Guest Blog: Taking the Mystery Out of the ADHD Evaluation

I’m very pleased to present a guest blog by Anahi Ortiz, MD. She’s an ADHD coach with a background in pediatrics. Below, she leads us through the steps in having a child evaluated for ADHD.

   Where do you go if your child’s teacher tells you your child has symptoms of ADHD? Or, you as a parent see your child is struggling in school? Where do you go if your child has problems with behavior at home and at school? When a parent has a child that is not doing well academically, behaviorally or socially, it can be an overwhelming situation for them. However, there are professionals that can guide you through the process of finding a diagnosis and getting treatment.

Your pediatrician or family physician should be the first professional to approach for assistance. At the first visit, your physician will most likely get a complete history from the parent and child about academics, learning, and activities.  It would be helpful for you as parent to bring any information you have on your child such as report cards, any evaluations they have had at school, etc. If you have had the same physician for years, he may not take a full past medical history but if this is a new physician he more than likely will take a full past medical history looking for any neurological problems, hospital admissions, history of trauma, poisonings, prematurity and a developmental history (when did your child walk, say first word, etc.) . The next step should be a complete physical exam including a full neurologic.

Depending on the results of the history and exam and the comfort level of the physician with ADHD, the next step is usually to have the parents and teachers fill out rating scales for the child. These can give the physician specifics on whether the child has the symptoms for a diagnosis of ADHD and to what extent.  Once the scales are completed and scored your physician will sit down with you and your child to discuss them and to discuss treatment options. Guidelines now advise that:

  • parents receive educational information on ADHD
  • a discussion on the various medications
  • information on support groups for parents
  • possible referral for therapy

I would also include a discussion on the importance of exercise, nutrition (increasing proteins), possibly ADHD coaching, and meditation if age appropriate.

Many times after the physician has taken the initial history and exam, he may find atypical symptoms, significant findings on the past medical history or exam. In that case the physician may (and should) refer the child for further evaluation by:

  • a neurologist
  • a developmental center for evaluation of autism/Asperger’s, etc.
  • a psychologist for psychoeducational testing
  • a psychiatrist for evaluation of significant depression, bipolar, etc.

Sometimes the rating scales may demonstrate symptoms of anxiety and or depression. Again, depending on the comfort level and training of the physician, he may address and treat this in the office or refer to a therapist and/or psychiatrist.

ADHD is a very complicated disorder which requires a lengthy evaluation to diagnose. The process may take a few weeks or even more if your child requires any referrals. I hope I have been able to give an idea of what is required to evaluate ADHD and take the mystery out of the process.

Bio: Anahi Ortiz M.D. is a pediatrician with 27 years of experience. She retired from clinical practice a year ago and is involved in ADHD coaching for students and adults. On a personal note, she has two children with ADHD. One is 25, lives in NYC and works as an office manager. She chose to not finish college but may go back in the future. Her son is in his second year at DePaul University in Chicago and loving it. He majors in chemistry and math and is doing well. Anahi also has a third child who is a twin to her son, also attends college and  does not have ADHD.  Her website is and it offers  a variety of educational blogs on ADHD.  UPDATE June 2014:  It appears the link to Anahi’s website no longer works.


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About janet565

I've lived in the Inland Empire of Southern California since 1982. My profession involves maps and geography. I hope you find the blog useful, and wish you well....

3 responses to “Guest Blog: Taking the Mystery Out of the ADHD Evaluation”

  1. Pining for Grace says :

    Nutrition and nutritional deficiencies is the first thing I would look at before medication. Of course, if the symptoms are life threatening then medication is in order first then look at nutrition.

    Something else, sometimes children may not be add or adhd. Tests should be taken to try and measure their levels of creativity. A creative mind is often bored in the traditional classroom setting. A school in my area is exploring this. So many children get medicated when it may be unnecessary …


    • janet565 says :

      Here is Anahi’s reply to Pining for Grace: Dear piningforgrace,
      Nutrition: it has definitely been shown that decreasing the amount of carbs in the diet and increasing proteins can improve concentration and focus. I like to get a nutrtion history from parents and the child and provide some guidance. Breakfast is a big culprit! Children (and adults) eat a huge amount of sugary cereals and very little protein in the morning. I suggest eggs, peanut butter, breakfast burrito, etc.
      I have definitely seen children and adolescents who are actually not being challenged enough and end up fidgeting, losing focus. This is why a good history by the physician, a review of academic records and speaking with the child are all so important. Many times a physician can glean that there is a lack of challenge and go on to advise psychoeducational testing either through a private psychologist or through the school system. Actually I had my own son tested by a private psychologist because I wasn’t sure and actually wanted a second opinion from that of his pediatrician’s. Yes, he does have ADHD but it turns out he is also gifted with a high IQ – I fought for both accomodations and his taking gifted classes ( something the school did not think he could do!) It was the best thing I could have done. If creativity or giftedness is suspected – appropriate testing and accomodations are so important. Your school sounds like they are on top of it!


  2. janet565 says :

    Pining for Grace, thanks for your comments! I also have heard about nutrition and its impact on ADHD symptoms, specifically the benefits of more protein and fish oil. If the kids are like mine, and resist changing what they eat, a product like Zone Perfect bars might be worth a try. Lots of protein, lots of flavors, and more acceptable to our guys since it was a “snack’ and not part of a “meal.” The bars are carried at Target, among other stores. As for fish oil, there are options other than swallowing the big gel capsules, such as packets of Coromega. Our guys were ok with taking Coromega, for a while at least…
    And I agree about kids with ADHD symptoms potentially being creative thinkers. It’s a shame students are forced into a standardized mold, where one size does NOT fit all. There’s so much more to figure out! Most psychologists, educators etc are doing the best they can, but (in my opinion) we just don’t understand enough about what we’re dealing with and how to make it turn out better for all.


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