ADHD Tests and Diagnosis

Diagnosing Attention Deficit Disorder in Children and Adults

On their own, none of the symptoms of attention deficit disorder are abnormal. Most people feel scattered, unfocused, or distracted at times. Furthermore, the symptoms of ADHD are easy to confuse with other problems, including learning disabilities and emotional issues, that require totally different treatments. That’s why it’s important to see a mental health specialist to determine if the symptoms really point to ADHD.

Diagnosing ADHD: What you need to know

Are you easily sidetracked, hopelessly disorganized, or frequently forgetful and wondering if attention deficit disorder’s to blame? Do you look at your rambunctious, fidgety child and think it might be ADHD? Before you jump to conclusions, keep in mind that diagnosing ADHD isn’t quite that simple. Even chronic hyperactivity or distractibility doesn’t necessarily equal ADHD.

There is no single medical, physical, or other test for diagnosing attention deficit hyperactivity disorder (ADHD), previously known as ADD. To determine if you or your child has ADHD, a doctor or other health professional will need to be involved, and you can expect him or her to use a number of different tools: a checklist of symptoms, answers to questions about past and present problems, or a medical exam to rule out other causes for symptoms.

Keep in mind that the symptoms of ADHD, such as concentration problems and hyperactivity, can be confused with other disorders and medical problems. Just because it looks like ADHD doesn’t mean it is, so getting a thorough assessment and diagnosis is important.

Making the ADHD diagnosis

ADHD looks different in every person, so there is a wide array of criteria to help health professionals reach a diagnosis. It is important to be open and honest with the specialist conducting your evaluation so that he or she can come to the most accurate conclusion.

To be diagnosed with ADHD, you or your child must display a combination of strong ADHD hallmark symptoms, namely hyperactivity, impulsivity, or inattention. The mental health professional assessing the problem will also look at the following factors:

How severe are the symptoms? To be diagnosed with ADHD, the symptoms must have a negative impact on you or your child’s life. In general, people who truly have ADHD have major problems in one or more areas of their life, such as their career, finances, or family responsibilities.

When did the symptoms start? Since ADHD starts in childhood, the doctor or therapist will look at how early the symptoms appeared. If you are an adult, can you trace the symptoms back to your childhood?

How long have the symptoms been bothering you or your child? Symptoms must have been going on for at least 6 months before ADHD can be diagnosed.

When and where do the symptoms appear? The symptoms of ADHD must be present in multiple settings, such as at home and school. If the symptoms only appear in one environment, it is unlikely that ADHD is to blame.

Common symptoms of ADHD
Symptoms of inattention
Often fails to give close attention to detail or makes mistakes Often has difficulty sustaining attention in tasks or activities Often does not seem to listen when spoken to directly Often does not follow through on instructions and fails to finish schoolwork or workplace duties Often has difficulty organizing tasks and activities Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort Loses things necessary for tasks or activities Is easily distracted by extraneous stimuli Is often forgetful in daily activities
Symptoms of hyperactivity and impulsivity
Often fidgets with or taps hands and feet, or squirms in seat Often leaves seat in situations when remaining seated is expected Often unable to play or engage in leisure activities quietly Often runs and climbs in situations where it is inappropriate (in adolescents or adults, may be limited to feeling restless) Is often "on the go," acting as if "driven by a motor" Often blurts out answers before a question has been completed Often has difficulty waiting their turn Often interrupts or intrudes on others Often talks excessively

Source: DSM-5 Criteria for ADHD, CDC

Finding a specialist who can diagnose ADHD

Qualified professionals trained in diagnosing ADHD can include clinical psychologists, physicians, or clinical social workers. Choosing a specialist can seem confusing at first. The following are steps you can take toward finding the right person to evaluate you or your child.

Get recommendations. Doctors, therapists, and friends you trust may like a particular specialist. Ask them questions about their choice and try out their recommendation.

Do your homework. Find out the professional certification and academic degrees of the specialists you are looking into. If possible, talk to former patients and clients, and find out what their experience was.

Feel at ease. Feeling comfortable with the specialist is an important part of picking someone right to evaluate you. Try to be yourself, ask questions, and be honest with the professional. You may need to speak with a few specialists before choosing the person that is best for you.

Check price and insurance. Find out how much the specialist will charge and if your health insurance will cover part or all of the ADHD evaluation. Some insurance policies cover evaluation for ADHD from one kind of specialist, but not from another.

Diagnosing ADHD in adults

Many people only learn that they have ADHD when they become adults. Some find out after their children receive the diagnosis. As they become educated about the condition, they realize that they also have it. For others, the symptoms finally outpace their coping skills, causing significant enough problems in their daily life that they seek help. If you recognize the signs and symptoms of ADHD in yourself, schedule a visit with a mental health professional for an assessment. Once you make that important appointment, being somewhat nervous about it is normal.

If you know what to expect, the process for evaluating ADHD isn’t confusing or scary. Many professionals will start by asking you to fill out and return questionnaires before an evaluation. You'll probably be asked to name someone close to you who will also take part in some of the evaluation. To determine if you have ADHD, you can expect the specialist conducting the evaluation to do any or all of the following:

Ask you about your symptoms, including how long they’ve been bothering you and any problems they’ve caused in the past.
Administer ADHD tests, such as symptom checklists and attention-span tests.
Talk to family members or someone close to you about your symptoms.
Give you a medical exam to rule out other physical causes for the symptoms.

Should I be tested for adult ADHD?

If you have significant problems with any of the following categories, you may want to get evaluated for ADHD:

Job or career: losing or quitting jobs frequently
Work or school: not performing up to your capacity or ability
Day-to-day tasks: inability to do household chores, pay bills on time, organize things
Relationships: forgetting important things, being unable finish tasks, getting upset over little things
Emotions: having ongoing stress and worry because you don't meet goals and responsibilities

Diagnosing ADHD in children

When seeking a diagnosis for your child, it can be helpful to have a team mentality. You are not alone, and with the help of others, you can get to the bottom of your child’s struggles. Together with specialists trained in diagnosing ADHD, you can help bring about a swift and accurate assessment that leads to treatment.

Your role as a parent

When seeking a diagnosis for your child, you are your child’s best advocate and most important source of support. As a parent in this process, your roles are both emotional and practical. You can:

Provide emotional support for your child during the diagnostic process
Ensure your child sees the right specialist and get a second opinion if necessary
Provide unique and helpful information for doctors/specialists, including open and honest answers to questions about your child’s history and current adjustment
Monitor the speed and accuracy of evaluation

The doctor’s or specialist’s role

Usually, more than one professional assesses a child for ADHD symptoms. Physicians, clinical and school psychologists, clinical social workers, speech-language pathologists, learning specialists, and educators may each play an important role in the ADHD evaluation.

As with adults, there are no laboratory or imaging tests available to make a diagnosis; instead, clinicians base their conclusions on the observable symptoms and by ruling out other disorders. The specialist who conducts your child’s evaluation will ask you a range of questions that you should answer honestly and openly. They may also:

Obtain a thorough medical and family history
Order or conduct a general physical and/or neurological exam
Lead a comprehensive interview with you, your child, and your child’s teacher(s)
Use standardized screening tools for ADHD
Observe your child at play or school
Use psychological tests to measure IQ and assess social and emotional adjustment

Getting your child evaluated for ADHD

Doctors, specialists, ADHD tests—it may all feel a little overwhelming to pursue a diagnosis for your child. You can take a lot of the chaos out of the process with the following practical steps.

Make an appointment with a specialist. As the parent, you can initiate testing for ADHD on behalf of your child. The earlier you schedule this appointment, the more quickly you can get help for their ADHD.

Speak to your child’s school. Call you child’s principal and speak directly and openly about your pursuit of a diagnosis. Public schools are required by law to assist you, and in most cases want to do what they can to make school life better for your child.

Give professionals the full picture. When you are asked the tough questions about your child’s behavior, be sure to answer honestly. Your perspective is very important to the evaluation process.

Keep things moving. You are your child’s advocate, and have the power to prevent delays in getting a diagnosis. Check in with doctors or specialists appropriately often to see where you are in the process.

If necessary, get a second opinion. If there is any doubt that your child has received a thorough or appropriate evaluation, you can seek another specialist’s help.

Understanding an ADHD diagnosis

It’s normal to feel upset or intimidated by a diagnosis of ADHD. But keep in mind that getting a diagnosis can be the first step toward making life better. Once you know what you’re dealing with, you can start getting treatment—and that means taking control of symptoms and feeling more confident in every area of life.

An ADHD diagnosis may feel like a label, but it may be more helpful to think of it as an explanation. The diagnosis explains why you may have struggled with things like paying attention, following directions, listening closely, organization—things that seem to come easily to other people.

In this sense, getting a diagnosis can be a relief. You can rest easier knowing that it wasn’t laziness or a lack of intelligence standing in your or your child’s way, but rather a disorder that you can do something about.

Also keep in mind that an ADHD diagnosis does not mean you are in for a lifetime of suffering. Some people have only mild symptoms, while others experience more pervasive problems. But regardless of where you or your child land on this spectrum, there are many things you can do to manage your symptoms.

Co-existing conditions and ADHD

It is important to understand that an ADHD diagnosis does not rule out other mental health conditions. The following disorders are not part of an ADHD diagnosis but sometimes co-occur with ADHD, or get confused with it:

Anxiety – Excessive worry that occurs frequently and is difficult to control. Symptoms include feeling restless or on edge, easily fatigued, panic attacks, irritability, muscle tension, and insomnia.

Depression – Symptoms include feelings of hopelessness, helpless, and self-loathing, as well as changes in sleep and eating habits and a loss of interest in activities you used to enjoy.

Learning disabilities – Problems with reading, writing, or mathematics. When given standardized tests, the student's ability or intelligence is substantially higher than his or her achievement.

Substance abuse – The impulsivity and behavioral issues that often go along with ADHD can lead to alcohol and drug problems.

Getting help after an ADHD diagnosis

A diagnosis of ADHD can be a great wake-up call—it can give you the extra push you need to seek help for the symptoms that are getting in the way of your happiness and success. If you or your child is diagnosed with ADHD, don’t wait to start treatment. The earlier you begin treating the symptoms, the better.

Managing ADHD takes work. Finding the right treatments for you or your child is a process—one that takes time, persistence, and trial and error. But you can help yourself along the way by keeping the following goals in mind: learning as much as you can about ADHD, getting plenty of support, and adopting healthy lifestyle habits.

ADHD is treatable. Don’t give up hope. With the right treatment and support, you or your child will be able to get the symptoms of ADHD under control and build the life that you want.

Treatment is your own responsibility. It’s up to you to take action to manage the symptoms of ADHD. Health professionals can help, but ultimately, the responsibility lies in your own hands.

Learning all you can about ADHD is key. Understanding the disorder will help you make informed decisions about all aspects of your or your child’s life and treatment.

Support makes all the difference. While treatment is up to you, support from others can help you stay motivated and get you through tough times.