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ADHD Evaluation - What Happens in the First Step?
A healthcare professional evaluating ADHD will interview you and your closest family members -- your spouse or sibling when you're an adultabout the symptoms you experience. This will provide information that questionnaires can't.
Diagnosing ADHD in adulthood is trickier because the diagnostic guidelines are geared toward children. It's crucial to locate an ADHD specialist who will take the time to assess you.
Symptoms
To conduct an ADHD assessment, the first step is for the patient to discuss openly and honestly about the symptoms and how they impact his life. Adults might not want to admit that they struggle with paying attention, following instructions or organizing tasks. But getting an accurate diagnosis can help you manage symptoms and lead a healthier life.
The evaluator will ask the person to tell them about their personal and medical history from childhood to the present. The evaluator will also review the American Psychiatric Association's clinical guidelines for the disorder, which are found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
To meet criteria for a diagnosis of ADHD, an adult must have a history of at least six established symptoms in one or both of two main categories--inattention or hyperactivity/impulsivity--for six months. The symptoms must have led to significant impairments in at minimum two crucial settings, such as school or work. The evaluator should also rule out other disorders which can cause similar symptoms as ADHD like anxiety, depression, or intellectual disability.
A doctor can also employ ADHD symptoms checklists or rating scales as well as an interview to gather data about the severity of symptoms. Psychological tests that assess executive functioning, visual and spatial reasoning and working memory can help in identifying ADHD symptoms in adults. Depending on the situation doctors may ask for permission to speak with people close to the person who could offer valuable advice and support. They may request the names and contact numbers of parents, spouses, or siblings in order to talk with them about the person's challenges at home and at work.
A physical exam is usually included in an ADHD evaluation. It helps rule other conditions that may cause similar symptoms. For instance, thyroid problems and seizures can trigger symptoms that look similar to ADHD. The evaluator may also conduct a neurological examination to determine if there's any sign of damage or injury to the brain that could explain the symptoms. The evaluator may also recommend blood and urine tests to evaluate for the presence of other conditions that might hinder treatment, like depression, alcohol or addiction.
Diagnosis
Your doctor will look at symptoms that are present in various situations, like at work, home or at school. They should be present for a long period of time. The doctor will then determine how much your symptoms impact your everyday activities. If they cause a lot of trouble, it's likely that you or your child will meet the criteria for a diagnosis of either inattentive or hyperactive-impulsive ADHD.
To diagnose children, doctors follow guidelines from the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-V). They will examine the symptoms of your child and how they affect their lives. They might also conduct an interview. The interview will discuss your child's medical background, family history, and psychiatric background. You will be asked questions about your child's mood, behavior, and productivity.
It is more difficult to diagnose adults. The DSM-V is designed to help diagnose children. There is some debate as to whether the criteria are still applicable to adults. To meet the criteria for a diagnosis, an adult must have 6 or more symptoms of inattentive ADHD or 7 or more symptoms of hyperactive-impulsive ADHD. They must be suffering from these symptoms for an extended duration of time, and they must significantly interfere with their daily activities at school, at home, or work.
Your doctor may also request other tests in addition the clinical interview to determine the nature and severity of your symptoms or those of your child. This could include the blood test or an EEG test. Other tests can help identify the cause of the same symptoms, like depression or learning disabilities.
To find a specialist to evaluate your or your child's ADHD, you can start by asking your family doctor for a referral. You can also contact your insurance provider to find out if professionals who specialize in ADHD assessments for adults are covered under your plan. You can also contact a local group of support and request recommendations. You can also contact an institution of higher education or a medical or graduate school to get the names of specialists who conduct ADHD evaluations.
Treatment
ADHD symptoms can cause serious problems at work and at school, and can cause problems with relationships. Being diagnosed and taking medication can improve functioning and reduce symptoms. People suffering from ADHD might also need to alter their lifestyles, such as adjusting sleep schedules or using a daily planner or increasing their exercise.
A person with ADHD should consult with their primary care doctor, a mental health professional or both to get an assessment. During this in-person interview the doctor will discuss topics including the development of the disorder as well as family and lifestyle history, and current symptoms and issues. The doctor will inquire about the person's performance productivity, as well as if they have problems with impulsive or focus-focused actions. They'll be interested in knowing how long the symptoms have gone on, where and when they started and how much stress or problems they cause.
The evaluator might want to discuss other people involved in the patient's daily life, such as parents, spouses siblings teachers, coaches daycare providers, or even friends. These people often provide insight that questionnaires don't uncover for example, the way that a person may stop tasks in the middle or is unable to remember things, and what circumstances trigger symptoms.
Many different behavioral therapies and medications are used to treat ADHD. Medications may include stimulants like amphetamine, or nonstimulant drugs such as atomoxetine (Serenade) and dexamfetamine (Vyvanse). These drugs boost the flow of blood to the brain and suppress actions that are impulsive that allow people to be attentive and follow directions. The drugs can be taken either orally or intravenously, and they are generally well tolerated.
Therapy can help those with ADHD develop strategies to compensate for the challenges they experience. Therapists can help people learn how to manage their lives, keep track of appointments and provide assistance and guidance in dealing with the effect ADHD symptoms have on work and family life. Marriage and family therapy can help address problems caused by the disorder in relationships and teach coping skills for conflict and discord that can occur in these situations.
Medication
To allow a medical professional to identify ADHD, they must evaluate various aspects. They will inquire with your child about their symptoms at school, at home and in other places. They will also use scales or questionnaires that are specific for ADHD. They may also inquire about the family history. They will also check for other conditions which could explain the symptoms such as mood disorders or learning disabilities. They will also evaluate the severity of the symptoms and if they impact your child's life.
There is no physical test for ADHD, like blood tests or an X-ray. To get a diagnosis, your child's healthcare provider will be following the guidelines developed by the American Psychiatric Association. These guidelines are geared towards children aged 4-18 years of age. Adults are more difficult to identify. This is because the symptoms may change over time. People who have ADHD can be diagnosed as predominately inattentive, predominately hyperactive-impulsive or a combination of the two.
A child must display at least six of the symptoms listed in the guidelines to be classified with ADHD. The guidelines also stipulate that the symptoms must be present for at least 6 months. If your child is being evaluated for ADHD the child should be evaluated by someone who is familiar with them. This includes teachers, coaches, religious leaders, and other caregivers. They should also be informed about how the symptoms affect their daily functioning and more info how they compare to other children of their age.
Medication is the most popular form of treatment for ADHD. Both nonstimulant and stimulant medications can be prescribed to reduce ADHD. The most frequently prescribed stimulants are amphetamine, methylphenidate and other stimulants. These drugs balance and boost levels of certain brain chemical. Other drugs that can be used to treat ADHD include the antidepressant atomoxetine and some antipsychotics. They are less potent than stimulants, but are useful for those who are unable to use stimulants due to serious adverse effects or health issues. The medications can be used in conjunction with other treatments like cognitive behavioral treatment.