ADHD Diagnostic Assessment
A trained health care provider typically a psychiatrist or psychologist, will diagnose ADHD. Neuropsychological tests and rating scales are used in the evaluation.
To evaluate ADHD it is crucial to gather data from many sources. The health care provider will be interested in knowing about the symptoms in various settings, such as the workplace, home and school.
Interviews and questionnaires
A doctor must interview the patient and review various information to diagnose ADHD. This includes a child's history of symptoms and how they impact 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 test. 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 guidelines provide a list that a doctor needs to determine in order to diagnose ADHD.
The process of interviewing often involves standardized questionnaires that measure ADHD symptoms. These rating scales can be narrowband or broadband and may be able to cover a wide range of symptoms or focus on specific subscales. Narrowband scales are usually more straightforward to score and take less time to complete. Broadband rating scales are used to collect data for research and require professional training.
Some patients aren't willing to admit to having symptoms of ADHD. This is especially the case if they are educated or have an occupation that is high-end. Others, on the contrary hand, are adamant about their issues and provide convincing evidence of their struggles like an unusual pattern of coping. The results of the questionnaires and interviews can be combined into a report for the doctor, who could also employ additional assessment tools.
A behavioral test can help in determining other conditions that might cause ADHD-like symptoms, including certain types of learning disabilities, depression or anxiety, and medication side effects. If a doctor suspects that the patient might have an intellectual disability, memory or cognitive impairments or a language or speech problem, a neuropsychological or psychometric test may be necessary. Physical examinations may also be necessary. If it is suspected that the symptoms are a result of a substance abuse disorder the alcohol or drug consumption should be assessed. These tests are typically done as part of a comprehensive evaluation that takes several hours or longer. Patients should arrive to their appointment rested and well-rested, and prepared to answer questions regarding their behavior, functioning, and family background.
Behavioral Tests
The most common first step to diagnose ADHD is to schedule an interview with a medical professional. During the interview, the individual will be asked to describe how the symptoms of ADHD affect their daily life. The individual might be asked to talk about other mental health issues they have experienced in the past, for example, anxiety or depression. The evaluator could also inquire about any medications that the person is currently taking. During the interview, it is crucial that the interviewer is honest and transparent.
The examiner might inquire if any of their family members have been diagnosed with ADHD, or if they themselves suffer from ADHD symptoms. This is because ADHD tends to be prevalent in families. Anyone with a parent's history of ADHD has a 91% chance to develop the disorder.
Once the evaluator has collected all of this information after which they can proceed to tests for behavior. Behavioral tests help to provide more evidence of the person might be suffering from symptoms of ADHD. These types of tests usually involve the evaluator asking the individual questions about how they behave in certain situations and then rating them. These ratings are compared to the ratings of other people. The use of these kinds of ratings that are standardized helps ensure that the results are accurate and consistent.
There are many different standardized rating scales that can be used to evaluate a person's ADHD symptoms. They range from broad-band rating scales designed to assess the person's behavior and emotional functioning to narrow-band rating scales designed to detect the presence of specific ADHD symptoms. A lot of these ratings are available online.
The use of computerized tests for diagnosing ADHD is increasing. These tests are called continuous performance test (CPT). In this type of test, the patient is required to complete a series of computer-based tasks that test their ability to pay attention to specifics. The examiner can then examine the results of this test with the results of other CPTs in order to help determine a possible diagnosis.
Tests for neuropsychological testing
To identify ADHD, an evaluation includes intelligence tests and neuropsychological assessments. These tests can help to identify deficiencies in the main areas of ADHD symptoms, such as executive functioning and working memory. Tests for intelligence are also used to determine the strengths and weaknesses of cognitive abilities which may aid in treatment planning.
In previous neuropsychological studies, people suffering from ADHD have exhibited impairments in a variety of cognitive test batteries. These deficits can be found mostly in frontal lobe function tests (e.g. reversed, Tower of Hanoi and Stroop Interference Test). However, not all individuals with ADHD have these problems in the same way. In fact, some don't show any impairments on these neuropsychological tests at all (Luo and co., 2014).
This is especially relevant to clinical comparison groups, which are typically targeted by local communities. They are comprised of people who have the diagnostic criteria for a different mental disorder or who do not suffer from psychiatric disorders at all but have a reason to be referred. The results of this study, despite diversity in cognitive differences that are observed among these study groups support the idea that neuropsychological tests may not be able to distinguish adult ADHD from other psychiatric illnesses in a clinical examination.
The neurocognitive battery was used to determine the hypothesized deficiencies in adults with 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 present study the neuropsychological tests mostly confirmed previous ADHD adult findings and backed the theory of a dysfunction in the frontal lobe for the disorder. This is in line with other studies suggesting that multifactorial models are likely 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 showed comparable cognitive functioning is consistent with previous behavioral and neuroimaging evidence that shows that frontal lobe dysfunction is prevalent in the general population of psychiatric patients.
Medical Evaluation
If a child or adult has issues at home and school or is having issues with relationships, it could be time to determine whether the issue is caused by stress or a learning disability, or ADHD. An evaluation can determine the type and severity of the symptoms, and aid in identifying other medical conditions, for example, thyroid problems or seizures. A physical exam is the first step. It may include hearing or eye tests for children or a thyroid exam for adults. The records of previous tests school reports, medical and other records are important as they can aid a doctor in tracking the beginning.
Questionnaires and interviews can help doctors understand the problem of a patient. Teachers, parents, significant others, colleagues and friends can be interviewed. A standardized rating scale can give details about the frequency and severity of symptoms. It is based on research that has compared the behaviors of those with ADHD and those without. Most clinicians will ask the patient as well as the significant other to complete an assessment scale.
Experts in the field of ADHD generally employ a broad approach to assess the severity of ADHD symptoms. They will make use of a variety of information including interviews and rating systems, and will follow the current criteria for diagnosis. They may recommend further evaluations like brain imaging, to determine any possible cause behind the symptom.
It is crucial that the physician carefully reviews symptoms in various settings and 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 should also take into consideration whether the person has any comorbid problems, such as anxiety or depression that feel and look like ADHD but aren't responding to treatment with stimulants.
If cost of adhd assessment worried that your child may be suffering from ADHD, start by asking for an appointment with your primary care physician or mental health specialist. You can also contact an organization that offers support in your area or a university-based hospital or graduate school in psychology for suggestions.