ADHD Evaluations and Diagnoses
The first step to managing symptoms is to receive a diagnosis. Find a licensed mental health professional or physician (psychiatrist, neurologist, family doctor) who is specialized in ADHD evaluations and diagnoses.
The expert will conduct an organized interview to review your background. They might request old reports, and talk to teachers, family members or friends to get information about your childhood behavior.
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. These symptoms can cause issues with relationships and learning at home, school and at work. If you or your child exhibit these symptoms, talk to a GP. They aren't able to officially diagnose ADHD but they can discuss your concerns with you and refer you to specialists, if required.
A GP will be able to determine if you are suffering from ADHD symptoms by asking questions, looking over medical records and your medical history, and performing a physical exam. It is also possible to discuss the history of ADHD in your family to aid in the diagnosis. The GP will then refer you to a psychiatrist or psychologist to complete a psychiatric assessment. The evaluation could include the description of your symptoms, questionnaires and scales completed by your caregivers, you and teachers along with a psychiatric assessment, physical exam and lab tests.
Psychologists and psychiatrists are able to diagnose ADHD in children and adolescents by following established guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. These include looking for patterns of inattention or hyperactivity that lasts for six months or more and determining if these symptoms have a significant impact on your daily routine at home, work and school.
Adults can be diagnosed with ADHD in the same way however, their symptoms tend to manifest differently as they age. They can have a predominantly inattentive presentation of the disorder, a predominantly hyperactive/impulsive presentation or a combination of both.
If your adult symptoms match the criteria for diagnosis, you could be treated with medication. Adults with ADHD are often prescribed psychostimulants that alter neurotransmitters. These medications improve concentration and focus, while increasing energy and alertness. They can be prescribed in extended-release versions to minimize the risk of side effects. Adults who present with inattentive ADHD can be treated with antidepressants. These drugs, like Wellbutrin (bupropion) and Effexor (venlafaxine), affect the brain's neurotransmitters and enhance mood and focus.
Diagnosis
Getting a diagnosis of ADHD is the first step in taking control of symptoms that could be affecting your life, both personally and professionally. A psychiatric assessment can be conducted by an accredited mental health professional or a physician (psychiatrist or neurologist, or family doctor or other type of medical specialist). A person with a diagnosis based on symptoms, such as ADHD, must meet certain guidelines set forth in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition for treatment for ADHD.
During an ADHD evaluation, your healthcare provider will inquire regarding your child's behavior in school, at home and in social settings. They will also discuss your child's development medical history and family history. They will then compare your child's behavior with the behavior of other children their age. They may use standardized ratings scales to measure the frequency of certain behavioral problems, such as inability to pay attention, forgetting about things, or 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 a variety of settings that affect your child's behavior and cause dysfunction, and have been 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 evaluation may include neuropsychological and psychological testing, and cognitive tests that are computer-based. Your healthcare provider will perform a physical examination and assess your child's heart rate to eliminate medical issues like thyroid disorders or head injuries that can be a cause of ADHD symptoms. They may also ask teachers and parents for a thorough history and conduct a thorough interview of your child and family members. They will consider whether there is any family history of ADHD because the condition is highly genetically inherited.
Treatment
If someone has been diagnosed with ADHD, he or she might require medication and/or therapy for behavioral issues. Behavioral therapy includes family and individual counseling, as well as group therapy such as dialectical behavior therapy and cognitive therapy. The first step to receive treatment is to locate an specialist in the field of diagnosing ADHD who is covered by your insurance. Start by contacting your insurance company or the local mental health support group like the National Alliance on website Mental Illness or CHADD for names of specialists in your area who specialize in ADHD. Some doctors use computer-based tests, like continuous performance tests, to check for issues with impulse control and attention. Other doctors use brain scans like single photon emission computed Tomography (SPECT) to look for abnormalities. Experts agree that the patient's interview is the most crucial component of an evaluation.
During an interview, the doctor will discuss the symptoms that prompted the appointment. The doctor may also request someone who is familiar with the patient like their spouse, parent or sibling, for details. The clinician will also talk to nannies, teachers, coaches and other professionals who spend a lot of time with the patient. This is a thorough procedure that could take up to an hour. The doctor will then write an assessment report and discuss the findings of the exam with the patient.
It is crucial to keep in mind that a diagnosis of ADHD will be based on the extent to which the symptoms interfere with the individual's daily activities. This means that the patient's symptoms must cause significant impairment in at minimum two major environments, like home and work. The impairment must be present for at least six months to be considered an appropriate diagnosis of ADHD.
During the consultation, the doctor will discuss with the patient their medical and psychiatric history and determine if they are in compliance with the diagnostic criteria outlined by the American Psychiatric Assocation's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision DSM-5. A valid diagnosis of ADHD must be supported by at least three of the five symptom categories: difficulty paying attention to small specifics and making mistakes, difficulty in staying focused on work or activities, trouble listening when spoken to and daydreaming or appearing to be distracted.
Prevention
People with inattentional ADHD are typically not diagnosed. They aren't as disruptive or as impulsive as hyperactive ADHD and are often overlooked. Their problems can have serious consequences. They may not do well at school, have problems with their peers, or struggle to find jobs. They also have to be treated.
The term ADD is still used infrequently however the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) defines the condition as an attention deficit hyperactivity disorder. The new definition takes into account the fact that children can suffer from inattentive symptoms alone.
There are differences between the way that the disorder is exhibited by boys and girls. Girls and children assigned female at birth (AFAB) tend to show more inattentive symptoms, which are less noticeable, than the hyperactive/impulsive symptoms. This makes them more likely to be undiagnosed and less likely to receive treatment.
An accurate diagnosis requires a thorough assessment by a medical professional. This may include the clinical interview, medical history review and physical examination. It also involves reviewing the reports of teachers, parents or other adults who know the patient well as well as standard rating scales that are completed by family members and educators. These are helpful in determining if the symptoms are present to a degree that impacts the functioning.
It is important to conduct a thorough evaluation to determine if the symptoms are related to other psychiatric or medical condition, such as depression or anxiety. In some cases, treating these other disorders will help relieve or eliminate the ADHD symptoms.
People who are who have been diagnosed with the disorder should to be aware of possible side effects and treatment. They should also remain in touch with their physician or nurse to ensure that the medication is working in the way they should.
The most common treatment for inattentive ADHD is stimulant drugs which can help improve concentration and reduce impulsive behaviors. Adults and children suffering from inattentive ADHD may benefit from other treatment options such as cognitive behavioral therapy or parent training. It is important to remind people who are prescribed ADHD medication to see their doctors regularly, as some patients may require adjustments to dosages or other treatment options.