· 9 min read
Can a Brain Scan Diagnose ADHD or Anxiety in a Child?
Board-Certified Adult Psychiatrist and Child and Adolescent Psychiatrist
Not today. New research found three brain “biotypes,” but they did not line up with diagnoses. Here’s how ADHD and anxiety are evaluated now, and what to bring to an appointment.
Not today. Brain scans used in new ADHD and anxiety research are scientific tools, not a diagnostic test a family can order. A Stanford Medicine-led study, published in October 2026, found three brain “biotypes” in children with ADHD, anxiety, or both — but each pattern showed up across those diagnoses. For now, a careful clinical evaluation of symptoms, history, and impairment at home and at school remains the way a child is assessed.
Trying to figure out if it's ADHD, anxiety, or just a phase? My parent guide Is It ADHD, Anxiety, or Just Being a Kid? helps you sort what you're seeing before you walk into an appointment.
What did the new brain-scan study actually find?
In a November 10, 2026, news release, Stanford Medicine described a study led in part by Yu Zhang, Ph.D., of Stanford, with lead author Yong Jiao, Ph.D., of the University of Iowa. The paper, “Deep learning of brain–behavior dimensions identifies transdiagnostic biotypes in youth with ADHD and anxiety disorders,” was published October 16, 2026, in Nature Mental Health.
The researchers used functional MRI (fMRI) scans — research images of how brain regions work together — plus cognitive and behavioral measures. The main analysis included 3,508 children, ages 9 to 11, from the Adolescent Brain Cognitive Development (ABCD) study, which enrolled more than 11,000 U.S. children at ages 9 or 10. Stanford also reported 693 children later diagnosed with ADHD, anxiety, or both, and 1,947 comparison children who never received either diagnosis. The findings were checked in 224 children of similar age from the Healthy Brain Network who already had ADHD or anxiety.
A machine-learning model identified two brain-behavior dimensions, related to cognitive control and to emotion and attention, and three biotypes: an externalizing-disinhibited pattern, more often linked with hostility, defiance, impulsivity, and rule-breaking, and more often seen with ADHD; an internalizing-distressed pattern, more often linked with guilt, tension, perfectionism, and anxious-depressed symptoms, and more often seen with anxiety; and a mixed pattern, more often linked with attention problems, irritability, and self-injury, and more often seen with ADHD. These are group findings, not a test a typical clinic can order for your child.
Why didn’t the biotypes match the diagnostic labels?
Each child was placed in only one biotype, but all three biotypes appeared in children with ADHD, with anxiety, and with both. The brain patterns did not line up neatly with clinic labels. Zhang said the team wanted to know whether biological differences “follow the diagnostic labels used in the clinic.” The answer, he said, was “not exactly.”
That finding is interesting rather than alarming. Clinicians have long known that ADHD and anxiety overlap, and that two children with the same diagnosis can look quite different. This work does not make existing diagnoses meaningless, and it does not mean a scan can now sort those differences for your child. The researchers also reported that the biotypes could be seen in baseline scans of children who had no diagnosis at enrollment but later received one. Zhang described that as a possible future early indicator — a research hope, not a current clinical test.
How are ADHD and anxiety evaluated today?
Today, both are diagnosed through a careful clinical evaluation, not a single lab test or image.
The American Academy of Pediatrics’ 2019 clinical practice guideline — still the current AAP guideline for ADHD in children and adolescents ages 4 through 17 — says a diagnosis should be based on DSM-5 criteria. That includes documenting symptoms and impairment in more than one major setting, such as home and school, using information from parents or guardians, teachers, and any mental health clinicians involved in the child’s care. The clinician should also look for other possible explanations and screen for conditions that often travel with ADHD, including anxiety, learning problems, and sleep difficulties.
For anxiety, the current American Academy of Child and Adolescent Psychiatry document is the 2020 Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. It frames assessment as a clinical process based on DSM-5 criteria: how often symptoms occur, how long they have lasted, how much distress they cause, how they affect daily life, and whether another medical or psychiatric explanation fits better. The evaluation typically includes a developmentally appropriate interview with the child and a parent or caregiver, with other information added when it helps.
Why do ADHD and anxiety overlap so often?
Parents often wonder whether restlessness or trouble focusing is “really ADHD” or “really anxiety.” Sometimes it is one, sometimes the other, and often elements of both are present. Stanford’s release notes that children with one of these conditions often have several symptoms of the other. A child who cannot settle into homework may be pulled away by worry, by differences in attention, or by both. The same surface behavior can have different drivers, which is why a thoughtful history matters so much.
What should I write down before an appointment?
Note when the behaviors or worries show up and how long they have been present; where they happen, including home, school, and bedtime; how often they occur; and what they get in the way of, such as schoolwork, friendships, or sleep. Teacher or caregiver input from another setting is especially helpful. A good evaluation should leave room for uncertainty and for more than one condition to be considered. This article cannot diagnose your child or recommend a particular treatment.
Are paid “ADHD brain scan” services a substitute for an evaluation?
Some companies market imaging as a way to diagnose ADHD. I would be cautious. In its 2007 practice parameter, AACAP wrote that neuroimaging is “a valuable research tool in the study of ADHD, but it is not useful for making a diagnosis of ADHD in clinical practice or in predicting treatment response.” Unless the medical history raises a separate neurological concern, it added, studies such as EEG, MRI, SPECT, or PET “are not indicated for the evaluation of ADHD.” The AAP’s 2019 guideline likewise describes diagnosis as a clinical, multi-informant process, not a brain scan.
The 2026 research does not change that advice. Those scans were research images, analyzed with a specialized model and interpreted at the group level. Zhang has said that symptom-based diagnoses “probably won’t be replaced” by biotypes, though the two approaches might one day complement each other in treatment-matching research. That is a direction for future trials, not a service a parent should expect to buy this week. If a clinician recommends imaging, it should be because your child’s history or examination raises a specific medical question.
You don't need a brain scan. You need a clear picture of your child.
ADHD and anxiety can look almost the same from the outside: the child who can't settle, can't finish homework, or falls apart at bedtime. That overlap is exactly why so many parents feel stuck, and why the most useful thing you can bring to an appointment is a clear picture of what you're seeing. I wrote Is It ADHD, Anxiety, or Just Being a Kid? to help you get there.
Inside, the guide helps you:
- sort typical childhood behavior from signs of ADHD or anxiety
- think through what you're seeing before an evaluation, so you walk into the appointment prepared
I wrote it from my experience as a child psychiatrist, for parents who want clarity instead of more worry.
Get Is It ADHD, Anxiety, or Just Being a Kid? →
Frequently asked questions
Is there a single test for ADHD?
No. There is no blood test, brain scan, or computer task that, by itself, can diagnose ADHD. The current standard is a clinical evaluation that uses established diagnostic criteria, information from more than one setting, and a search for other explanations and co-occurring conditions.
Can a child have both ADHD and anxiety?
Yes. The conditions often overlap, and children with one may have symptoms of the other. This is general information, not a diagnosis of any child.
Will brain scans be used to diagnose ADHD or anxiety in the future?
Possibly as a complement to clinical care, but that is not established yet. Until future studies show that a scan improves real-world care for individual children, diagnosis should continue to rest on a thorough clinical evaluation.
This article is for educational purposes and is not a substitute for medical advice, diagnosis, or treatment. It does not provide an individual diagnosis or recommend a change in medication or other care. Please consult a qualified clinician about your child’s specific situation.
Sources
- Erin Digitale, “Three brain biotypes found in Stanford Medicine-led study of kids with ADHD, anxiety,” Stanford Medicine, November 10, 2026, https://med.stanford.edu/news/all-news/2026/11/adhd-biotypes.html.
- Yong Jiao, Xiaoyu Tong, Gregory A. Fonzo, Ian H. Gotlib, Kilian M. Pohl, Theodore D. Satterthwaite, Jing Jiang, and Yu Zhang, “Deep learning of brain–behavior dimensions identifies transdiagnostic biotypes in youth with ADHD and anxiety disorders,” Nature Mental Health, published October 16, 2026, https://www.nature.com/articles/s44220-026-00740-3.
- Mark L. Wolraich et al., “Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents,” Pediatrics 144, no. 4 (2019): e20192528, https://publications.aap.org/pediatrics/article/144/4/e20192528/81590/clinical-practice-guideline-for-the-diagnosis.
- Heather J. Walter et al., “Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders,” Journal of the American Academy of Child & Adolescent Psychiatry (2020), https://www.jaacap.org/article/S0890-8567(20)30280-X/fulltext. (Current AACAP anxiety guideline; the full PDF could not be re-opened in this writing session because of site access limits, so assessment details above are limited to the guideline’s established scope and should be re-checked against the full text during medical review.)
- Steven Pliszka and the AACAP Work Group on Quality Issues, “Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder,” Journal of the American Academy of Child & Adolescent Psychiatry 46, no. 7 (July 2007): 894–921, https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/jaacap_adhd_2007.pdf.