A Scoping Review of Attention-Deficit/Hyperactivity Disorder Assessment and Diagnosis: Tools, Practices, and Sex Bias

Article

Crocker, Sasha L., Roemer, Anja, Strohmaier, Sarah, Wang, Grace Y and Medvedev, Oleg N.. 2025. "A Scoping Review of Attention-Deficit/Hyperactivity Disorder Assessment and Diagnosis: Tools, Practices, and Sex Bias ." Advances in Neurodevelopmental Disorders. https://doi.org/10.1007/s41252-025-00452-2
Article Title

A Scoping Review of Attention-Deficit/Hyperactivity Disorder Assessment and Diagnosis: Tools, Practices, and Sex Bias

ERA Journal ID211643
Article CategoryArticle
AuthorsCrocker, Sasha L., Roemer, Anja, Strohmaier, Sarah, Wang, Grace Y and Medvedev, Oleg N.
Journal TitleAdvances in Neurodevelopmental Disorders
Number of Pages10
Year2025
PublisherSpringer
Place of PublicationSwitzerland
ISSN2366-7532
2366-7540
Digital Object Identifier (DOI)https://doi.org/10.1007/s41252-025-00452-2
Web Address (URL)https://link.springer.com/article/10.1007/s41252-025-00452-2
Abstract

Objectives
Accurately diagnosing attention-deficit/hyperactivity disorder (ADHD) is challenging due to the overlap of symptoms with other mental health conditions. This scoping review evaluated the dependability and accuracy of prevalent diagnostic scales and investigates potential obstacles to ADHD assessment diagnosis including potential sex bias.

Method
Following the PRISMA-ScR guidelines, 11 widely used diagnostic scales were identified and included. All scales were evaluated based on their psychometric quality and alignment with DSM-5 diagnostic criteria for ADHD.

Results
The Attention Deficit Disorders Evaluation Scale emerged as the most reliable among the 11 scales, with the Symptom Checklist-4 ranking as the least reliable. No single assessment tool was adequate for ADHD diagnosis; additional testing was required for accurate conclusions. The literature revealed sex and age biases in some of the assessments. It was discovered that girls were diagnosed with ADHD less often than boys, yet their likelihood of misdiagnosis was notably lower.

Conclusions
This review emphasizes the necessity of comprehensive, multi-method assessment approaches for accurate ADHD diagnosis, as no single tool demonstrated sufficient diagnostic precision. Effective clinical assessment design must incorporate strong psychometric measures, address sex-based diagnostic disparities, and emphasize the importance of evaluating behavioural changes over time and their functional impact across settings.

KeywordsADHD ; Assessment ; Diagnosis ; Sex diferences; Reliability ; Validity
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020520101. Child and adolescent development
520108. Testing, assessment and psychometrics
Byline AffiliationsUniversity of Waikato, New Zealand
Massey University, New Zealand
Victoria University
School of Psychology and Wellbeing
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Methadone Maintenance Treatment and Cognitive Function: A Systematic Review
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Some light in the fog?
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How well do selection tools predict performance later in a medical programme?
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Rethinking the admission criteria to nursing school
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Bipolar disorder and medical adherence: A Chinese perspective
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