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ADHD Evaluation - What Happens in the First Step?
A healthcare professional who's evaluating ADHD will ask you, and the people closest to you such as your spouse or sibling if you're an adult -- about your symptoms. This will provide information that questionnaires are not able to provide.
It's more difficult to identify ADHD in adults, because the guidelines for diagnosis are developed for children. It is essential to find a specialist in the field who takes their time when evaluating you.
Signs and symptoms
The first step in an ADHD assessment is to let the patient talk honestly and openly about the symptoms and how they affect his life. Some adults are reluctant to admit they struggle with paying attention, following directions or organizing tasks, but obtaining an accurate diagnosis is the best way to gain rid of symptoms and lead a a more fulfilling life.
The evaluator will ask the person about their personal and medical history from childhood until the present. The evaluator will also review the American Psychiatric 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 caused significant impairments in at minimum two crucial contexts, such as work or school. In addition, the evaluator must rule out other disorders that can cause similar symptoms to ADHD, such as depression, anxiety or an intellectual disability.
In addition to an interview, a doctor may employ behavioral rating scales or ADHD symptoms checklists to collect information about the severity of symptoms. Psychological tests that test executive functioning, spatial and visual reasoning and working memory can 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 support. For instance, they may seek out 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, as it can help identify other disorders that may cause similar symptoms. For instance, thyroid problems and seizures can trigger symptoms that look like ADHD. The evaluator may also conduct a neurological examination to determine if there are any signs of brain injury or damage which could cause the symptoms. The evaluator may also recommend urine and blood tests to determine the presence of other medical conditions that could interfere with treatment, such as depression, alcohol or drug abuse.
Diagnosis
Your doctor will look at symptoms that can be seen in different settings, like at work, home or at school. They should be present for a long amount of time. The doctor will then determine how much your symptoms affect your 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 follow guidelines in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). They will review the child's symptoms and how they impact their lives. They might also conduct an interview with a clinical psychologist. The interview will cover your child's medical background, family history, and psychiatric background. You will be asked about your child's mood and behavior as well as their performance.
It is more difficult to identify adults. The DSM-V symptom guide is geared towards diagnosing children, but there is some controversy over whether these 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 period of time, and they must significantly hinder their daily functioning at school, home or at work.
Your doctor might also recommend additional tests in addition to the clinical interview to determine the nature and severity of your symptoms or that of your child. These could include a blood test or an EEG. Other tests can help determine if a condition is similar to depression or learning disabilities.
To find an expert to evaluate your your child's ADHD you can begin by asking your family doctor for a referral. You can also contact your insurance provider to find out if professionals who specialize in ADHD assessments for adults are covered by your plan. Another option is to contact an organization that supports local residents and request suggestions. You could also call a university-based hospital or a medical or graduate school to get an inventory of professionals who conduct ADHD evaluations.
Treatment
The symptoms of ADHD can cause serious problems at school and work and affect relationships. Finding a diagnosis and taking medication can help improve performance and lessen symptoms. Patients with ADHD may also have to make lifestyle changes like adjusting their sleeping schedules or using a daily planner or increasing their exercise.
A person with ADHD should see his or her primary care physician, a mental health professional or both to receive an evaluation. In this in-person consultation the doctor will discuss issues such as the development of the disorder, 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 have problems with impulsive or focusing actions. They will inquire about the duration of the symptoms, their frequency, when and where they started, and the level of distress they cause.
The evaluator is likely to need to talk to other people in the life of the patient, like parents, spouses, or siblings for adults as well as teachers, coaches, daycare providers or friends for children. These people often provide insight that questionnaires cannot for example, the reasons why a person might stop tasks in the middle or is unable to remember things and what types of situations cause symptoms.
Many behavioral therapies and medicines treat ADHD. The medications may include stimulants such as amphetamine, or nonstimulant drugs like atomoxetine (Serenade) and dexamfetamine (Vyvanse). These drugs increase blood flow to the brain and reduce actions that are impulsive which allows people to be attentive and follow directions. They can be administered either orally or intravenously and are usually well tolerated.
Alongside medication Therapy can help those with ADHD learn strategies to deal with their issues. Therapists can assist people with learning techniques to manage their lives and keep track of appointments, as well as provide support and guidance in dealing with the effects of ADHD symptoms on family and work life. Family and marriage therapy can help address problems caused by the disorder of relationships and teach how to handle conflict and discord that can occur in these situations.
Medication
To diagnose ADHD the medical professional needs to consider many factors. They will ask about your child's behavior at home, in school and in other places. They will also use questionnaires or scales specifically designed for ADHD. They may also inquire about family history. They will also look for other conditions that may cause the symptoms, such as mood disorders and learning disabilities. They will also evaluate the severity of the symptoms and if they are affecting your child's everyday life.
There is undiagnosed adhd in adults to confirm ADHD. This includes blood tests and X-rays. The doctor treating your child is following guidelines established by the American Psychiatric Association to diagnose ADHD. These guidelines are intended for children aged 4 to 18. Adults are more difficult to diagnose. The symptoms of ADHD can change with 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 of the symptoms described in the guidelines to be classified with ADHD. The guidelines also state that the symptoms must be present for a minimum of six months. If your child is being evaluated for ADHD It is crucial that someone familiar with them conducts an interview. Included in this are 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 compare with other children their own age.
The most commonly used medication is a form of treatment for ADHD. There are stimulant and nonstimulant medications that can be prescribed to treat ADHD symptoms. Stimulants, such as amphetamine and methylphenidate, are the most frequently prescribed. These drugs balance and boost levels of certain brain chemical. Other medications that can be used to treat ADHD include the antidepressant atomoxetine, as well as antipsychotics. They are not as potent as stimulants but can be useful for those who are unable to use stimulants due to severe side effects or health issues. These medications can be utilized alongside other treatments, such as cognitive behavioral therapy.