How to Get a Diagnosis For ADHD
ADHD is treatable. Everyone has difficulty concentrating at times, but if symptoms interfere with school, work, or relationships, treatment is necessary. A diagnosis starts with a physical exam and review of medical and school records.
The diagnosis of ADHD in adults is more complicated than it is for children because the diagnostic guideline for symptoms used for children doesn't apply to adults. A complete evaluation will include an interview with a doctor and a screening to determine if there are co-existing disorders.
Medical History
To determine the presence of ADHD To diagnose ADHD, a health care provider will review the patient's medical history. This includes the symptoms, family history and any other information that is relevant to the person's daily life such as relationship problems or work issues. The doctor will also look at how the symptoms impact daily functioning. Health professionals follow the guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR) to aid in their diagnoses.
The doctor will also perform a physical exam. This will include checking for health issues like hearing and vision issues or thyroid disease. They will also look at the behavior of the adult or child and look over old school reports. Based on the circumstances the doctor may inquire about previous alcohol or drug abuse and any other mental health issues.
A pediatrician, or mental health professional who is specialized in mental disorders, can diagnose ADHD in children. In addition to interviewing the child or adolescent, the provider will often utilize standardized ADHD symptom checklists or questionnaires that have ratings scales and a series of questions that are targeted toward the person's age. These tools help the health care professional determine whether the symptoms fit the DSM-5 criteria for ADHD and if they are inattentive or hyperactive/impulsive.
To make a diagnosis of ADHD in children, the health care professional will need to find that several of the inattentive or hyperactive/impulsive symptoms are present and have been ongoing for at least six months. These symptoms should manifest in more than one setting such as home, school and social situations and cause dysfunction in those areas of the person's life. In adult adhd diagnoses must hinder a child's ability to perform everyday activities. They must also be more severe than would be expected of children of that age.
Adults can experience slightly different symptoms. Someone suffering from ADHD may be able to complete their schooling and be successful in their profession however, they may struggle with finances and relationships due to impulsive, troubled behaviors.
Psychological Evaluation
If you or your child are experiencing symptoms of ADHD the first step in treatment is to get a psychological assessment from a licensed healthcare professional. The most effective method to determine ADHD is through an in-depth and thorough clinical interview using rating scales, direct observation and neuropsychological tests. The test may be lengthy however the benefits of obtaining an accurate diagnosis are huge.
The healthcare practitioner conducting the ADHD evaluation will review your medical background and family history to determine whether the condition runs in your family. They may also request details from those who spend a lot of time with your children, such as teachers and babysitters. They could utilize checklists or questionnaires that are geared towards your child's specific age. They could also request school reports on performance from previous years to identify patterns in the behavior of your child.
It is essential that the doctor who will conduct your ADHD evaluation is experienced in diagnosing and treating this disorder. They should also know the DSM-5 criteria. They should also be acquainted with the most recent research findings on the validity and reliability of various assessment tools. It is also beneficial when the healthcare professional has access to test results for key clinical populations, as this will help them build confidence in their diagnostic findings.
If you or your child has been diagnosed with ADHD, the healthcare practitioner will provide you with recommendations for treatment. This treatment usually includes the combination of behavioral therapy and medication. Medications may provide relief from some of the symptoms that are a result of this disorder. Behavioral therapy, on the other hand, is designed to teach you strategies and methods to help you manage your behavior.
Depending on the severity of your symptoms and the degree that they affect your life, your doctor will suggest treatment options that are the most suitable for you. Those treatments might include psychotherapy or psychotherapy, which is the technical term for mental health therapy or adaption strategies (similar to step stools that allow shorter people to get to higher levels). Some doctors may also prescribe medication. The use of medication can help alleviate some of the most problematic symptoms of ADHD, but it should be administered under the supervision of a doctor or psychiatrist who has experience working with this condition.
Behavioral Tests
Behavioral tests look for specific symptoms that indicate ADHD in people of all age groups. They can be characterized by inattention, difficulty following directions, and difficulties completing assignments at home or in school. People with this disorder may also have a hard time being quiet, fidgeting or interacting without thinking about consequences or interrupting others. They may also have trouble not paying attention to important details. These issues are more prevalent for boys than girls however both be affected.
The evaluation process starts with an extensive interview to collect medical and family background. The healthcare professional wants to know when symptoms began and what triggers them to worsen or improve. The therapist will typically inquire about the person's family or life style, and may discuss other household members or those who spend a lot of time with them like coaches, teachers or babysitters.
A thorough ADHD evaluation takes time and a person suffering from the condition is not diagnosed in a 15-minute visit. The speed at which you go through this process increases the chance of misdiagnosis and missing a secondary mental issue that may benefit from treatment.
In order for an ADHD diagnosis, a person must show that they have both inattentive and hyperactive-impulsive symptoms in two or more settings (like school or work). The symptoms have to be present since the age of a child. Additionally the therapist should ensure that the symptoms aren't the result of another issue, such as depression or anxiety.
For children and teens, a screening questionnaire is often used to identify the symptoms. They are asked how they have been behaving and their responses are compared with the responses of other children and teenagers. Broad-spectrum scales can screen for psychiatric conditions as well, and these are often ordered when the doctor suspects that a comorbid issue like depression or anxiety could be contributing to the ADHD symptoms.
Other diagnostic tools are also commonly employed. These can include neuropsychological test batteries as well as cognitive abilities assessments and rating scales. These can provide an objective analysis of the strengths and weaknesses of the patient and help to determine if or not an ADHD diagnosis.
Brain Scan
When diagnosing an adhd patient the brain scan can give valuable information. Different types of brain scans are available, including MRI, CT, and PET scans. CT and MRI scans are used to examine cross-sections of spine and the brain, whereas PET scans measure the levels of certain neurotransmitters present in the brain. MRI scans are the most safe screening option because they do not make use of radiation.
The DSM-5 definition of ADHD requires documentation of six or more symptoms of inattention or hyperactivity/impulsivity in two settings. The symptoms must have been present for at minimum six months and be disruptive with the individual's academic or social functioning. ADHD is a common disorder affecting 2.5-9 percent of the population worldwide. It is more prevalent among boys than girls, and it presents differently depending on gender. In girls, symptoms tend to be more characterized by physical and impulsive behavior rather than inability to keep attention or organization abilities.
It can be difficult to tell the difference between ADHD symptoms and normal childhood behavior. Inattention-related symptoms can be concealed by poor academic performance or social anxiety, and they may be confused with depression or other disorders.
One way to decrease the chance of making a mistake in diagnosis is to use objective measures to assess a child's cognitive functioning. However, the use of standardized rating scales to diagnose ADHD is not without its limitations. Continuous observational measures like continuous performance tests are prone to bias and their correlation with the symptom reports of teachers or parents is low to moderate (1 2)
A recent study by Brown et al. evaluated the diagnostic accuracy of fMRI brain imaging in a group of medication-naive subjects with an history of ADHD and no comorbid diagnosis of psychiatric disorders. The subject group was subjected to the baseline SPECT scan while at rest and performing an activity, using visual analysis ROIs to detect differences in their ADHD diagnosis when compared to the group of control subjects. The authors were able, using these methods, to attain 100% sensitivity and 89% specificity. They also found that the beginning symptoms in the orbital-frontal cortex correlate with clinical symptomatology. The findings of this research show that SPECT-fMRI can be used to reliably diagnose ADHD in the clinical setting.