Copies of reports from any previous psychological testing should also be brought to the appointment. For adults who experience problems in the workplace, job evaluations should be brought for review if available. Many professionals will ask the individual to complete and return questionnaires before the evaluation and to identify a spouse or other family member who can also participate in parts of the evaluation. Timely completion and return of the questionnaires will expedite the evaluation.
Although different clinicians will vary somewhat in their procedures and testing materials, certain protocols are considered essential for a comprehensive evaluation.
These include a thorough diagnostic interview, information from independent sources such as the spouse or other family members, DSM-5 symptom checklists, standardized behavior rating scales for ADHD and other types of psychometric testing as deemed necessary by the clinician. These are discussed in more detail below. The single most important part of a comprehensive ADHD evaluation is a structured or semi-structured interview, which provides a detailed history of the individual. The interviewer asks a pre-determined, standardized set of questions in order to increase reliability and decrease the chances that a different interviewer would come up with different conclusions.
The clinician covers a broad range of topics, discusses relevant issues in detail and asks follow-up questions to ensure that all areas of interest are covered. The examiner will review the diagnostic criteria for ADHD and determine how many of them apply to the individual, both at the present time and since childhood. The diagnostic interview: screening for other psychiatric disorders.
The examiner will also conduct a detailed review to see if other psychiatric disorders that may resemble ADHD or commonly co-exist with ADHD are present. ADHD rarely occurs alone, and research has shown that more than two-thirds of people with ADHD have one or more co-existing conditions.
The most common include depression, anxiety disorders, learning disabilities and substance use disorders. A comprehensive evaluation includes screening for co-existing conditions. When one or more co-existing conditions are present along with ADHD, it is essential that all are diagnosed and treated. Failure to treat co-existing conditions often leads to failure in treating the ADHD. And, crucially, when the ADHD symptoms are a secondary consequence of depression, anxiety or some other psychiatric disorder, failure to detect this can result in incorrect treatment of the individual for ADHD.
It is also essential for the clinician to interview one or more independent sources, usually a significant other spouse, family member, parent or partner who knows the person well. Many adults with ADHD have a spotty or poor memory of their past, particularly from childhood. They may recall specific details but forget diagnoses they were given or problems they encountered.
Thus, the clinician may request that the individual being evaluated have his or her parents fill out a retrospective ADHD profile describing childhood behavior. This procedure helps the non-ADHD spouse or partner develop an accurate understanding and an empathetic attitude concerning the impact of ADHD symptoms on the relationship, setting the stage for improving the relationship after the diagnostic process has been completed.
If it is not possible to interview the loved ones, having them fill out checklists of symptoms is a good alternative. Many adults with ADHD may feel deeply frustrated and embarrassed by the ongoing problems caused by the disorder.
It is very important that the person being evaluated discuss these problems openly and honestly and not hold back information due to feelings of shame or fear of criticism. The quality of the evaluation and the accuracy of the diagnosis and treatment recommendations will be largely determined by the accuracy of the information provided to the examiner. A comprehensive evaluation can include one or more standardized behavior rating scales. Scores on the rating scales are not considered diagnostic by themselves but serve as an important source of objective information in the evaluation process.
Depending on the individual and the problems being addressed, additional psychological, neuropsychological or learning disabilities testing may be used as needed.
The testing can also help determine the presence and effects of co-existing conditions. For example, in order to determine whether the individual has a learning disability, the clinician will usually give a test of intellectual ability as well as a test of academic achievement. If the individual being evaluated has not had a recent physical exam within 6—12 months , a medical examination is recommended to rule out medical causes for symptoms. Some medical conditions, such as thyroid problems and seizure disorders, can cause symptoms that resemble ADHD symptoms.
A medical examination does not confirm ADHD but is extremely important in helping to rule out other conditions or problems. Towards the end of the evaluation the clinician will integrate the information that has been collected through diverse sources, complete a written summary or report, and provide the individual and family with diagnostic opinions concerning ADHD as well as any other psychiatric disorders or learning disabilities that may have been identified during the course of the assessment.
The clinician will then review treatment options and assist the individual in planning a course of appropriate medical and psychosocial intervention. Barkley, RA. Attention-deficit hyperactivity disorder, fourth edition: A handbook for diagnosis and treatment. As part of your assessment, the specialist will ask about your present symptoms. However, under current diagnostic guidelines, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood.
If you find it difficult to remember whether you had problems as a child, or you were not diagnosed with ADHD when you were younger, your specialist may wish to see your old school records, or talk to your parents, teachers or anyone else who knew you well when you were a child.
For an adult to be diagnosed with ADHD, their symptoms should also have a moderate effect on different areas of their life, such as:. If your problems are recent and did not occur regularly in the past, you're not considered to have ADHD. This is because it's currently thought that ADHD cannot develop for the first time in adults. Page last reviewed: 30 May Next review due: 30 May When you see a GP, they may ask you: about your symptoms or those of your child when these symptoms started where the symptoms occur — for example, at home or in school whether the symptoms affect your or your child's day-to-day life — for example, if they make socialising difficult if there have been any recent significant events in your or your child's life, such as a death or divorce in the family if there's a family history of ADHD about any other problems or symptoms of different health conditions you or your child may have Next steps If the GP thinks your child may have ADHD, they may first suggest a period of "watchful waiting" — lasting around 10 weeks — to see if your child's symptoms improve, stay the same or get worse.
For adults with possible ADHD, the GP will assess your symptoms and may refer you for an assessment if: you were not diagnosed with ADHD as a child, but your symptoms began during childhood and have been ongoing since your symptoms cannot be explained by a mental health condition your symptoms significantly affect your day-to-day life — for example, if you're underachieving at work or find intimate relationships difficult You may also be referred to a specialist if you had ADHD as a child or young person and your symptoms are now causing moderate or severe functional impairment.
Assessment There are a number of different specialists you or your child may be referred to for a formal assessment, including: a child or adult psychiatrist a paediatrician — a specialist in children's health a learning disability specialist, social worker or occupational therapist with expertise in ADHD Who you're referred to depends on your age and what's available in your local area.
The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. What is ADHD? The criteria of symptoms for a diagnosis of ADHD: Inattentive presentation: Fails to give close attention to details or makes careless mistakes. Has difficulty sustaining attention. Does not appear to listen.
Struggles to follow through on instructions. Has difficulty with organization. Avoids or dislikes tasks requiring sustained mental effort. Loses things.
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