ADHD Evaluation - What Happens in the First Step?
A medical professional conducting an ADHD assessment will ask you and those around you, such as a spouse, sibling or friend for adults -- about the symptoms. This is often a way to gain insights that questionnaires don't.
Diagnosing ADHD in adulthood is trickier, as guidelines for diagnosis are designed for children. It's important to find a specialist with the field who takes his or her time with your evaluation.
Signs and symptoms
For an ADHD evaluation, the first step is for the patient to discuss openly and honestly about symptoms and how they impact his life. Some adults are reluctant to admit that they have difficulty paying attention, following directions or organizing tasks, but obtaining an accurate diagnosis is the best method to take control of the symptoms and live a an enjoyable life.
The examiner will inquire of the person about their medical history and personal life from childhood to present. The evaluator will also review the American Psychiatric Society'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 least two important contexts, such as school or work. The examiner should also rule out other disorders that may cause similar symptoms as ADHD like depression, anxiety or intellectual disabilities.
A doctor could also utilize ADHD symptoms checklists or rating scales in addition to an interview to collect information on the severity of the symptoms. Psychological tests that measure executive functioning, spatial and visual reasoning, and working memory can help identify ADHD symptoms in adults. Depending on the situation, doctors often ask for permission to talk with those close to the person who can provide valuable information and support. They may request the names and contact details of parents, spouses or siblings to interview them regarding the individual's issues at home and at work.
A physical examination is typically included in an ADHD evaluation. It could help rule out other disorders out that may cause similar symptoms. In some instances thyroid problems and seizures may mimic the symptoms of ADHD. The evaluator could also conduct a neurological examination to determine if there's any indication of injury or damage to the brain that could explain the symptoms. The evaluator may also suggest blood and urinary tests to determine if there are any other conditions that could hinder treatment. For example, depression or addiction to alcohol or drugs.
Diagnosis
In determining ADHD, your doctor will look for symptoms that manifest in various environments, such as at home, school or at work. They must also last for a lengthy amount of time. The doctor will then assess the extent to which 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.
Doctors employ the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition to diagnose children. They will review the symptoms of your child and how they impact their lives. They may 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 and behavior as well as their performance.
For adults, it is trickier to make an accurate diagnosis. The DSM-V is a diagnostic tool designed for children. There is some debate as to whether the criteria still apply 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. These symptoms must be present for a prolonged time and must interfere with everyday functioning at school, work or home.
Besides conducting a clinical interview, your doctor could request other tests to determine the extent of your or your child's symptoms. This could include the blood test or an EEG test. Other tests can help identify the cause of similar symptoms, such as depression or learning disabilities.
Asking your family doctor to recommend you to an expert who can evaluate your ADHD or the ADHD of your child is the best place to begin. You can also call your insurance provider to inquire if there are professionals that are covered by your plan and who specialize in ADHD evaluations for adults. Another option is to reach out to an organization that supports local residents and request suggestions. You can also try calling an institution of higher education or a medical or graduate school for a list of professionals who perform ADHD evaluations.
Treatment
The symptoms of ADHD can cause serious problems in work and school and affect relationships. Diagnosed with ADHD, taking medication and improving your performance can reduce symptoms. People with ADHD might also have to make lifestyle adjustments like changing their sleeping schedules, using daily planners or increasing exercise.
Anyone suffering from ADHD must see their primary care physician, psychiatrist or both for an assessment. During the in-person interview an expert will discuss subjects like the development of the person, their family history, lifestyle and the current symptoms. The doctor will ask questions about the person's performance, behavior, and productivity and whether they are struggling with impulsive behavior or focus. They'll be interested in finding out how long the symptoms have gone on, the location and time they began, and the amount of distress or issues they cause.
The evaluator may want to talk to other people in the patient's life, such as spouses, parents or siblings for adults, as well as teachers, coaches or daycare providers for children. These people can offer insights that questionnaires don't uncover, such as the way that a person may stop tasks in the middle or is unable to remember things, or what circumstances trigger symptoms.
ADHD is treated with the use of a variety of behavioral therapies and drugs. Some medications include stimulants such as amphetamine or nonstimulant drugs such as atomoxetine (Serenade) and dexamfetamine (Vyvanse). These drugs improve blood flow to the brain, reducing impulsive behavior and allow people to pay more focus and follow instructions. They can be administered either orally or intravenously and are usually well tolerated.
Therapy can help people suffering from ADHD create strategies to compensate for the difficulties they experience. Therapists can help people learn how to organize their lives and keep track of appointments, and offer support and guidance in dealing with the effects of ADHD symptoms on their home and at work. Family and marriage therapy can assist in addressing issues caused by the disorder in relationships and teach how to handle conflict and discord that could arise in these situations.
Medication
To determine if your child has ADHD, a health professional will take into consideration various factors. They will inquire about your child's behavior at home, in school, and in other settings. They may also employ questionnaires and scales specifically designed for ADHD. They might also inquire about the history of their family. They will search for other conditions that may cause the symptoms, like mood disorders or learning diagnosis adhd disabilities. They will also assess the severity of the symptoms and whether they are affecting your child's everyday life.
There isn't a physical test for ADHD that is comparable to a blood test or an X-ray. To diagnose ADHD the healthcare provider for your child will follow guidelines that were developed by the American Psychiatric Association. These guidelines are for children aged 4 to 18. It is harder to diagnose ADHD in adults. The symptoms of ADHD 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 exhibit at least six of the symptoms listed in the guidelines in order to be diagnosed as having ADHD. The guidelines also state the symptoms must be present for at least six months. If your child is being tested for ADHD It is crucial that someone who is familiar with them interviews them. Included in this are their coaches, teachers, religious leaders and other caregivers. You should also ask them how their symptoms affect their daily activities and how they perform to other children their age.
The most popular treatment for ADHD is medication. There are both stimulant and nonstimulant medications that can be prescribed to decrease ADHD symptoms. The most commonly prescribed stimulants are methylphenidate, amphetamine and other stimulants. These drugs aid in boosting and regulate levels of certain brain chemicals. Antipsychotics and atomoxetine are two drugs that treat ADHD. They are less effective than stimulants, but they can be helpful for people who cannot take stimulant medications because of health issues or severe adverse effects. The medications can be used with other treatments such as cognitive behavioral therapy.