ADHD Evaluations and Diagnoses
Making a diagnosis is the first step to understanding and addressing symptoms. Find a licensed mental health professional (psychiatrists and neurologists, family physicians) who is experienced in ADHD assessments.
The specialist will conduct an interview that is structured to review your past. They may ask to see old reports, and talk to teachers, family members or friends to learn about your childhood behaviors.
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 can also interfere with relationships and learning at school, work and at home. Consult your GP if you or your child displays these signs. They're not able to definitively diagnose ADHD however, they can discuss your concerns with you and refer you to specialists, if required.
A GP can help you determine if your symptoms are related to ADHD by asking questions, reviewing your health history and medical records and conducting physical examination. You may also mention your family's history of ADHD to aid in the diagnosis. The GP can then refer you to a psychiatrist or psychologist to complete a psychiatric evaluation. The evaluation could include a description and scales of your symptoms that are completed by you and your family members, as well as physical examination, laboratory tests, and a psychiatric examination.
Psychologists and psychiatrists are able to diagnose ADHD in adolescents and children by following established guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. This includes looking for patterns of inattention or hyperactivity that lasts for six months or more and determining whether these symptoms have a significant impact on your daily life at home, work and school.
Adults can also be diagnosed with ADHD, but their symptoms are likely to manifest differently as they get older. 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 specific to adults you could be prescribed medication. Psychostimulants, which affect neurotransmitters in the brain, are typically prescribed to treat ADHD in adults. These drugs boost energy and alertness, while also improving focus and concentration. They can be prescribed as extended-release versions to minimize the risk of adverse effects. Adults who suffer from inattentive ADHD can be treated with antidepressants. These medications, such as Wellbutrin (bupropion) and Effexor (venlafaxine) can affect neurotransmitters in the brain to improve mood and focus.
Diagnosis
A diagnosis of ADHD can assist you in taking control of the symptoms that could be affecting both your professional and personal lives. A licensed mental health professional (psychiatrists or neurologists, or family doctors) can conduct a psychiatric assessment. A person with a symptom-based diagnosis such as 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 assessment, you will be asked questions about your child’s behavior at home, in school as well as in social situations. They will also review your child's growth, medical history and family history. They will then compare your child's behavior with that of other children his age. They can employ standardized ratings scales to measure the frequency of certain behavior problems, such as inability to focus, forgetting about things and 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 more than one setting, affect your child's functioning and cause dysfunction and be present for at least six (6) months.
If your child does not meet the requirements 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 comprehensive psychiatric assessment could include computer-based psychological and cognitive tests as well as psychological and neuropsychological testing. Your healthcare provider will also conduct a physical examination and examine your child's heart rate to rule out medical conditions such as thyroid disorders and head injuries that may be similar to ADHD symptoms. Teachers may also ask and caregivers for a detailed history of your child's development and conduct a thorough interview with your child and your family. They'll also be looking into whether there is a history of ADHD in the family, since it is highly heritable.
Treatment
If someone has been diagnosed as having ADHD, they may need treatment with medication or behavioral therapy. Behavioral therapy can include family and individual counseling as well as group therapies, such as cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). To start treatment, you must first locate a specialist who is skilled in ADHD diagnosis and is covered by insurance. You can start by calling your insurance provider or asking the local mental health support group like the National Alliance on Mental Illness or CHADD, for names of specialists in your area who specialize in ADHD. Some doctors employ computer-based tests, like continuous performances tests, to determine issues with impulse control and attention. Other doctors use brain scans, like single-photon emission computed tomography (SPECT), to look for any abnormalities. Experts agree that the patient's interview is the most important component of an evaluation.
During an interview, the doctor will review the symptoms that led to the appointment. The doctor may also request anyone who is familiar with the patient such as their spouse, parent or sibling, for details. The clinician will also interview teachers, coaches, nannies and other adults who spend much time with the patient. This is a very thorough process that could take an hour or more. The clinician will then complete an assessment report and discuss the results of the examination with the patient.
It is crucial to keep in mind that the definition of ADHD depends on how the symptoms interfere with the life of a person. This means that symptoms have to be causing significant impairment in two major settings such as at work and at home. In order for ADHD to be diagnosed, the impairment must have been present at least six month.
During the interview, the doctor will discuss the person's medical and psychiatric history, and determine whether or not the person meets the diagnostic criteria set by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition Text Revision (DSM-5). A valid diagnosis of ADHD must be backed by at least three of the five symptom categories: difficulty paying attention to the smallest of details and making careless mistakes, difficulty remaining focused on work or activities and difficulty listening when talking to others and daydreaming or appearing distracted.
Prevention
Often, people with inattentive ADHD symptoms aren't identified. They aren't as disruptive as those with hyperactive or impulsive forms of ADHD and can be easily overlooked. Their problems can have serious consequences. They may not do well in school, experience problems with their peers, or struggle to hold an occupation. These individuals need to be treated, too.
The term ADD is still used occasionally, but the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) defines the condition as an attention deficit hyperactivity disorder. The newer name takes into account that children can be suffering from an inattention symptom.
While many of the symptoms are present in all cases, there are a few distinct ways in which the disorder manifests 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 increases the likelihood that they will not be diagnosed, and less likely to receive treatment.
A thorough examination by a medical professional is required to establish an accurate diagnosis. This may include the clinical interview, medical history review and a physical examination. It involves examining reports from teachers, parents, or other adults with an understanding of the person, as well as normative ratings scales that are completed by family members and educators. These are useful in determining whether the symptoms are serious enough to cause impairment in functioning.
A careful evaluation is also important to determine if the symptoms are caused by a different psychiatric or medical condition, such as depression or anxiety. In some cases the treatment of other disorders may aid in reducing or eliminating ADHD symptoms.
People who are who have been diagnosed with the disorder should be aware of potential adverse effects and treatments. They should diagnose adhd also remain in contact with their doctor or nurse to make sure that the medications are working as they should.
Stimulant drugs are the most popular treatment for inattentive ADHD. They can help improve concentration and decrease impulsive behavior. Other treatments, such as cognitive behavior therapy and parent training are very beneficial for adults and children with this condition as well. It is important to remind people who are prescribed ADHD medication to see their doctors regularly, as certain patients may require adjustments in dosages or alternative treatment options.