ADHD Evaluation - What Happens in the First Step?
A healthcare professional conducting an ADHD evaluation will ask you and your family members close to you -- a spouse, sibling, or friend for adults -- about the symptoms. This may provide information that questionnaires are not able to provide.
Diagnosing ADHD in adulthood is trickier since the diagnostic guidelines are geared toward children. It is essential to find a specialist in the field who takes their time when evaluating you.
Symptoms
To conduct an ADHD assessment, the first step is for the patient to talk openly and honestly about his symptoms and how they affect his life. Adults may not want admit to having trouble paying attention, following instructions or organizing tasks. However, getting an accurate diagnosis will help you control symptoms and lead a more enjoyable life.
The evaluator will ask the person to provide information about their medical history and personal life from childhood to the present. The evaluator will also go over the American Psychiatric Society's clinical guidelines for the 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 minimum two crucial contexts, such as school or work. In addition, the evaluator must rule out any other conditions that can cause similar symptoms to ADHD, such as depression, anxiety or an intellectual disability.
In addition to an interview, a physician may use behavioral rating scales or ADHD symptoms checklists to collect information about the severity of symptoms. Psychological tests that assess working memory, executive functioning skills and visual and spatial reasoning are useful in identifying ADHD symptoms in adults. Based on the circumstances doctors will often request permission to contact people close to the person in order to offer valuable advice and support. For instance, they could ask for the names of parents, spouses, or siblings to talk with them about the person's struggles at home and at work.
A physical exam is usually included in an ADHD assessment. It helps rule other disorders out that may cause similar symptoms. For instance, thyroid issues and seizures can cause symptoms that resemble similar to ADHD. The evaluator can also perform a neurological examination to determine if there are any symptoms of brain damage or injury that could be the cause of the symptoms. The evaluator could also suggest blood and urine tests to check for the presence of any other conditions that could interfere with treatment, such as depression or alcohol and addiction.
Diagnosis
Your doctor will look at symptoms that occur in different environments, such as at work, home or at school. The symptoms must also persist for a prolonged period of time. The doctor will evaluate how these symptoms affect 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 adhere to the guidelines of the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-V). They will examine the symptoms of your child and how they affect their lives. They may also conduct an interview with a clinical psychologist. 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 mood, behavior, and productivity.
It is more difficult to diagnose adults. The DSM-V is designed to diagnose children. There is some debate as to whether the criteria are still applicable in adulthood. 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 be suffering from these symptoms for an extended duration of time and have them significantly affect their daily life at school, home, or work.
Besides conducting a clinical interview, your doctor could request additional tests to determine the extent of your your child's symptoms. This may include blood tests or an EEG. Other tests can help rule out conditions that are causing the same symptoms like learning disabilities or depressive disorders.
The suggestion of asking your family physician to refer you to an expert who can assess your ADHD or that of your child is an excellent place to begin. You can also contact your insurance company to find out if there are professionals covered by your policy who specialize in ADHD evaluations for adults. You can also contact a local group of support and ask for suggestions. You can also contact a university-based hospital or a medical or graduate school to get the names of specialists who perform ADHD assessments.
Treatment
The symptoms of ADHD can cause significant problems at school and at work and affect relationships. Finding a diagnosis and taking medication can improve functioning and reduce symptoms. Patients with ADHD also may need to alter their lifestyles like adjusting their sleep schedules or using a daily planner or increasing their exercise.
A person with ADHD should consult with the primary care doctor or a mental health professional or both to receive an evaluation. During this in-person interview, the practitioner will cover issues such as development of the person's family and lifestyle, and current symptoms and concerns. The doctor will ask questions about the person's behavior, performance and productivity and whether they have issues 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 distress or problems they create.
The evaluator will likely be looking to speak to other people who are in the patient's life for example, parents, spouses or siblings for adults, as well as coaches, teachers, daycare providers or friends for children. These people can offer insights that questionnaires can't provide, such as the way that a person may stop tasks in the middle or is unable to remember things and what types of circumstances trigger symptoms.
ADHD is treated using a variety of behavioral therapies and drugs. Medications may include stimulants like amphetamine, or nonstimulant drugs such as atomoxetine (Serenade) and dexamfetamine (Vyvanse). These drugs improve blood flow to the brain, reduce impulsive behavior and allow people to pay more focus and follow instructions. The drugs can be taken intravenously or orally, and they generally are well-tolerated.
In addition to medication, therapy can help people with ADHD develop strategies to deal with their difficulties. Therapists can help people learn how to organize their lives and keep track of appointments, and offer assistance and guidance when dealing with the effects of ADHD symptoms on family and work. Family therapy and marriage therapy is a fantastic way to tackle the issues caused by ADHD in relationships. It can also teach how to manage stress and resolve conflict that may occur.
Medication
To diagnose ADHD A health care professional must consider several factors. They will ask about your child's symptoms at home, at school, and in other settings. They may also employ questionnaires and scales that are specific to ADHD. They may also inquire about the history of their family. They may also search for other conditions that may be the cause of the symptoms, like learning disabilities and mood disorders. They will also determine the severity of the symptoms and whether they affect your child's daily life.
There is no physical test that can determine ADHD. This includes X-rays and blood tests. The doctor treating your child is following guidelines established by the American Psychiatric Association to diagnose ADHD. These guidelines are for children aged 4 to 18. Adults are more difficult to recognize. 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, a child must display more than 6 symptoms as described in the diagnostic guidelines. The guidelines also stipulate that the symptoms must be present for at least 6 months. If your child is being evaluated for ADHD, it's important that someone who is familiar with them conducts an interview. This includes teachers, coaches, religious leaders, and other caregivers. They should also be asked about how their symptoms affect their daily functioning and how they compare to other children of their age.
Medication is the most common method of treating ADHD. Both stimulant and nonstimulant medication are available to treat ADHD. The most frequently prescribed stimulants are methylphenidate, getting diagnosed with adhd as an adult amphetamine and other stimulants. These drugs balance and increase levels of certain brain chemicals. Antipsychotics and atomoxetine are also medications that can treat ADHD. They are slower than stimulants, but they can be beneficial for people who are unable to use stimulant medication because of health issues or severe side effects. Medications can be used in conjunction with other treatments, for example, cognitive behavioral therapy.