ADHD Diagnostic Assessment
A trained health care provider, usually psychologist or psychiatrist, will diagnose ADHD. In the course of assessing of the disorder, rating scales and neuropsychological tests are employed.
To determine ADHD it is crucial to gather data from various sources. The health professional wants to know about the symptoms at home, at school, and at work.
Interviews and questionnaires
To confirm an ADHD diagnosis the doctor will interview the patient and review a variety of information. This includes the child's previous symptoms and how they affect their academic or work performance. For adults, it can include the family health history and personal health history and the results of any medical tests that 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 provide a list of symptoms that a doctor must identify in order to determine if they have ADHD.
The process of interviewing often involves standardized questionnaires that measure ADHD symptoms. These may be broadband or narrowband rating scales. They can be used to assess a variety of symptoms, or even focus on specific subscales. Narrowband scales are usually more straightforward to score and take less time to complete. Broadband rating scales are employed to gather data for research studies and usually require professional training to interpret.
Some patients are reluctant to agree that they have symptoms of ADHD even when they are educated or employed in a position of high-level. Others, on the contrary hand, are adamant about having issues and offer convincing evidence of their difficulties, such as an unusual pattern of coping behavior. The results of the interviews and questionnaires can be combined into one report to the doctor, who can also use other assessment tools.
A behavioral test can be useful in ruling out other conditions that might cause ADHD-like symptoms, including certain types of learning disabilities, depression or anxiety and the effects of medication. Psychometric or neuropsychological tests may be required if the doctor suspects that the patient has intellectual disability, other cognitive or memory issues or a language or speech impairment. A physical exam also might be necessary. If the symptoms are believed to be due to an addiction to drugs or alcohol or alcohol use, the drug or alcohol usage should be analyzed. These tests are typically performed as part of an overall evaluation that takes several hours or more. Patients should show up to the appointment well rested and ready to spend time answering questions about their behavior, functioning, and family background.
Behavioral Tests
Often, the first step in diagnosing ADHD is to have an interview with a health professional. During the interview, the patient is asked how ADHD symptoms impact their daily lives. The patient may be asked to describe other mental health issues they have had in the past, for example, depression or anxiety. The examiner may also inquire about any medications the individual is currently taking. During the interview it is important that people are honest and transparent.
The examiner will likely to inquire about any family members who have been diagnosed with ADHD or suffer from ADHD symptoms of their own. This is because ADHD is a common occurrence within families. Anyone with a family background of ADHD can have up to 91% of the chance of developing the disorder.
After the evaluator has collected all the data after which they can proceed to behavioral tests. Behavioral tests help to provide more evidence of the person may be suffering from symptoms of ADHD. These tests involve asking the person about their behavior in various situations and rating it. These ratings are compared to the ratings of others. The use of these types of ratings that are standardized helps ensure that the results are consistent and accurate.
There are a variety of standardized rating scales that can be used to evaluate the person's ADHD symptoms. These scales vary from broad-band which are designed to assess an individual's emotional and behavioral functioning to narrow-band scales created to detect specific ADHD symptoms. More Material of these ratings can be found online.
The use of computerized tests to determine ADHD is increasing. These tests are referred to as continuous performance test (CPT). This type of test requires the person to complete a number of computer-related tasks that test their concentration on details. The evaluator can then examine the results of this test with those from other CPTs to help identify a possible diagnosis.
Neuropsychological Tests
For a complete diagnosis of ADHD the evaluation will include tests of intelligence and various neuropsychological assessments. These tests can help to identify deficiencies in the main areas of ADHD symptoms like executive functioning and working memory. Intelligence tests can also be used to assess the strengths and weaknesses of cognitive abilities and can help guide treatment planning.
In previous neuropsychological studies, individuals with ADHD have been found to be impaired in a variety of cognitive test batteries. These impairments are evident mostly in frontal lobe function tests (e.g. reversed, Tower of Hanoi and Stroop Interference Test). Not all ADHD sufferers exhibit these deficits in the same manner. Some people do not show any impairments at all on these neuropsychological assessments (Luo, et al. 2014).
This is particularly true for clinical comparisons groups, which are often targeted by local communities. They comprise people who meet the diagnostic criteria for a mental disorder of another kind or who do not suffer from psychiatric disorders at all but have a reason for referral. The findings of this study, despite diversity in cognitive differences that are observed among these study groups confirm the notion that neuropsychological tests might not be able to distinguish adult ADHD from other psychiatric conditions during a clinical evaluation.
Participants in the study had a thorough psychotherapy interview and CHAMPS assessment by one of two licensed clinical psychologists. The participants also completed a neurocognitive battery selected to test hypothesized impairments related to 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 performed in the present study confirmed previous ADHD adult findings, and supported the frontal brain theory of the disorder. This is consistent with other research suggesting that multifactorial models are likely to be crucial in the cause of ADHD and that the function of the frontal lobe could be a common affliction. Additionally, the finding that the ADHD group and the clinical comparison groups showed similar cognitive performance is in line with previous neuroimaging and behavioral data showing that frontal lobe dysfunction is prevalent in the general psychiatric population.
Medical Evaluation
If a child or adult has issues at school and home or is having difficulty with relationships, it could be time to determine whether the problem is stress or a learning disability, or ADHD. A medical examination can aid in determining the severity and type of symptoms and rule out other medical conditions like seizures or thyroid disorders. A physical exam is usually the first step, and it could include hearing and eye tests (for children) or a thyroid test for adults. The records of previous tests, school reports and medical records are important as they can aid medical professionals in determining the beginning.
Interviews and questionnaires can help doctors better understand the person's issues. Teachers, parents as well as significant others, colleagues and friends can be questioned. A standardized rating system can give information about the severity and frequency of symptoms. It is based on research comparing the behavior of people with and without ADHD. Most clinicians will ask the patient as well as their significant other to fill out a rating scale.
Most of the time, a specialist in the field of ADHD will employ a comprehensive method to evaluate the severity of symptoms. They will use various sources of information, such as interviews and rating systems and will stick to the current criteria for diagnosis. They may recommend additional evaluations, including brain imaging, in order to identify any underlying causes of the symptom pattern.
It is essential that the clinician carefully reviews symptoms in various settings and over a period of six months for adults. A diagnosis of ADHD requires a minimum of five established symptoms of inattention and/or hyperactivity/impulsivity. The specialist must also determine if the person suffers from other conditions that are comorbid, like anxiety or depression that look and feel like ADHD, but don't respond well to treatment with stimulants.
If you're concerned that your child might have ADHD Start by asking for a referral from your primary care physician or mental health specialist. You can also contact a local support group, a university-based mental health hospital or a graduate school of psychology for recommendations.