Module 1: ADHD Diagnosis: Why, When & How (1.25 hours)

1. Identify red flags for ADHD

2. Screen for ADHD using clinical tools

3. Diagnose ADHD across the lifespan

4. Distinguish ADHD myths from facts.

1. American Psychiatric Association. (2013). Anxiety Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05
2. Barkley, Russell A., et al. “The adolescent outcome of hyperactive children diagnosed by research criteria—III. Mother–child interactions, family conflicts and maternal psychopathology.” Journal of Child Psychology and Psychiatry 32.2 (1991): 233-255.
3. Barkley, Russell A., et al. “Driving in young adults with attention deficit hyperactivity disorder: knowledge, performance, adverse outcomes, and the role of executive functioning.” Journal of the International Neuropsychological Society 8.5 (2002): 655-672.
4. Bertelsen, Elin Næs, et al. “Childhood epilepsy, febrile seizures, and subsequent risk of ADHD.” Pediatrics 138.2 (2016).
5. Biederman, Joseph, et al. “Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study.” Journal of the American Academy of Child & Adolescent Psychiatry 36.1 (1997): 21-29.
6. Biederman, Joseph. “Impact of comorbidity in adults with attention deficit/hyperactivity disorder.” The Journal of clinical psychiatry (2004).
7. Brown, Ronald T., and Joseph N. Pacini. “Perceived family functioning, marital status, and depression in parents of boys with attention deficit disorder.” Journal of Learning Disabilities 22.9 (1989): 581-587.
8. CADDRA – Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines, 4.1 Edition, Toronto ON; CADDRA, 2020.
9. Castellanos, F. Xavier, et al. “Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder.” Archives of general psychiatry 53.7 (1996): 607-616..
10. Caye, Arthur, et al. “Life span studies of ADHD—conceptual challenges and predictors of persistence and outcome.” Current psychiatry reports 18.12 (2016): 111.
11. Chang, Zheng, et al. “Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study.” JAMA psychiatry 71.3 (2014): 319-325.
12. Coffin, Joan M., et al. “Impaired cerebellar learning in children with prenatal alcohol exposure: a comparative study of eyeblink conditioning in children with ADHD and dyslexia.” Cortex 41.3 (2005): 389-398.
13. Curatolo, Paolo, Elisa D’Agati, and Romina Moavero. “The neurobiological basis of ADHD.” Italian journal of pediatrics 36.1 (2010): 79.
14. Dalsgaard, Søren, et al. “Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study.” The Lancet 385.9983 (2015): 2190-2196.
15. DiScala, Carla, et al. “Injuries to children with attention deficit hyperactivity disorder.” Pediatrics 102.6 (1998): 1415-1421.
16. D’Onofrio, Brian M., et al. “Causal inferences regarding prenatal alcohol exposure and childhood externalizing problems.” Archives of general psychiatry 64.11 (2007): 1296-1304.
17. Ducharme, Simon, et al. “Decreased regional cortical thickness and thinning rate are associated with inattention symptoms in healthy children.” Journal of the American Academy of Child & Adolescent Psychiatry 51.1 (2012): 18-27.
18. Faraone, Stephen V., et al. “Attention-deficit/hyperactivity disorder in adults: an overview.” Biological psychiatry 48.1 (2000): 9-20.
19. Faraone, Stephen V., and Alysa E. Doyle. “The nature and heritability of attention-deficit/hyperactivity disorder.” Child and adolescent psychiatric clinics of North America 10.2 (2001): 299-316.
20. Faraone, Stephen V., and Eric Mick. “Molecular genetics of attention deficit hyperactivity disorder.” Psychiatric Clinics 33.1 (2010): 159-180.
21. Gizer, Ian R., Courtney Ficks, and Irwin D. Waldman. “Candidate gene studies of ADHD: a meta-analytic review.” Human genetics 126.1 (2009): 51-90.
22. Groenman, Annabeth P., Tieme WP Janssen, and Jaap Oosterlaan. “Childhood psychiatric disorders as risk factor for subsequent substance abuse: A meta-analysis.” Journal of the American Academy of Child & Adolescent Psychiatry 56.7 (2017): 556-569.
23. Hauser, Peter, et al. “Attention deficit-hyperactivity disorder in people with generalized resistance to thyroid hormone.” New England Journal of Medicine 328.14 (1993): 997-1001.
24. Huggins, Suzanne Perrigue, Mary E. Rooney, and Andrea Chronis-Tuscano. “Risky sexual behavior among college students with ADHD: Is the mother–child relationship protective?.” Journal of attention disorders 19.3 (2015): 240-250.
25. Jerome L. Segal A. Validation of a driving questionnaire for patients with ADHD: the Jerome Driving Questionnaire. ADHD. Attention Deficit and Hyperactivity Disorders. VOl. No. 1 May (2009). p.151.
26. Juneja, Monica, et al. “Iron deficiency in Indian children with attention deficit hyperactivity disorder.” Indian pediatrics 47.11 (2010): 955-958.
27. Kessler, Ronald C., et al. “The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication.” American Journal of psychiatry 163.4 (2006): 716-723.American Psychiatric Association.
28. Leibson, Cynthia L., et al. “Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder.” Jama 285.1 (2001): 60-66.NHTSA, 1997
29. Mannuzza, Salvatore, et al. “Educational and occupational outcome of hyperactive boys grown up.” Journal of the American Academy of Child & Adolescent Psychiatry 36.9 (1997): 1222-1227.Doshi et al., 2012
30. Michelson, David, et al. “Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies.” Biological psychiatry 53.2 (2003): 112-120.Wender PH, et al. Ann N Y Acad Sci. 2001;931:1-16.
31. Milberger, Sharon, et al. “Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children?.” The American journal of psychiatry (1996).
32. Milberger, Sharon, et al. “Pregnancy, delivery and infancy complications and attention deficit hyperactivity disorder: issues of gene-environment interaction.” Biological psychiatry 41.1 (1997): 65-75.
33. Mohr-Jensen, Christina, and Hans-Christoph Steinhausen. “A meta-analysis and systematic review of the risks associated with childhood attention-deficit hyperactivity disorder on long-term outcome of arrests, convictions, and incarcerations.” Clinical psychology review 48 (2016): 32-42.
34. O’Leary, Colleen M. “Fetal alcohol syndrome: diagnosis, epidemiology, and developmental outcomes.” Journal of paediatrics and child health 40.1‐2 (2004): 2-7.
35. Østergaard, Søren D., et al. “Teenage parenthood and birth rates for individuals with and without attention-deficit/hyperactivity disorder: a nationwide cohort study.” Journal of the American Academy of Child & Adolescent Psychiatry 56.7 (2017): 578-584.
36. Pomerleau, Cynthia S. “Co‐factors for smoking and evolutionary psychobiology.” Addiction 92.4 (1997): 397-408.
37. Potter, Alexandra S., Paul A. Newhouse, and David J. Bucci. “Central nicotinic cholinergic systems: a role in the cognitive dysfunction in attention-deficit/hyperactivity disorder?.” Behavioural brain research 175.2 (2006): 201-211.
38. Rucklidge, Julia J. “Gender differences in attention-deficit/hyperactivity disorder.” Psychiatric Clinics 33.2 (2010): 357-373.
39. Sharp, Sally I., Andrew McQuillin, and Hugh MD Gurling. “Genetics of attention-deficit hyperactivity disorder (ADHD).” Neuropharmacology 57.7-8 (2009): 590-600.
40. Shaw, Philip, et al. “Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation.” Proceedings of the National Academy of Sciences 104.49 (2007): 19649-19654.
41. Shaw, Philip, et al. “Cortical development in typically developing children with symptoms of hyperactivity and impulsivity: support for a dimensional view of attention deficit hyperactivity disorder.” American Journal of Psychiatry 168.2 (2011): 143-151.
42. Swanson, J. M., et al. “Association of the dopamine receptor D4 (DRD4) gene with a refined phenotype of attention deficit hyperactivity disorder (ADHD): a family-based approach.” Molecular psychiatry 3.1 (1998): 38-41.
43. Swanson, James, et al. “Cognitive neuroscience of attention deficit hyperactivity disorder and hyperkinetic disorder.” Current opinion in neurobiology 8.2 (1998): 263-271.
44. Swanson, James M., et al. “Attention deficit hyperactivity disorder.” Encyclopedia of Cognitive Science (2006).
45. Vincent A. My Brain Still Needs Glasses. Montréal: Juniper Books; (2017).
46. Wilens, Timothy E., Joseph Biederman, and Thomas J. Spencer. “Attention deficit/hyperactivity disorder across the lifespan.” Annual review of medicine 53.1 (2002): 113-131.Statistics Canada, 2004 projected to 2005, available at http://www.statcan.gc.ca
47. Wilens, Timothy E., Thomas J. Spencer, and Joseph Biederman. “Are attention-deficit hyperactivity disorder and the psychoactive substance use disorders really related?.” Harvard Review of Psychiatry 3.3 (1995): 160-162.Groenman et al., 2017

Feel free to post in the ‘Ask an Expert’ forum (look in the left-hand menu) with any questions regarding applying the content of this module to your own practice. You will receive a response from one of our Experts.

This program is fully funded by CADDRA – Canadian ADHD Resource Alliance, and has not received any external financial or in-kind support.

The development and planning of this learning activity was completed by an independent scientific planning committee. Content of this learning program is based on quality scientific evidence.

Dr. Joan Flood
Family Physician, The Shoniker Clinic, Scarborough
Board Member, CADDRA – Canadian ADHD Resource Alliance
​Chair, Advocacy Committee, CADDRA

Relationships with financial sponsors
Click for Conflict of Interest Declaration
Honoraria, speaker fees, and unrestricted educational grants from the following companies: Purdue, Janssen Ortho, and Shire. Board Member and Advisory Committee Chair, CADDRA

Any questions about navigating your course can be emailed to stacey.espinet@caddra.ca