ADHD Evaluations and Diagnoses
The first step to managing symptoms is to obtain a diagnosis. Find a licensed mental health specialist or physician (psychiatrist or neurologist, or family doctor) who is specialized in ADHD assessments and diagnoses.
The specialist will conduct an interview designed to look at your past. They might request old reports, and talk to family members, teachers or friends to get information about your childhood behavior.
Signs and symptoms
Children and adults who have symptoms of attention-deficit/hyperactivity disorder (ADHD) often have trouble with paying close attention, listening attentively and following directions--things that come naturally to others. The symptoms also may interfere with learning and relationships at school, work and home. If you or your child exhibit these symptoms, speak to a GP. They aren't able to officially diagnose ADHD but they can discuss your concerns with you and recommend specialist services, if needed.
A GP can help you determine whether your symptoms are related to ADHD by asking questions, looking over your health history and medical records and conducting an examination. You may also mention the history of your family members with ADHD to help with diagnosis. The GP will then refer you to a psychologist or psychiatrist to conduct a psychiatric examination. The evaluation could include the description and scales of your symptoms, completed by you and your caregivers, along with physical examination, lab tests, and a psychiatric examination.
Psychologists and psychiatrists can diagnose ADHD among adolescents and children using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association. They look for hyperactivity, inattention and impulsivity patterns that last for a period of six months or more and assess whether the symptoms affect your family life, at home, at work, and at school.
Adults may be diagnosed with ADHD however the symptoms of ADHD will likely manifest differently as they age. They can have a predominantly inattentive presentation of the disorder, a predominantly hyperactive/impulsive presentation or a combination of both.
If you meet the requirements for diagnosis and your symptoms are adult-specific you could be prescribed medication. Psychostimulants are substances that alter neurotransmitters within the brain, are often prescribed to treat ADHD in adults. These drugs boost energy and alertness, while also improving focus and concentration. These medications can be administered in extended-release versions to lessen the effects of side effects. Antidepressants are sometimes employed to treat the inattention manifestation of ADHD in adults. These drugs, like Wellbutrin (bupropion) and Effexor (venlafaxine) can affect neurotransmitters in the brain to improve mood and focus.
Diagnosis
Getting a diagnosis of ADHD is the first step in controlling the symptoms that may be affecting your life, both personally and professionally. A psychiatric examination is conducted by a licensed mental health specialist or physician (psychiatrist, neurologist, family doctor, or any other kind of medical specialist). A person with a symptom-based diagnosis like ADHD, must meet certain guidelines laid out in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition to be eligible for treatment for ADHD.
During the ADHD evaluation, you'll be asked questions about your child's behavior at home, at school, and in social situations. They will also discuss your child's development as well as medical history and family history. They will then assess your child's behavior to those of other children of similar age. They can use standard ratings scales to determine the frequency of certain behavioral problems, like inability to pay attention, ignoring things, or interrupting other people.
There are three presentations of ADHD - predominately inattentive, hyperactive-impulsive and combined. To be diagnosed with ADHD, your child must meet six of the nine symptoms that fall under either the inattentive or the hyperactive-impulsive categories. They must be present in two or more settings, affect your child's functioning and cause dysfunction, and have been present for at least six months.
If your child isn't meeting the criteria for an inattentive ADHD diagnosis, your healthcare provider may diagnose them with unspecified ADHD. They might also decide that your child does not have a hyperactive-impulsive presentation of the condition and not give them an official ADHD diagnosis.
A thorough psychiatric assessment may include neuropsychological and psychological tests, as well as computer-based cognitive tests. Your healthcare provider will perform a physical examination and examine your child's heart rate to rule out medical conditions such as thyroid disorders or head injuries that here could be similar to ADHD symptoms. They may also ask for a detailed history of the issue from caregivers and teachers, and conduct a thorough interview with your child and family members. They will take into consideration whether there is a family history of ADHD since the condition is highly genetically inherited.
Treatment
If someone has been diagnosed as having ADHD it is possible that they will require medication or behavioral therapy. Behavioral therapy can include individual and family counseling, and group therapy such as dialectical behavior therapy and cognitive therapy. The first step to get treatment is to locate an expert in the field of diagnosing ADHD who is covered by your insurance. You can start by calling your insurance company or the local mental health support group, such as the National Alliance on Mental Illness or CHADD for the names of specialists in your area who specialize in ADHD. Certain doctors utilize computer tests, like continuous performance tests, to determine problems with attention and impulse control. Other doctors use brain scans, such as single-photon emission computed tomography (SPECT) to search for abnormalities. Experts agree that the patient's interview is the most important component of an assessment.
During an interview, the clinician will review the symptoms that prompted the appointment. The clinician may also request anyone who is familiar with the patient, like their spouse, parent or sibling, for information. The doctor will also speak with teachers, coaches, nannies and other professionals who spend a lot of time with the patient. This is a thorough process that can take up to an hour. The doctor will write a report, and discuss the findings with the patient.
It is crucial to keep in mind that a diagnosis of ADHD will be based on the extent to which the symptoms impact the person's everyday life. This means that symptoms have to be significantly affecting two major settings such as at work and at home. In order for ADHD to be diagnosed the disorder must have been present at least six month.
During the interview, the doctor will discuss with the patient their medical and psychiatric history and determine if they are in compliance with the diagnostic criteria outlined by the American Psychiatric Society's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision DSM-5. A valid diagnosis of ADHD requires at minimum three of the following five symptoms: difficulty paying attention to specifics, making erroneous mistakes, difficulty staying focused on tasks or other activities, and difficulty listening to someone's voice when they speak.
Prevention
People with inattentional ADHD are often not diagnosed. They aren't as disruptive as hyperactive or impulsive types of ADHD, and they can be easily ignored. However, their problems can result in consequences: they might underperform at school, clash with classmates or struggle to hold their job. These individuals require treatment, as well.
Attention deficit hyperactivity disorder is the official name for the condition. The term ADD is still occasionally used but it's not the most commonly used. The newer definition is based on the fact that children can suffer from inattentive symptoms alone.
While many of the symptoms are common to all cases, there are a few variations in the way that the disorder presents itself between girls and boys. Girls and children assigned female at birth (AFAB) tend to show more inattentive symptoms, which are less noticeable, than the hyperactive/impulsive symptoms. This makes them more likely to not be diagnosed, and less likely to receive treatment.
An accurate diagnosis requires a thorough assessment by a health care professional. This may include a clinical interview, medical history review and a physical examination. It is also a matter of reviewing reports from teachers, parents or other adults who know the person, as well as normed scales of rating used by loved ones and educators. These can be useful in determining whether the symptoms are severe enough to affect functioning.
A careful evaluation is also important to determine if the symptoms are caused by another psychiatric or medical condition, such as anxiety or depression. In some cases treating these other disorders can help relieve or eliminate the ADHD symptoms.
People who are diagnosed with the disorder need be aware of potential side effects and treatment. They should also remain in touch with their doctor or nurse to ensure that the medications are working in the way they should.
Stimulant medications are the most common treatment for inattention ADHD. They can improve concentration and reduce the impulsive behavior. Other treatments, including cognitive behavior therapy and parent training are very effective for children and adults with this condition too. It is essential to remind people who are prescribed ADHD medication to visit their doctor regularly, since some patients may need adjustments in dosages or alternative treatment options.