ADHD Evaluation - What Happens in the First Step?
A medical professional conducting an ADHD assessment will question you and those around you -- a spouse, sibling or a friend for adults -- about symptoms. This may provide information that questionnaires cannot.
It is more difficult to identify ADHD in adults, since diagnostic guidelines are designed for children. It is important to find a doctor who specializes in the field who takes his or her time when evaluating you.
Symptoms
The first step in an ADHD assessment is to have the patient talk honestly and openly about his issues and how they affect his life. Adults might not want to admit that they struggle with paying attention, following directions or organizing tasks. But getting diagnose adult adhd can help you manage symptoms and live a happier life.
The examiner will inquire of the person about their medical and personal history from childhood to present. The evaluator also reviews the American Psychological Association's guidelines for treating this disorder 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 significant situations, like school or at work. The examiner should also rule out other disorders that can trigger similar symptoms to ADHD, such as anxiety, depression, or intellectual impairment.
A doctor could also utilize ADHD symptom checklists or behavioral rating scales in conjunction with an interview to gather information about the severity of the symptoms. Psychological tests that test executive functioning, spatial and visual reasoning, and working memory may help in identifying ADHD symptoms in adults. Based on the circumstances doctors will often request permission to contact people close to the person who could provide valuable insight and help. For instance, they may ask for the names of parents, spouses, or siblings to interview them about the person's struggles at home and at work.
A physical exam is usually part of an ADHD evaluation. It could help rule out other conditions that may cause similar symptoms. In certain instances, thyroid issues and seizures can be a cause of ADHD. The evaluator could also perform a neurological examination to determine if there are indications of injury or damage to the brain that could explain the symptoms. The evaluator could also suggest blood and urine tests to determine the presence of other conditions that might hinder treatment, like depression, alcohol or addiction.
Diagnosis
In diagnosing ADHD the doctor will look for signs that are present in different environments, such as at home, school, or work. They should also last for a lengthy amount of time. The doctor will evaluate how these symptoms interfere with your daily routine. 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 the guidelines of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V). They will discuss the symptoms of your child and how they affect their lives. They may also conduct an interview. The interview will consist of a review of your child's medical family, psychiatric, and medical history. They will also inquire about the impact of your child's behavior on their daily mood, behaviors, and productivity.
It is more difficult to diagnose adults. The DSM-V is a diagnostic tool designed for children. There is some debate over 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 exhibit these symptoms for an extended period of time and must be able to hinder their daily functioning at school, at home, or work.
In addition to conducting a clinical interview, your doctor might order other tests to determine the extent of your or your child's symptoms. This could include a blood or EEG test. Other tests may help determine if a condition is similar to learning disabilities or depressive disorders.
The suggestion of asking your family physician to refer you to an expert who will evaluate your ADHD or that of your child is a good place to start. You can also contact your insurance provider to inquire if there are professionals covered by your policy who specialize in ADHD evaluations for adults. Another option is to reach out to an organization that supports local residents and ask for recommendations. You can also try calling a university-based hospital or a medical or graduate school for a list of professionals who conduct ADHD evaluations.
Treatment
The signs of ADHD can lead to serious issues at school and work and can affect relationships. Diagnosed with ADHD and taking medication to improve your functioning can help reduce symptoms. People suffering from ADHD may also have to make lifestyle changes, such as adjusting sleeping schedules or using a daily planner, or increasing exercise.
A person suffering from ADHD must be assessed by their primary care provider or an expert in mental health. During this in-person interview the doctor will discuss issues such as the development of the disorder, family and lifestyle history, and current symptoms and issues. The doctor will ask questions about the person's performance, behavior and productivity, and if they are struggling with impulsive behavior or focus. They'll be interested in knowing how the symptoms have lasted on, when and where they started and the amount of distress or issues they create.
The evaluator is likely to be looking to speak to other people in the life of the patient, such as spouses, parents or siblings for adults, as well as coaches, teachers and daycare providers for children. These people often provide insight that questionnaires can't provide, such as the reasons why a person might stop tasks halfway or forgets things, or what circumstances trigger symptoms.
Many behavioral therapies and medications treat ADHD. The medications may include stimulants such as amphetamine, or nonstimulant medicines like atomoxetine and dexamfetamine. These drugs boost the flow of blood to the brain and reduce impulsive actions, allowing people to be attentive and follow directions. These drugs can be administered by mouth or intravenously, and they generally are well-tolerated.
Alongside medication Therapy can help those with ADHD discover strategies to overcome their difficulties. Therapists can help individuals learn how to manage their lives, keep track of appointments, and offer support and guidance when dealing with the effects ADHD symptoms have on work and home life. Family therapy and marriage counseling can help address problems caused by the disorder of relationships and also teach coping skills for conflict and disagreement that may occur in these situations.
Medication
For a medical professional to identify ADHD the doctor must look at several things. They will inquire about your child's symptoms at home, at schools, and elsewhere. They will also use questionnaires or scales that are specific for ADHD. They might also inquire about family history. They will also look for other conditions that may be the cause of the symptoms, for example mood disorders or learning disabilities. They will also assess the severity of the symptoms and if they affect your child's life.
There isn't a physical test for ADHD, like the blood test or an X-ray. The healthcare provider for your child follows guidelines established by the American Psychiatric Association to diagnose ADHD. These guidelines are intended for children between the ages of 4 and 18. It is more difficult to identify ADHD in adults. The symptoms of ADHD can change as time passes. People who have ADHD can be diagnosed as predominately inattentive, predominately hyperactive-impulsive or a combination of the two.
To be diagnosed with ADHD the child must display 6 or more of the symptoms listed in the guidelines for diagnosis. The guidelines also state that the symptoms must have been present for a minimum of six months. If your child is being evaluated for ADHD, they should be questioned by a person who knows them well. Included in this are their coaches, teachers, religious leaders and other caregivers. They should also be asked about how the symptoms affect their daily functioning and how they compare to other children their age.
The most common treatment for ADHD is medication. There are both stimulant and nonstimulant medications that can be prescribed to treat ADHD symptoms. Stimulants, such as amphetamine and methylphenidate, are the most commonly prescribed. These drugs balance and increase levels of certain chemicals in the brain. Other medications that are used to treat ADHD include the antidepressant atomoxetine and some antipsychotics. They are slower than stimulants, however they are beneficial for people who cannot take stimulant medications due to health issues or serious side effects. The use of medications can be in conjunction with other treatments for example, cognitive behavioral therapy.