ADHD Assessments For Adults and Children
If you or a loved one has signs of ADHD, your doctor will test you with several different tests. A full assessment may last up to three hours for children and adults.
The clinical interview is used to diagnose by comparing symptoms to DSM criteria. Some physicians use standardized rating scales, usually narrow-band, to aid during the clinical interview.
Signs and symptoms
If you suspect you may be suffering from ADHD it is crucial to get an accurate diagnosis. You'll need an experienced mental health professional or doctor with experience in ADHD assessments for adults. This professional will conduct a formal interview and examine your medical, psychiatric and personal history. They will use different tools to assess your symptoms. These include ADHD symptom checklists, and standardized scales for assessing your behavior. They'll also seek information from your spouse, your significant other or family members, as well as coworkers who are familiar with you.
Adhd symptoms are characterized by difficulty in paying attention or daydreaming, or being easily distracted. It may also be difficult to follow instructions or complete tasks. Someone who exhibits these symptoms is often guilty of making mistakes at work or in school. They have difficulty focusing on a task and have trouble keeping their items in order. They are often forgetful and may be unable to find items needed to carry out daily activities like school supplies, books, tools, pencils, wallets, keys and paperwork, as well as eyeglasses.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth Edition, by the American Psychiatric Association provides guidelines for doctors to diagnose ADHD. It states that a person must have six or more symptoms of inattentive ADHD and/or hyperactivity-impulsivity to qualify for this diagnosis. The DSM-5 defines inattentive ADHD symptoms as being "difficulty paying attention" or having difficulty organizing tasks. The DSM-5 defines hyperactive-impulsive ADHD symptoms as being fidgeting, unable to sit still or having excess energy, speaking without thinking and interrupting others.
If a person has both inattentive and hyperactive-impulsive symptoms, they are described as having mixed ADHD. This is the most frequent type of the disorder, affecting 70% of people suffering from ADHD. This presentation tends to occur in children and younger adolescents, and the symptoms are more evident in inattentive ADHD patients.
Some healthcare professionals ask patients to rate their symptoms on the basis of a behavioral scale like the Adult ADHD Self-Assessment Scale (ACAARS). This tool can help people recognize and measure their symptoms. Another useful tool is the Observer Version of the CAARS-L: S/O (CAARS-L O). This assessment requires an observer to rate the person's ADHD symptoms. This is a great alternative to having the person rate their own symptoms and is more reliable than asking the individual to describe their own symptoms.
Medical Histories
The specialist will ask the patient for a detailed medical history, beginning with their childhood. They will ask about symptoms and how they affect everyday life at work, home and at school. They will also ask the person about their mood and how previous traumas or illnesses, like divorce or accidents, have affected them.
The people's family and friends will be asked to share their experiences of the symptoms. They might have seen the person play around or climb into an inappropriate place, cause problems at school or during play, fail to listen to the speaker, give answers before the question is fully asked, or interrupt games or activities. The doctor will also be interested in knowing whether there are any additional problems with learning or psychiatric that have been diagnosed.
Based on the person the individual, the use of a rating scale or neuropsychological test may be used in conjunction with the interview. Standardized rating scales are employed to compare a person's behaviour with that of a normative group, usually dependent on gender and age. This will help determine if the person's symptoms could be related to ADHD and provide guidance on how to interpret the results.
Narrow-band rating scales, on the other hand, provide information about specific emotional and behavioral symptoms. They can be used to detect the presence of other conditions that may be present alongside ADHD. For instance depression or anxiety disorders.
For adults, the current diagnostic guidelines for ADHD stipulate that a diagnosis is only made if the symptoms have been present since childhood and frequently observed in more than one place (for instance, at school and at home). However, even in children, a specialist should use their discretion when assessing an individual. Still for instance, a specialist reported that "some children were very inexplicably destructive - breaking things, tossing toys of other children into the flame and so on" - although this doesn't seem to meet the current definition of ADHD.
Some experts believe it is possible for ADHD to develop in adulthood. This is not the case in many cases.
Family History
The presence of a family history of ADHD and other mental health issues can increase the chance that a person will develop these disorders. Research has demonstrated that hereditary factors can play a major part in the development and transmission of these disorders. In why are adhd assessments so expensive to identifying those who are at risk for these illnesses, understanding the family history can help individuals and families make better informed choices about mental health screenings, and foster a culture of wellbeing within the home and in the community.
A comprehensive assessment will include information on a person's behaviors in various settings, such as at work, school, and during activities like sports or Scouting. The evaluation will also include interviews with the child's parents or caregivers as well as teachers, school staff and other professionals who have worked with the child, such as religious and scout leaders and coaches. This is important because the symptoms of many children might not be the same across settings and the full spectrum required to be able to meet ADHD diagnostic criteria might not be present in every environment.
There are a variety of rating scales and questionnaires that are available to evaluate ADHD symptoms, and the expert conducting the test will know which one to choose for the specific situation. There will be rating scales that are appropriate for adolescents and children and also retrospective assessments for adults using narrow-band rating scales that reflect childhood/adolescent symptom using informant memories.
Other factors, such as the quality and stability of the family environment, the emotional stability of the mother during pregnancy and childbirth as well as the profession and education level of the father may influence a child's ADHD. Research has found that children in families with less stable environments and lower education levels are more at risk of developing ADHD than children who live who live in more stable, well-off families (Austerman 2015).
A specialist in ADHD will also want to examine a child's and adult's school records from prior years. This will allow the expert to determine if ADHD symptoms of the person were present throughout the adolescence and childhood. It will also help establish the diagnosis for people under the age of 16. According to current diagnostic guidelines it is impossible for a specialist to diagnose ADHD in adults, despite the problem being present in childhood or adolescence.
Personal Insight
ADHD assessments differ from other medical tests which use questionnaires. They require a personal conversation. A doctor will talk with the patient, and if appropriate, relatives and others who play significant roles in the life of the patient. These interviews can reveal important information that is not possible to gather from questionnaires. A sibling or spouse might observe that someone is often forgetting details or misplaces things. The personal insight interviews not only identify underlying factors but also help determine if additional evaluations are needed.
For teenagers, there's usually a more substantial emphasis on how the person's symptoms affect peer interactions and their ability to handle increasing responsibilities such as driving or working at a part-time job. There's also typically more attention paid to how the teen's academic performance may be affected. Adults may be required to answer self-report questions, although the UC's personal insight questionnaires are specifically designed to adults and include questions on how the person's symptoms affect their ability to perform in various settings (home school, work, home).
The broad-spectrum scales serve as a screening tool for other psychiatric disorders. If a doctor suspects that a patient has a mood disorder such as depression or anxiety, they'll likely order further tests to look for these conditions. Certain doctors conduct brain scans to see whether the symptoms are caused by chemical imbalances in the brain.
A trained professional will also conduct a variety of behavioral assessments as part of an ADHD assessment. These observations can be conducted in the clinical setting, at the home of the patient or, for children, in a classroom. They may be recorded using a particular rating scale designed to measure how ADHD symptoms affect the child in different situations.
Assessments online are becoming more popular, despite not having the direct observation and interactive elements of in-person testing. Some online tests, like the Brown ADD Scales, can give valuable insight into how a client’s symptoms develop over time and how they interact. This kind of test helps the clinicians develop effective treatment plans. It's important for patients to allow the time to complete these assessments. Rushing through evaluations increases the chance of the patient being misdiagnosed or avoiding the benefits that come with an accurate diagnosis and treatment plan.