ADHD Diagnostic Assessment
A health professional who is trained typically psychologists or psychiatrists, will diagnose ADHD. Neuropsychological tests and rating scales are used as part of the evaluation.
The first step in evaluating for ADHD is to collect information from a variety of sources. The health care provider needs to know about the signs at home, at school as well as at work.
Interviews and questionnaires
A doctor has to talk with a patient and review various information to determine ADHD. For children, this usually includes the child's history of symptoms as well as their impact on their school or work performance. Adults may also include their family health history as well as personal health history, as well as the results of any medical testing. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) released by the American Psychiatric Association provides clinical guidelines to diagnose ADHD. These provide a list of symptoms that a doctor must be able to identify in order to establish an ADHD diagnosis.
The interview process typically includes standardized questionnaires that measure ADHD symptoms. These may be broadband or narrowband rating scales, and they may cover a wide range of symptoms, or even focus on specific subscales. Narrowband rating scales generally have a shorter time to finish and are simpler to score. Broadband rating scales are 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 highly educated or in the top positions in their profession. Some patients are more assertive and insistent about their problems. They may even present convincing evidence, such as an unusual pattern of behaviours for coping. The results of questionnaires and interviews could be combined into a single report to the doctor, who can also use other assessment tools.
A behavioral test can help in determining other conditions that can cause similar symptoms to ADHD, including certain kinds of learning disorders, depression or anxiety as well as medication-related side effects. A neuropsychological or psychometric test might be necessary if the doctor suspects that a patient has intellectual disability, other cognitive or memory impairments, or an issue with speech or language. A physical examination may be needed as well. If the symptoms are believed to be caused by a substance abuse disorder or alcohol use, the drug or alcohol usage should be analyzed. These assessments are often done as part of a comprehensive evaluation that takes several hours or more. Patients should arrive at their appointment rested and well-rested, and willing to be able to answer questions about their behavior functioning, their health, and family history.
Behavioral Tests
The most common first step in identifying ADHD is to conduct an interview with a health care professional. During the interview, the individual is asked how ADHD symptoms impact their daily lives. The patient may be asked to describe other mental health issues that they have experienced in the past, like anxiety or depression. The evaluator will also inquire about any medications the person is taking. During the interview, it is important for people to be honest and open when they answer questions.
The examiner may inquire if any of their family members have been diagnosed with ADHD or if they have ADHD symptoms. This is due to the fact that ADHD is a common occurrence within families. An individual who has a family history of ADHD has 91% of the chance of developing the disorder themselves.
After the evaluator has gathered all the data, they will move on to a behavioral test. These tests provide more objective evidence that the person may be suffering from symptoms of ADHD. These tests involve asking the person about their behavior in various situations, and then rating it. These ratings are then compared to the ratings of normal people. These kinds of standardized ratings aid in ensuring that the results are accurate and consistent.
There are several different standard scales of rating available to determine a person's ADHD. assessed for adhd range from broad-band scales designed to assess the overall behavior and emotional functioning to narrow-band rating scales that are designed to detect the presence of specific ADHD symptoms. A lot of these ratings can be found on the internet.
Computerized tests are becoming increasingly popular in diagnosing ADHD. These tests are known as continuous performance tests (CPT). In this type of test, the person is asked to perform a series of tasks on the computer that challenge their ability to pay attention to the details. The examiner will then compare the results to other CPTs in order to identify a potential diagnosis.
Neuropsychological Tests
To determine a full diagnosis of ADHD, an evaluation will include tests of intelligence and a variety of neuropsychological tests. These tests can aid in identifying deficiencies in the main areas of ADHD symptoms, such as executive functioning and working memory. Intelligence tests can also be used to assess the strengths and weaknesses of cognitive functioning. This can help inform treatment planning.
In previous neuropsychological studies adults with ADHD have been found to be impaired on a variety of cognitive test batteries. These deficits are most often seen in frontal lobe functions tests (e.g. Reversal learning, Tower of Hanoi, Stroop Interference Test). However, not all individuals with ADHD show these issues in the same manner. Some people do not show any impairments at all on these neuropsychological assessments (Luo, et al. 2014).
This is especially true for clinical comparison groups, which are usually recruited from local community populations and consist of individuals who meet diagnostic criteria for another psychiatric condition or who do not have any psychiatric issues but have a need to be referred. The findings of this study, despite the heterogeneity in cognitive differences observed among these study groups support the idea that neuropsychological tests may not be able to distinguish adult ADHD from other psychiatric conditions during a clinical evaluation.
Participants in the study had a thorough psychotherapy interview as well as the CHAMPS assessment by one of two licensed clinical psychologists. They also completed a neurocognitive test to measure the hypothesized cognitive deficits that are 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).
The neuropsychological tests in the present study confirmed previous ADHD adult results, and supported the frontal brain theory of the disorder. This is in agreement with other research that suggests that multifactorial models may be significant in the etiology of the disorder and frontal lobe dysfunction may be a common deficiency. Moreover, the finding that the ADHD group and the clinical comparison groups showed similar cognitive performance is in line with previous neuroimaging and behavioral evidence that shows that frontal lobe dysfunction is prevalent in the general population of psychiatric patients.
Medical Evaluation
If your child or adult is experiencing problems at home and school or is having difficulty with relationships, it may be time to determine whether the problem is stress, a learning disability or ADHD. A medical evaluation can aid in determining the severity and nature of symptoms and rule out other medical conditions such as thyroid disorders or seizure disorder. A physical examination is the first step. It could include eye and/or hearing 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 assist doctors track the development of the condition.
Interviews and questionnaires can help doctors gain a better understanding of the problem of a patient. They may interview parents, teachers, the person's significant other and friends or coworkers. A standardized rating scale will provide details on the frequency and severity of symptoms. It is based on research that has compared the behaviors of those with ADHD and those who do not. The majority of clinicians ask the patient and the partner to complete a rating scale.
Experts in the field of ADHD typically employ a comprehensive approach to assess the severity of ADHD symptoms. They will utilize a variety of sources of information including interviews and rating systems and will follow the current criteria for diagnosis. They may recommend additional evaluations such as brain imaging to determine any underlying causes of the symptom patterns.
It is crucial that the clinician carefully reviews symptoms in different settings and over six months for adults. A diagnosis of ADHD requires a minimum of five established symptoms of inattention and/or hyperactivity/impulsivity. The doctor should also take into consideration whether the person has any other comorbid issues, like anxiety or depression that appear and feel similar to ADHD but do not respond to treatment with stimulants.
Contact your primary care doctor or a mental specialist for a referral if think that your child or you might have ADHD. You can also call an organization that offers support in your area or a hospital that is a university graduate school in psychology for suggestions.