ADHD Evaluation - What Happens in the First Step?
A healthcare professional who is conducting an ADHD assessment will question you and people close to you, such as a spouse, sibling or friend for adults -- about their symptoms. This can provide insight that questionnaires can't uncover.
The process of diagnosing ADHD in adulthood is a bit more difficult, as guidelines for diagnosis are designed for children. It is important to find a specialist with the field who takes their time with your evaluation.
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To conduct an ADHD evaluation, the first step is for the patient to talk openly and honestly about the symptoms and how they impact his life. Some adults are reluctant to admit they struggle with paying attention and following directions or organising tasks, but obtaining an accurate diagnosis is the best way to gain control of the symptoms and live a an enjoyable life.
The evaluator asks the person to tell them about their medical history and personal life, from childhood until now. The evaluator also reviews 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 caused significant impairments in at least two significant settings, such as work or school. In addition, the evaluator must rule out any other conditions that could cause similar symptoms to ADHD like depression, anxiety or an intellectual impairment.
A doctor may also use ADHD symptom checklists or behavioral rating scales in addition to an interview to gather data about the severity of the symptoms. Psychological tests that test executive functioning, spatial and visual reasoning, and working memory can help in identifying ADHD symptoms in adults. Based on the specific situation doctors will often request permission to speak with people close to the person who can offer valuable advice and support. They may ask for the names and contact numbers of the spouse, parents, or siblings in order to talk with them about the individual's issues at home and at the workplace.
A physical exam is typically part of an ADHD evaluation, since it can help rule out other conditions that could cause similar symptoms. For instance, thyroid issues and seizures can cause symptoms that look like ADHD. The evaluator may conduct a neurological examination to see whether there is any sign of injury or damage to the brain that could explain the symptoms. The evaluator might also recommend blood and urine tests to evaluate for the presence of other medical conditions that might hinder treatment, like depression, alcohol or substance abuse.
Diagnosis
Your doctor will look at symptoms that occur in different settings, like at work, at home, or school. The symptoms must also persist for a long time. The doctor will then assess the extent to which your symptoms interfere with everyday 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 adhere to guidelines from the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-V). They will assess the symptoms of your child and how they impact their lives. They may also conduct an interview for a clinical nature. The interview will consist of a review of your child's medical, family, and psychiatric history. You will be asked questions about your child's daily mood and behavior as well as their productivity.
For adults, it is trickier to make a diagnosis. The DSM-V is designed to help diagnose children. There is some debate about 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. They must have these symptoms for a long time period and must be able to affect their daily functioning at school, at home or at work.
Apart from conducting a medical interview, your doctor could conduct other tests to determine severity of the child's symptoms. This could include a blood or EEG test. Other tests can be used to rule out the cause of the same symptoms, like depression or learning disabilities.
To find a specialist to assess your child's ADHD you can begin by asking your family physician for an appointment. You can also call 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 a local support group and request suggestions. You can also call the medical school or university hospital to get a list of professionals that perform ADHD evaluations.
Treatment
Symptoms of ADHD can lead to serious issues in work and school, and interfere with relationships. Getting a diagnosis and taking medication can improve performance and lessen symptoms. People with ADHD might also have to alter their lifestyles like changing their sleeping schedules, using daily planners or increasing exercise.
A person suffering from ADHD needs to be evaluated by their primary healthcare provider or an expert in mental health. During the in-person interview the practitioner will talk about subjects like the development of the disorder, family history, lifestyle, and current symptoms. The doctor will ask questions about the person's performance, behavior and productivity, and if they are struggling with impulsive actions or focus. They'll be interested in knowing how the symptoms have lasted on, when and where they first began and how much stress or problems they cause.
The evaluator is likely to be looking to speak to other people who are in the patient's life like parents, spouses, or siblings for adults as well as coaches, teachers and daycare providers for children. They can provide insights that questionnaires cannot, such as how the person often stops tasks mid-way or forgets things, or what situations cause symptoms.
ADHD is treated by 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 flow to the brain, reducing the impulsive behavior of people and enable them to pay more focus and follow instructions. These drugs can be administered intravenously or orally and are generally well tolerated.
Therapy can help people suffering from ADHD create strategies to deal with the challenges they experience. Therapists can help people learn how to manage their lives, manage their appointments and provide support and guidance when dealing with the effect ADHD symptoms have on their work and family life. Marriage and family therapy is a fantastic way to address the problems caused by ADHD in relationships. It can also teach strategies for dealing with stress and assist in resolving conflict that may arise.
Medication
To determine if your child has ADHD the health care professional must consider many factors. They will ask about your child's symptoms at home, in school, and in other settings. They will also use scales and questionnaires that are specific to ADHD. They might also request an history of the family. They will look for other conditions that may explain the symptoms, such as mood disorders or learning disabilities. They will also evaluate the severity of the symptoms and whether they are affecting your child's everyday life.
There is no physical test to diagnose ADHD. This includes blood tests and X-rays. The healthcare provider for your child follows guidelines established by the American Psychiatric Association to diagnose ADHD. These guidelines are for children between the ages of 4 and 18. It is more difficult to identify ADHD in adults. 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 exhibit six or more symptoms listed in the guidelines in order to be diagnosed with ADHD. The guidelines also state that the symptoms must be present for at least 6 months. If your child is being evaluated for ADHD the child should be interviewed by someone who knows them well. This includes their teachers, coaches, religious leaders, and other caregivers. You should also ask them what the effects of their ailments are on their daily life and how they perform to other children their age.
Medication is the most common form of treatment for ADHD. Both nonstimulant and stimulant medication can be prescribed to reduce ADHD. Stimulants, like amphetamine and methylphenidate are the most frequently prescribed. These drugs aid in boosting and balance levels of specific brain chemicals. Antipsychotics and atomoxetine are also medications that can treat ADHD. They are slower than stimulants, however they can be beneficial for people who are unable to use stimulant drugs due to health problems or severe adverse effects. They can be combined with other treatments such as cognitive behavioral treatment.