should be excluded. Such a physical examination also serves to assess the child for potential contraindications to pharmacological interventions;
- Where there is a clinical indication only, neurological examination to include brain scan or EEG.
- Referral to paediatric occupational therapist or in line with local referral arrangements for assessment of developmental co-ordination disorder (DCD) if there are concerns about the child's fine and gross motor skills;
- Referral to speech and language therapist where there is concern about language development.
- Referral for educational psychology assessment (if not already undertaken) where learning difficulties are suspected. A short WISC (Wechsler Intelligence Scale for Children) or equivalent is better than no assessment at all in these circumstances.
N.B. laboratory assessments e.g. the Continuous Performance Test do not distinguish children and young people with ADHD from psychiatric controls or normal peers and should therefore not be used routinely.
