Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition. The parents give you a copy of a form titled This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work. Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.


Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects both children and adults. The prevalence of ADHD in children is estimated to be around 5-10% (Polanczyk et al., 2007). Clinicians often rely on multiple sources of information, including parent and teacher reports, in order to make an accurate diagnosis of ADHD. In the case of Katie, an 8-year-old Caucasian female, her teacher has suggested that she may have ADHD, prompting her parents to seek evaluation from a psychiatrist.

Evaluation and Diagnosis

The evaluation for ADHD typically involves a comprehensive assessment that includes clinical interviews with the child and the parents, questionnaires assessing ADHD symptoms, behavioral observations, and sometimes additional psychometric testing. In Katie’s case, her teacher has already completed a questionnaire, suggesting symptoms of inattention, distractibility, forgetfulness, poor academic performance, and poor task completion.

The teacher’s observations, along with the parents’ denial of ADHD symptoms, highlight the importance of gathering information from multiple sources. It is not uncommon for parents to be initially resistant to the idea of their child having ADHD, as they may have misconceptions or misunderstandings about the disorder. Denial of symptoms can also stem from cultural or societal factors, such as stigma associated with mental health conditions or fear of medication. It is therefore crucial for clinicians to approach the evaluation with sensitivity and provide psychoeducation about ADHD to the parents.

In order to make an accurate diagnosis, it is important to rule out other potential causes for Katie’s symptoms. Several medical conditions, such as anxiety disorders, learning disabilities, or mood disorders, can present with symptoms similar to those of ADHD. Additionally, environmental factors, such as stressors at home or school, can also contribute to inattentive and hyperactive behavior. Therefore, a comprehensive assessment should include a thorough medical history, developmental history, and assessment of comorbid conditions, as well as collaboration with the school.

Differentiating ADHD from Other Conditions

ADHD is characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning or development (American Psychiatric Association, 2013). To differentiate ADHD from other conditions, clinicians rely on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These criteria include the presence of symptoms before the age of 12, impairment in social, academic, or occupational functioning, and symptoms being present in at least two settings (e.g., home and school).

In Katie’s case, her teacher’s report of inattention, poor academic performance, and task completion difficulties is consistent with the DSM-5 criteria for ADHD. However, it is important to gather additional information to confirm the diagnosis. Collateral information from the parents, as well as observations of Katie’s behavior in different settings, such as at home and during social activities, can provide valuable insights into her functioning and help differentiate ADHD from other conditions.

In addition to ruling out other conditions, it is important to take into account developmental factors when considering ADHD diagnosis in a child. Developmental changes, such as typical age-related improvements in attention and impulse control, can sometimes lead to inaccurate diagnosis or overdiagnosis of ADHD. It is therefore crucial to consider the child’s developmental stage, as well as cultural and contextual factors, when evaluating ADHD symptoms.


In conclusion, the case of Katie highlights the importance of a comprehensive evaluation for ADHD, taking into account information from multiple sources. The teacher’s report of inattention, distractibility, and poor academic performance aligns with some of the criteria for ADHD diagnosis. However, it is necessary to gather additional information, including collateral reports from the parents and observations of Katie’s behavior in different settings. Ruling out other potential causes for her symptoms is important to ensure an accurate diagnosis and appropriate treatment planning.