ADHD Diagnostic Assessment
A trained health care provider typically psychologists or psychiatrists, will diagnose ADHD. Neuropsychological tests and rating scales are used as part of the evaluation.
The first step to evaluate for ADHD is to gather data from multiple sources. The health professional wants to know about the symptoms at home, at school, and at work.
Interviews and Questionnaires
A doctor has to talk with patients and review a variety of information to determine ADHD. For children, this usually includes the child's history of symptoms and their impact on their school or work performance. For adults, it could include family health history as well as personal health history and the results of any medical tests that may be taken. The American Psychiatric Association has published clinical guidelines for diagnosing ADHD, known as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These guidelines offer a list of symptoms of symptoms that a doctor must determine in order to determine if they have ADHD.
The process of interviewing often involves standardized questionnaires that assess ADHD symptoms. These scales of rating may be broadband or narrowband and can encompass a broad spectrum of symptoms or be focused on specific subscales. Scales for narrowband are typically simpler to score and require less time to complete. Broadband rating scales can be used to collect data for research and require professional training.
Some patients will not admit that they suffer from ADHD. This is especially the case if they are educated or have a high-level job. Some, on the other on the other hand, are determined about having issues and offer convincing evidence of their challenges and a unique pattern of coping behavior. The results of interviews and questionnaires can be consolidated into a single report for the doctor, who could also utilize other assessment tools.
A behavioral test can be useful to rule out other conditions that can cause symptoms similar to ADHD. These include specific types of learning disabilities or anxiety, depression or drug-related adverse effects. If the doctor suspects the patient may have intellectual disability, memory or cognitive impairments or a speech or language problem, a neuropsychological or psychometric test may be necessary. A physical exam may be required as well. If the symptoms are believed to be due to an addiction to drugs or alcohol, drug or alcohol use should be analyzed. These tests are typically conducted as part of a comprehensive assessment which can take several hours or more. Patients should arrive to their appointment rested and well-rested, and ready to spend time answering questions about their behavior and functioning, as well as their family background.
Behavioral Tests
An interview with a health professional is usually the first step in diagnosing ADHD. During the interview, the patient is asked how ADHD symptoms affect their daily life. The person may be asked to describe other mental health issues that they have faced in the past, like anxiety or depression. The examiner will also inquire about any medications the person is taking. During the interview, it's important that people are honest and forthcoming.
The evaluator will likely to inquire about any family members who have been diagnosed with ADHD or have ADHD symptoms themselves. This is due to the fact that ADHD tends to run in families. Anyone with a family background of ADHD has a 91% chance of developing the disorder themselves.
After the evaluator has gathered all of this information, they will move on to a behavioral test. Behavioral tests help to provide more objective evidence that the individual may have symptoms of ADHD. These tests involve asking the individual about their behavior in different situations and rating it. These ratings are then compared with those of people who are not. The use of these types of standardized ratings helps to ensure that the results are consistent and accurate.
There are a variety of standard scales of rating available to assess the severity of ADHD. They range from broad-band scales that aim to evaluate the person's behavior and emotional functioning to narrow-band scales of rating that are designed to detect the presence of particular ADHD symptoms. A lot of these ratings are accessible on the internet.
Computerized tests are becoming more popular for diagnosing ADHD. These tests are referred to as continuous performance test (CPT). This type of test requires the person to complete a number of computer tasks that test their attention to detail. The examiner can then compare the results of this test with the results of other CPTs in order to help determine a possible diagnosis.
Neuropsychological Tests
To determine a full diagnosis of ADHD the evaluation will include tests of intelligence and various neuropsychological assessments. These tests may help identify weaknesses in the primary areas of ADHD symptoms, like working memory and executive functioning. Intelligence tests are also used to assess the strengths and weaknesses of the brain which may guide the treatment plan.
In previous neuropsychological studies individuals with ADHD have exhibited impairments on many different types of cognitive test batteries. These deficiencies are usually observed in frontal lobe function tests (e.g., reversal learning, Tower of Hanoi, Stroop Interference Test). However, not all people with ADHD show these issues in the same manner. In fact, some don't have any issues on these tests of neuropsychological ability at all (Luo and co., 2014).
This is particularly true for clinical comparison groups, which are often drawn from the local community and consist of individuals who meet the diagnostic criteria for a different psychiatric disorder, or who do not suffer from any psychiatric disorder but have reasons for referral. The findings of this study, despite heterogeneity in cognitive differences found in these study groups suggest that neuropsychological tests will not be able of separating adult ADHD from other psychiatric illnesses during a clinical evaluation.
All participants in the current study were administered a comprehensive psychotherapy interview and CHAMPS assessment by one of two licensed clinical psychologists and performed a neurocognitive assessment to test hypothesized impairments associated with adult ADHD. These tests included a number of simple attention/vigilance tasks, complex cognitive functions including working memory (NBV correct responses), inhibition/interference control (Go/No-Go omissions and Stroop Interference test naming interference) and cognitive flexibility (TMT part B/TMT part A, SWITCH task switch accuracy).
In the current study, the neuropsychological tests mostly confirmed previous ADHD adult findings and supported the theory of a dysfunction in the frontal lobe for the disorder. This is in line with previous studies that suggest that multifactorial models could be crucial in the cause of ADHD and that frontal lobe function could be a common affliction. Additionally, the finding that the ADHD group and the clinical comparison groups exhibited similar cognitive performance is in line with previous neuroimaging and behavioral research that has shown that frontal lobe dysfunction is a common occurrence in the general population of psychiatric patients.
Medical Evaluation
If a person, whether a child or an adult, is having issues at school and home, or is having trouble with relationships, it may be time to determine whether the issue is caused by stress or a learning disability, or ADHD. A medical examination can help determine the severity and nature of symptoms and rule out other medical conditions like seizures or thyroid disorders. A physical examination is the first step. It can include hearing and eye tests for children as well as a thyroid test for adults. Medical records, which include the results of previous tests and school reports are also crucial as they can help doctors determine the beginning of the disorder.
Interviews and questionnaires can help doctors understand the person's issues. Teachers, parents, significant others, coworkers and friends may be questioned. A standardized rating scale can provide information about the frequency and severity of symptoms. assessment for adhd is based on research that compares the behavior of people with and without ADHD. Most clinicians ask both the patient and the partner to fill out a rating scale.
A specialist in the field of ADHD will take a comprehensive approach to evaluate the symptoms of a person. They will use several sources of information, including interviews and rating scales and they will stick to the standard criteria for diagnosing. They may suggest additional tests such as brain imaging to discover any root causes behind the symptom pattern.
It is important that the clinician carefully reviews the symptoms in various settings as well as over the course of six months for adults. A diagnosis of ADHD requires a minimum of five established symptoms of inattention and/or hyperactivity/impulsivity. The doctor will also need to determine if the person suffers from comorbid conditions, such as anxiety or depression that look and feel like ADHD however, they are not well-responsible to stimulant treatment.
Ask your primary care doctor or a psychiatrist for a referral if believe that you or your children might have ADHD. You can also reach out to a local support group, a university-based mental health hospital or a graduate school of psychology for suggestions.