ADHD Evaluation - What Happens in the First Step?
A medical professional conducting an ADHD assessment will question you and people close to you -- a spouse, sibling, or friend for adults -- about their symptoms. This will provide information that questionnaires are not able to provide.
It's harder to determine ADHD in adults, since the diagnostic guidelines are specifically designed for children. It is essential to find a doctor who specializes in the field who takes their time with your evaluation.
Signs and symptoms
The first step in the process of conducting an ADHD assessment is to have the patient speak honestly and openly about the symptoms and how they affect his daily life. Some adults do not want to admit they are having trouble paying attention, following directions or organizing tasks, but getting an accurate diagnosis is the best way to get rid of symptoms and lead a an enjoyable life.
The person being evaluated is asked to provide details about their personal and medical history from childhood to the present. The evaluator also reviews the American Psychiatric Society's clinical guidelines for the condition 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 caused significant impairment in at least two important settings, such as school or work. In addition, the evaluator must rule out any other conditions that can cause similar symptoms as ADHD, such as depression, anxiety or an intellectual impairment.
In addition to an interview, a physician may use behavioral rating scales or ADHD symptoms checklists to collect details about the severity of the symptoms. Psychological tests that measure executive functioning, visual and spatial reasoning, and working memory may help identify ADHD symptoms in adults. Doctors may ask for permission depending on the situation to speak with family members or friends who may offer valuable advice and help. They may request the names and contact details of parents, spouses or siblings to talk with them about the individual's issues at home and at the workplace.
A physical exam is usually part of an ADHD evaluation, since it can help identify other conditions that could cause similar symptoms. In some cases thyroid issues and seizures can be a cause of ADHD. The evaluator might conduct a neurological examination to see whether there is any sign of damage or injury to the brain that could explain the symptoms. The evaluator might also recommend blood and urine tests to check for the presence of any other conditions that could interfere with treatment, like depression or alcohol and substance abuse.
Diagnosis
Your doctor will be able to examine symptoms that occur in different settings, like at work, at home or at school. They should also last for a significant period of time. Then, the doctor will assess how much these symptoms interfere with your day-to-day life. 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 in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). They will assess your child's symptoms, and how they impact their lives. They might also conduct a clinical interview. The interview will comprise a review of your child's medical, family, and psychiatric history. You will be asked about your child's mood and behavior, as well as productivity.
It is more difficult to diagnose adults. The DSM-V is designed to help diagnose children. There is some debate about 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 have these symptoms for a long duration of time, and they must significantly hinder their daily activities at school, at home or at work.
Besides conducting a clinical interview, your doctor might conduct other tests to determine the extent of your the child's symptoms. These might include a blood test or an EEG. Other tests can help identify a condition that is causing similar symptoms, such as depression or learning disabilities.
To find an expert to assess your child's ADHD you can begin by asking your family doctor for the referral. 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 contact an organization that supports local residents and request suggestions. You can also contact a university-based hospital or a medical or graduate school to get a list of professionals who perform ADHD assessments.
Treatment
ADHD symptoms can cause serious problems at work or at school, and can cause problems with relationships. Being diagnosed and taking medication can improve functioning and decrease symptoms. People suffering from ADHD also may need to change their lifestyle, such as adjusting the time of their sleep and using a daily planner or increasing exercise.
A person with ADHD must be assessed by their primary healthcare provider or a mental health professional. In this in-person consultation, the practitioner will cover issues such as development, family and lifestyle history as well as current symptoms and concerns. The practitioner will ask about the person's performance productivity, as well as if they are having issues with impulsive or focus-focused actions. They'll want to know about how long the symptoms have been going on, when and where they first began and the amount of distress or issues they cause.
The evaluator will likely be looking to speak to other people in the patient's life, like parents, adult adhd diagnoses spouses, or siblings for adults, as well as teachers, coaches, daycare providers or friends for children. They can provide insights that questionnaires cannot like the way that a person may stop tasks halfway or forgets things, and what situations cause symptoms.
ADHD is treated using 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 increase blood circulation to the brain, reducing impulsive behavior and allow people to pay attention and follow directions. They can be taken either orally or intravenously and are generally well-tolerated.
Therapy can help those with ADHD develop strategies to deal with the difficulties they encounter. Therapists can assist people in learning how to manage their lives, keep track of appointments, and provide support and guidance when dealing with the effect ADHD symptoms have on work and home life. Marriage and family therapy is a fantastic way to tackle the issues caused by ADHD in relationships. It can also help teach coping skills and help resolve conflicts that might occur.
Medication
In order for an expert to diagnose ADHD, they must evaluate various aspects. They will inquire with your child about his or her symptoms at school, at home and in other places. They may also utilize questionnaires or scales that are specific for ADHD. They may also ask for an history of the family. They will also look for other conditions that could cause the symptoms, such as mood disorders or learning disabilities. They will also determine the severity of the symptoms and if they affect your child's daily life.
There is no physical test that can diagnose ADHD. This includes X-rays and blood tests. To diagnose ADHD the healthcare provider for your child will follow guidelines that were developed by the American Psychiatric Association. These guidelines are aimed at children aged between 4 and 18. Adults are more difficult to diagnose. The symptoms of ADHD can 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 six or more of the symptoms described in the guidelines to be diagnosed as having ADHD. The guidelines also state the symptoms must have been present for a minimum of six months. If your child is being assessed for ADHD the child should be interviewed by someone who knows them well. This includes their teachers, religious leaders, coaches and other caregivers. It is also important to inquire what the effects of their ailments are on their daily functioning and how they compare with other children their own age.
The most popular treatment for ADHD is medication. There are both stimulant and nonstimulant drugs that can be prescribed to decrease ADHD symptoms. The most common stimulants prescribed are methylphenidate, amphetamine and other stimulants. These drugs balance and increase levels of certain brain chemical. Other medications that can be used to treat ADHD include the antidepressant atomoxetine and some antipsychotics. They are less effective than stimulants, however they are beneficial for those who are unable to take stimulant medications due to health problems or severe adverse effects. They can be combined in conjunction with other treatments like cognitive behavioral therapy.