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At this time diagnosing ADHD, or for that matter any neurological or mental disorder, is not as simple as we would like it to be. There are no blood tests or scans that will give us a quick and simple answer. The process includes evaluating symptoms; defining their inclusion into the typical ADHD symptom list while excluding any other physical or mental health reason for these symptoms.
For a diagnosis to be made, symptoms need to be apparent in more than one setting. This is necessary because symptoms may be due to conditions in a particular environment, rather than being due to a medical condition. The diagnosis also requires that symptoms be present before the age of twelve and be at a level of impairment. Children must have at least six symptoms of inattention and/or hyperactivity and impulsivity as outlined in DSM 5. Older adolescents (over age 17 years) must present with at least five symptoms.
To view the DSM 5 symptom list access, http://www.cdc.gov/ncbddd/adhd/diagnosis.html It is not uncommon for a diagnosis of ADHD to be missed if the symptoms do not present in the typical manner. If the child if not visibly hyperactive or displaying other symptoms that parents and teachers find annoying, which can be typical for primarily inattentive ADHD, ADHD may not be suspected. This presentation is more common but certainly not exclusive to girls and women. It is important to note that it is the symptom of attention regulation impairment which causes the greatest functional impairment, not the symptoms of hyperactivity and impulsivity.
Children with ADHD who are very bright can often cope at school by relying on their sheer intelligence however these children can end up feeling extremely frustrated, bored and rarely end up working to their potential. They may be able to function adequately in elementary and even high school without too much trouble, but when attention and executive functioning skills are in greater demand at the post-secondary level, they often crash and burn.
If your physician is unfamiliar with ADHD they should access, the CADDRA Canadian ADHD Practice Guidelines at http://www.cdc.gov/ncbddd/adhd/diagnosis.html . These guidelines have been developed to educate physicians on proper assessment procedures and good clinical practice in treatment. These guidelines are geared for physicians and are not meant to be used for self-diagnosis or treatment.