Psychologist or Paediatrician: Who Should Assess My Child for ADHD?

If you're concerned that your child may have Attention-Deficit/Hyperactivity Disorder (ADHD), one of the first questions you might have is whether to arrange an assessment with a psychologist or a paediatrician.

Both psychologists and paediatricians can assess and diagnose ADHD. However, there are important differences in their training, the approach they take to assessment, and the support they can provide following a diagnosis.

For many families, psychologists and paediatricians play complementary roles in understanding a child's difficulties and developing an appropriate treatment and support plan.

What is ADHD and how is it diagnosed?

ADHD is a neurodevelopmental condition that affects a person's ability to regulate attention, activity levels and impulses. Children with ADHD may experience difficulties with concentration, organisation, remembering instructions, managing emotions, sitting still or thinking before acting.

ADHD can present differently from one child to another. Some children are noticeably active and impulsive, while others are predominantly inattentive, appearing distracted, forgetful or easily overwhelmed.

ADHD is diagnosed using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).

For a diagnosis of ADHD, a child must demonstrate a persistent pattern of inattention and/or hyperactivity-impulsivity that:

• Has been present for at least six months.
• Includes several symptoms that were present before 12 years of age.
• Occurs in two or more settings, such as home and school.
• Interferes with their everyday functioning, learning, relationships or wellbeing.
• Cannot be better explained by another condition.

For children aged 16 and under, at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity are required.

Importantly, there is no single test that can establish whether a child has ADHD. Diagnosis requires a careful evaluation of the child's development, behaviour, experiences and functioning across different environments.

What is the role of a psychologist in an ADHD assessment?

A psychologist approaches an ADHD assessment by developing a comprehensive understanding of the child within their developmental context.

Rather than looking only at attention or behaviour, a psychological assessment considers how the child is progressing across several important areas of development, including:

• Emotional wellbeing: How the child experiences and manages emotions, including frustration, anxiety, sadness and emotional regulation.
• Cognitive development: The child's thinking and learning abilities, including reasoning, memory, attention, processing speed and executive functioning.
• Social development: How the child forms friendships, understands social situations and interacts with others.
• Behavioural functioning: How the child manages everyday expectations, routines, impulses and behaviour at home and school.

This broader developmental perspective is important because difficulties with attention, learning or behaviour are not always caused by ADHD.

What does a psychological ADHD assessment involve?

A comprehensive psychological assessment will typically include several components.

1. Parent interview and developmental history

The psychologist meets with parents or caregivers to discuss the child's early development, medical and family history, educational experiences, emotional wellbeing, behaviour and current concerns.

This helps establish when difficulties first emerged and how they have changed as the child has grown.

2. Cognitive and learning assessment

Some psychological ADHD assessments include cognitive testing to better understand a child's intellectual and thinking abilities. At Future Minds Psychology, cognitive testing forms part of our comprehensive ADHD assessment process.

This can provide valuable information about areas such as working memory, processing speed, verbal reasoning and problem-solving.

Where there are concerns about academic progress, a formal learning assessment may also be recommended to investigate possible difficulties with reading, writing or mathematics.

Cognitive testing is not required to diagnose ADHD, and performance on cognitive tests cannot independently establish or exclude an ADHD diagnosis. However, it can provide a more detailed understanding of a child's strengths and difficulties, particularly where there are concerns about learning, intellectual development or executive functioning.

This information can also help inform practical recommendations for supporting the child at school and at home.

3. Standardised questionnaires

Parents and teachers complete questionnaires that examine attention, hyperactivity, impulsivity, executive functioning, behaviour and emotional wellbeing.

Depending on their age and developmental level, the child may also complete questionnaires about their own experiences.

Gathering information from different people is particularly important because children may behave differently across environments.

4. School consultation

The psychologist may interview the child's teacher and, where appropriate, observe the child in their educational setting.

Teachers can provide valuable information about the child's attention, learning, organisation, social relationships and capacity to manage classroom expectations.

5. Clinical interpretation and diagnosis

The psychologist brings together information from the interviews, questionnaires, testing and school consultation, considering the findings against the DSM-5-TR diagnostic criteria for ADHD.

An important part of this process is considering whether the child's difficulties might be better explained by another condition, or whether ADHD occurs alongside other developmental or mental health concerns.

These might include anxiety, depression, autism, trauma-related difficulties or specific learning disorders.

For example, a child experiencing significant anxiety might struggle to concentrate in class. Another child may appear inattentive because they have difficulty understanding or completing academic tasks.

An accurate assessment considers these possibilities rather than assuming that difficulties with attention necessarily indicate ADHD.

What happens after the psychological assessment?

Following the assessment, the psychologist prepares a comprehensive report outlining:

• The child's developmental and psychological profile.
• Their cognitive strengths and areas of difficulty.
• Findings from parent, teacher and child interviews and questionnaires.
• Whether the findings meet diagnostic criteria for ADHD or another condition.
• An explanation of factors contributing to the child's current functioning and wellbeing.
• Recommendations for home, school and any further treatment or support.

The report can provide parents, teachers and treating health professionals with a shared understanding of the child's needs.

Importantly, a psychological assessment is valuable even when ADHD is not diagnosed, because it can help explain the child's difficulties and identify appropriate supports.

What is the role of a paediatrician in an ADHD assessment?

A paediatrician is a medical doctor who specialises in the health and development of children and adolescents.

Like psychologists, paediatricians can diagnose ADHD and consider a child's developmental history, emotional wellbeing, learning, behaviour and social functioning.

However, paediatricians also bring specialist medical expertise to the assessment.

This includes considering physical health, sleep difficulties, medical conditions, medications and other factors that may contribute to difficulties with attention or behaviour.

A paediatrician will generally gather information about the child's developmental history, current symptoms and functioning at home and school. They may also use standardised ADHD questionnaires completed by parents and teachers.

A paediatrician may undertake a comprehensive ADHD assessment and make a diagnosis without requiring a psychological assessment first. Some paediatricians complete the diagnostic process independently, while others refer children to a psychologist for a more detailed evaluation of their cognitive, learning, emotional or behavioural functioning.

A referral for psychological assessment may be particularly helpful when a child's presentation is complex, when there are concerns about co-occurring conditions, or when additional information is needed to understand their learning and developmental needs.

Where a psychological assessment has already been completed, the paediatrician can use the report to inform their own diagnostic evaluation and treatment recommendations.

ADHD medication and ongoing medical management

One of the most important differences between psychologists and paediatricians is their role in medical treatment.

Both appropriately qualified psychologists and paediatricians can diagnose ADHD, but psychologists cannot prescribe ADHD medication. Medication must be prescribed by a medical practitioner who is authorised to do so, such as a paediatrician or psychiatrist.

When medication is considered appropriate, a paediatrician can discuss the available options with the family, assess relevant medical factors and prescribe treatment.

The paediatrician is also responsible for monitoring the child's response to medication, including its effectiveness, possible side effects and any necessary adjustments to the dose or type of medication.

Medication is not required for every child with ADHD. Decisions about treatment should take into account the child's individual needs, the impact of their symptoms and the family's preferences.

Paediatricians may also refer children to psychologists for therapeutic support, including assistance with emotional regulation, executive functioning, behaviour, anxiety and family relationships.

Do you need to see both a psychologist and a paediatrician?

Not necessarily. Both appropriately trained psychologists and paediatricians can diagnose ADHD, and a comprehensive assessment does not always require both professionals.

However, their involvement can be particularly helpful when a child's difficulties are complex or when medication is being considered.

For example, a psychologist may undertake a comprehensive assessment to investigate whether ADHD explains a child's difficulties with concentration, learning and emotional regulation.

The psychologist's report may identify ADHD alongside anxiety or a specific learning disorder and provide recommendations for school and home.

A paediatrician can then review these findings, consider relevant medical factors and discuss whether medication may form a useful part of the child's treatment plan.

The psychologist may continue working with the child and family to develop strategies for managing attention, emotions, organisation and everyday challenges.

In this way, the two professionals contribute different but complementary areas of expertise. Their involvement can help ensure that both the psychological and medical aspects of a child's needs are appropriately considered.

Where should parents start?

If you're concerned that your child may have ADHD, either a psychologist experienced in ADHD assessment or a paediatrician can be an appropriate starting point.

A comprehensive psychological assessment may be particularly helpful when:

• There are concerns about ADHD alongside learning difficulties, anxiety, autism or emotional regulation.
• Parents or teachers are uncertain about the reasons for the child's difficulties.
• A detailed understanding of the child's cognitive and developmental strengths and needs would assist with educational planning.
• The family would benefit from a comprehensive report with practical recommendations for school and home.

If medication is being considered, consultation with a paediatrician or another appropriately authorised medical practitioner will also be necessary. A prior psychological diagnosis may provide useful information, but the prescribing clinician will need to undertake their own medical evaluation.

Regardless of where you begin, the most important consideration is that the assessment is thorough, evidence-based and conducted by a professional experienced in assessing ADHD in children.

ADHD Assessments at Future Minds Psychology

At Future Minds Psychology, we provide comprehensive ADHD assessments for children and adolescents.

Our assessments consider more than whether a child meets the diagnostic criteria for ADHD. We aim to develop a detailed understanding of each child's developmental, cognitive, emotional, social and behavioural functioning, helping families understand not only what difficulties their child is experiencing, but why.

As part of this approach, our comprehensive assessments include cognitive testing to help identify strengths and difficulties that may influence the child's learning and everyday functioning. Although cognitive testing is not necessary to diagnose ADHD, we believe it can add valuable information to a broader developmental assessment.

We provide comprehensive psychological reports with diagnostic conclusions and individualised recommendations for home, school and ongoing support.

Where appropriate, our findings can also be shared with a child's GP or paediatrician to support coordinated care and consideration of medical treatment.

Have Questions About an ADHD Assessment?

At Future Minds Psychology, we help families understand their child's developmental, learning and emotional needs through comprehensive psychological assessments.

If you're unsure whether an ADHD assessment is appropriate for your child, our team can discuss your concerns and help you consider the next steps.

Contact Future Minds Psychology to enquire about an assessment.