A. You don't.
Attention-Deficit Hyperactivity Disorder (AHDH) is nothing more than a professional opinion, it is not a fact. Even in the "Diagnostic and Statical Manual of Mental Disorders; Fifth Edition" (DSM-5) is says, and I quote:
"No biological marker is diagnostic for ADHD."
This is a complex way to say, there is no sure way ADHD can be proven.
Working in the prison system with high risk young offenders, it will be no surprise to you that most of those I come in contact with have been labelled with ADHD. My problem with this, is that the exact same young people who have been labelled with ADHD, have histories of extreme trauma from childhood.
The symptoms of those suffering from complex trauma are almost completely identical to the symptoms of ADHD.
DSM-5 goes on to stat:
"Informant symptom ratings may be influenced by cultural group of the child and the informant, suggesting that culturally appropriate practices are relevant in assessing ADHD."
This means that if a professional is going to assess and diagnose a person with ADHD they need to have a understanding of the cultural experience of that person to determine whether the behaviour difficulties stem from the person's life experience and cultural perception of the world, or not.
For example; a young black man who was born in the UK, raised in Uganda, then grew up in the middle of Angel Town and considered 'gang associated', should be assessed and diagnosed by a practitioner who has a full understanding of the impact of these circumstances. The same goes for a young white British man who has grown up in the middle of a poor and violent council estate.
My professional opinion for both young men, would be that they have both suffered complex traumas, therefore neither would qualify in fitting the official clinical diagnostics for ADHD. The same can be said for other labels we love to give adolescents, "Personality Disorder" is quickly becoming a new favourite with forensic psychologists who work with 'gang associated' young men.
As someone who specialising in violence and trauma, specifically with adolescence involved in the Criminal Justice System, I cannot stress enough how important it is we begin to focus more on the root causes of behavioural issues. Labels like ADHD and Personality Disorder within these settings are not helping because they beginning to group young people rather than looking at each individual with care, we also negatively affect the young person by giving him or her this label on top of the many others they have already received.
When we work from a trauma informed perspective and start to really understand why lil' Bobby cannot focus or sit still in class, we help him a lot more than when we label him and give him medication (PS the medication for ADHD is basically speed anyway).
I have a young man I work with in prison, he is inside for violence and was previously one of the most violent prisoners in this particular YOI. He had been diagnosed with ADHD from childhood, a childhood that was extremely traumatic for him, within 4 months of working with him from a trauma informed perspective he was no longer violent. In fact, he is now in education, a peer rep and can sit for hours on end in silence playing chess.
For me this is not a unique case, there are many young people suffering in silence, especially within our prison estates, who need our support to heal rather than our judgements and opinions on what to call their suffering.
Another quick rant from me but a discussion I feel worth having...