ADHD Diagnosis
Adults are more difficult to diagnose than children. A good diagnosis starts with a consultation with an expert in ADHD.
It is recommended to bring any medical or academic records to your appointment. It's also helpful to bring rating scales and interview transcripts that provide information regarding your symptoms.
Signs and symptoms
A doctor will conduct a physical examination and interview you to determine whether ADHD is present. The examiner may inquire about a person's family history and childhood and use checklists to note symptoms. The evaluator will also review the records of work and school and may also want to speak with teachers or other people who interact with the person.
The evaluator will use the official lists of symptoms for inattention and hyperactivity-impulsivity to determine whether the person meets diagnostic criteria. Those criteria are that the person suffers from multiple symptoms for at least 6 months and that the symptoms manifest in more than one place -- for example, at home, work or school. The evaluator may also check for other conditions that may cause similar symptoms, such as depression or anxiety.
In adults the evaluator will determine how severe the symptoms are and how they impact social or work life. The evaluation will also inquire how the individual feels about the symptoms and how they interfere with daily functioning.
Many people with ADHD have trouble remembering whether their problems started in the beginning or later. This is why a specialist will usually interview someone who is familiar with the person, such as a spouse or sibling for an adult, or parents or teachers for children. The evaluator may use checklists to evaluate adults as well as a list of child-related behaviors.
Contrary to the previous guidelines for diagnosing the adult can't be diagnosed with ADHD until symptoms are present before the age of 12. This change is designed to stop people who experienced ADHD as children from being misdiagnosed with other disorders like depression or anxiety.
Medical Histories
If you suspect that your child or yourself suffer from ADHD, your first step is to speak with an expert who will conduct an exhaustive evaluation. Contact your doctor or an area mental health specialist for recommendations, or search the phone book under "psychiatry" or "psychology." You can also contact an adult ADHD support group, since many will have worked with local specialists who can provide recommendations.
During the ADHD diagnostic evaluation, a healthcare specialist will examine the patient's medical and family history. They will inquire as to whether the symptoms affect functioning in various situations, including at home, at work or with relationships. It is crucial to determine the severity of the symptoms, as the APA's guidelines for ADHD state that symptoms require significant impairment in order to be considered a diagnosis.
The healthcare professional will interview the patient, but they may also ask for details from the patient's parents or siblings as well as friends who are familiar with him. Some healthcare professionals will ask people to complete questionnaires or fill out rating scales, including ADHD symptom checklists and standardized behavior ratings. Teachers and other caregivers are often valuable sources of information too.
The APA's Diagnostic Guidelines stipulate that symptoms must be frequent and affect performance. This is vital, as other conditions, such as mood disorders or learning disabilities could appear similar to ADHD (Austerman 2015). A medical exam can also be done to determine if there are other possible causes of the symptoms. These could include thyroid issues and hearing or vision issues, or prescription medications such as stimulants and sedatives.
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In some instances there are instances where an ancestor's history of ADHD is a crucial element in determining if you have the diagnosis. It is highly inherited and a review of the patient's and their relatives' histories can aid in determining if there is any pattern of inheritance in the family.
It is essential for health professionals to be able to see the full picture of a patient's symptoms, for example, whether they happen at work, school or in social settings. A doctor must also determine the extent of how a patient's symptoms hinder their everyday functioning. This is a more accurate measure than simply calculating symptoms or looking at the intelligence of patients.
For teens and children, a doctor may interview the child or teen as well as their parents. In many cases, a pediatrician or psychiatrist is an expert in the diagnosis and treatment of ADHD. A mental health specialist with a vast knowledge of ADHD is required to conduct a detailed interview for adults.
A thorough assessment usually includes a physical exam that can rule out certain health conditions that can cause similar symptoms to ADHD. A complete medical record is also required. This may include school and medical documents as in addition to a psychologist's or school counselor's psychological assessment. For adults documents from school are often useful in establishing if symptoms started in childhood.
When diagnosing adults, it is important to consider how symptoms impact daily life. A thorough psychiatric evaluation might be required, which may include scoring scales and questions asked by the caregiver and patient and caregivers, as well as a clinical interview and referral to a medical exam. Additionally assessment of neuropsychological or psychometric factors is sometimes used for adults in order to see how the symptoms relate to learning disorders and other cognitive impairments.
Interviews
A healthcare professional will ask you or your child questions regarding their issues at home, school and in the community. The provider will also ask about the child's or yours's medical and personal history, as well as family and personal histories and will look over any records that you might bring along including old school report cards. This information will enable the doctor to determine whether you or your child should to take tests for ADHD.
Your provider will use rating scales to identify if you or your child meets criteria for ADHD, including six established symptoms in the two main categories of the disorder -- inattention and hyperactivity/impulsivity. These ratings are typically taken over a period of six months and include both school and home. The ratings should be given by people who know your child and yourself well, such as teachers, coaches, religious leaders, scouts, and parents.
To be diagnosed with ADHD, children and adults must exhibit a symptomatic behavior that is a source of distress and hinders everyday functioning in multiple situations, like at school, at work or playing. The signs should be evident in childhood, usually before 12 years of age. They are not caused by any other mental health disorder.
The sensitivity and precision of ADHD assessments can be enhanced through the use of psychometric and neuropsychological tests that measure IQ and cognitive function. However, they should be used as part of an assessment strategy that includes a clinical interview and rating scales. These assessments could involve the administration of a standard questionnaire like the ADHD Diagnostic Interview for Adults (DIVA) or a computer-based adaptive testing method that allows for measurement of the speed of response, short-term memory and executive functions. In the near future, digital technology, such as virtual reality and head motion sensors for continuous performance tests can help improve the validity of ecological tests by permitting people to immerse themselves into their natural environment instead of sitting in a clinic.
Tests
If your GP or mental healthcare professional suspects ADHD, he or she might recommend you to an ADHD specialist. A thorough assessment should include a comprehensive interview, information from independent sources like your spouse or significant others, and standardized behavior rating scales for ADHD. The evaluator will order tests in accordance with the clinical impression and will screen for any conditions that may be affecting your symptoms. This includes depression or learning disabilities, or a medical illness.
A thorough ADHD evaluation is required by the examiner to determine if your symptoms are significantly impairing your life and functioning. Impairment can be in a variety of settings, including your workplace, home, school and social relationships. The examiner should inquire about how your symptoms have impacted you in each setting. This will assist the evaluator determine a diagnosis and formulate treatment recommendations.
A comprehensive test will include in addition to symptoms ratings and standard performance tests for ADHD. These tests are founded on research that examines the behavior of people with ADHD and those who do not. These instruments can help overcome the limitations of a standard clinical interview because they focus more on specific behaviors rather than an individual's overall functioning. These measures can assist evaluaters determine if a person is lying or attempting to cheat on a test. This problem has been recognized in the field for years.
A thorough ADHD evaluation may include an examination of the brain or other neuroimaging procedures in addition to the normal test and symptom-rating scales. However these tests aren't commonly used in a clinical setting due to the cost and expose the patient to radiation.