ADHD Diagnosis
Finding out if you have ADHD in adults can be more difficult than diagnosing children. A clinical interview with an ADHD expert is the first step to an accurate diagnosis.
You should bring any medical or academic documents to your appointment. It's also helpful to bring rating scales and interviews which can provide details about your health issues.
Symptoms
A doctor will conduct a physical examination and interview you to determine if ADHD is present. The evaluator might inquire about a person's childhood and their family history and use checklists to document symptoms. The evaluator will also go over documents from the workplace and school, and may want to talk with teachers or other individuals who spend time 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. The criteria is that the person has several symptoms that last for at least 6 months, and that the symptoms occur in more than one setting -- for example, at home and at work or school. The evaluator may also look for other ailments that could trigger similar symptoms, such as anxiety, depression, or a thyroid condition.
In adults the evaluator will evaluate how severe the symptoms are and how they affect social or work life. The evaluation will also inquire what the person's feelings are about his or her symptoms and how they affect their daily life.
Many people with ADHD are unable to remember the time when their issues began. A specialist may interview someone who is familiar with the person, like their spouse, sibling or parent for an adult, or a teacher or parent of a child. The evaluator may use checklists to evaluate adults and a list of child-related behaviors.
In contrast to the past, current diagnostic guidelines state that an adult can't be diagnosed with ADHD when symptoms were evident before the age of 12. This change is intended to stop people suffering from ADHD who were diagnosed as kids from being wrongly diagnosed as having other disorders, such as depression or anxiety.
Medical History
If you suspect that you or your child suffers from ADHD The first step is to find an expert who can perform an exhaustive assessment. Ask your personal physician or a local mental health care specialist for recommendations, or look in the phone book for "psychiatry" or "psychology." You can also contact a support group for adults with ADHD, as many of them will have worked with local experts who can offer referrals.
A healthcare professional will look over the medical history of a patient and family history during the ADHD diagnostic evaluation. They will inquire about what the symptoms hinder functioning in various situations, including at home, at work or with relationships. It is important to assess the severity of the symptoms because the APA's diagnostic guidelines for ADHD stipulate that the symptoms must cause significant impairment to be diagnosed.
The healthcare professional will generally interview the patient, but they may also ask to speak to the person's siblings, parents and friends who are familiar with him. Some healthcare professionals will ask patients to fill out questionnaires or scales. These include ADHD symptom checklists and rating of behavior. Teachers and other caregivers are useful sources of information too.
It is important to assess how the individual's symptoms affect in various environments, as the APA's diagnostic guidelines state that symptoms must manifest often and cause impairment to performance. This is important, as other conditions like mood disorders or learning disabilities may present in a similar way as ADHD (Austerman 2015). A medical exam may also be done to determine if there are any other possible causes for the symptoms. This could be thyroid issues, vision or hearing issues, or medications such as stimulants and sedatives.
Family History
In certain instances, a history of ADHD in the family can be a major factor making a diagnosis. It is highly inherited and a thorough review of the patient and their relatives' histories will aid in determining if there is any family-related pattern.
It is crucial that healthcare professionals have a complete understanding of the symptoms of their patients, such as whether or not they happen in work, school or in social settings. A doctor must also determine the extent to which a person's symptoms affect their daily functioning. This is a more reliable test than simply looking at the number of symptoms or examining a patient's IQ.
A doctor may conduct an interview with teens or children, and also their parents. In many cases, a psychiatrist or pediatrician specializes in the diagnosis and treatment of ADHD. A mental health specialist with a vast knowledge of ADHD is required to conduct a thorough interview for adults.
A thorough evaluation typically includes a physical examination, which can rule out certain health conditions that can cause similar symptoms to ADHD. A complete medical record is also required. For children, this could include medical and school records, as well as an evaluation of the psychological state by school counselors or psychologists. For adults the old school records are often helpful in determining the cause of symptoms that began in the early years of life.
If you are diagnosing an adult with psychiatric disorders, it is particularly important to look at how the symptoms impact everyday functioning. A thorough psychiatric exam could be required that includes rating scales and questionnaires by the patient and their caregivers, a medical interview and referral for a medical exam. In addition, psychometric or neuropsychological assessment is sometimes used for adults to determine if the symptoms are related to learning disorders and other cognitive impairments.
Interviews
A healthcare professional will ask you or your child about their issues at home, school and in the community. The provider will also inquire about your or your child's past medical and personal history, as well as family and personal histories and will review any records that you might bring along including old school reports. This information will help the doctor decide whether you or your child should take a test for diagnosing 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 conducted over a period of six months, and cover both home and school. The ratings should be given by people who know your child or yourself well, such as coaches, teachers, religious leaders, scouts and parents.
Adults and children who are diagnosed with ADHD must exhibit symptoms that are debilitating, and affect their daily activities whether at school, work or playing. adhd assessment should manifest in the early years of childhood, usually before the age of 12. They are not caused by any other mental health condition.
Psychometric and neuropsychological tests that measure IQ, brain function, and cognitive functioning can improve the sensitivity and specificity of ADHD assessments. However, they should only be used as part of an assessment strategy that includes a clinician interview as well as rating scales. These assessments could involve the administration of a standard questionnaire, such as the ADHD Diagnostic Interview for Adults (DIVA) or a computerized adaptive testing approach that measures the speed of response short-term memory, executive functions. In the near future, digital technology like virtual reality and head movement sensors for continuous performance tests could help improve the ecological validity by giving people the opportunity to immerse into their natural environment instead of sitting in a clinic.
Tests
Your GP or mental health care professional may recommend you to specialists if he/she suspects ADHD. A thorough assessment should include an extensive interview, details from independent sources like your spouse or significant other, and standardized behavior rating scales for ADHD. Based on the clinical findings the evaluator could also request tests to check for any other conditions that could have an impact on your symptoms, like depression, learning disabilities or a medical condition.
In order to conduct an exhaustive ADHD assessment, the evaluator must determine if the symptoms have a significant impact on your life and functioning. The problem can manifest in many different settings, such as at home, at work, in school, or with your social interactions. The evaluator will ask you how your symptoms affected you in every situation. This will help the evaluator identify the cause and make treatment recommendations.
In addition to the symptom ratings, a complete assessment will typically include one or more standardized performance test for ADHD. These instruments for testing are based on research comparing the behavior of people with ADHD to those who do not. These instruments improve on the limitations of a standard clinical interview by focusing more on specific behaviors rather than the overall functioning of an individual. These tests can help assessors identify when a person is lying or trying to cheat a test. This issue has been recognized in the field for a long time.
In addition to the standardized test and the symptom-rating scales, a thorough ADHD evaluation should include brain scans or other neurological imaging procedures. These tests are not utilized in clinical settings because they cost a lot of money and expose patients to ionizing radioactivity.