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ADHD Evaluation: What to Expect

ADHD Evaluation
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Written by Andrew Le, MD.
Medically reviewed by
Last updated November 29, 2024

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Some people delay or avoid ADHD evaluations because of anxiety or uncertainty about the process. For instance, around 1 in 4 US adults think they might have ADHD, yet many hesitate to seek an assessment, which can result in years of confusion and missed opportunities.

An ADHD evaluation involves looking at your history, daily experiences, and cognitive functioning as a whole. In this article, you will learn the step

🔑 Key Takeaways

  • An ADHD evaluation involves gathering comprehensive data on an individual's medical, behavioral, and cognitive history to assess symptoms, rule out other conditions, and determine effective treatments.
  • The initial consultation is a critical step in the ADHD evaluation process, during which healthcare professionals gather detailed medical and behavioral histories to understand the impact of symptoms on daily life.
  • Behavioral assessments utilize standardized tools, such as behavior rating scales, completed by parents, teachers, or caregivers to evaluate behaviors across various settings and environments.
  • The DSM-5 criteria for ADHD diagnosis require persistent symptoms of inattention and/or hyperactivity-impulsivity lasting at least six months in two or more settings, negatively affecting academic, social, or occupational functioning.
  • Cognitive testing includes computer-based tasks that measure attention span, response times, and the ability to filter distractions, providing objective data to support the ADHD diagnosis.
  • The post-evaluation process involves analyzing data from behavioral assessments, cognitive tests, medical exams, and input from caregivers to arrive at an accurate ADHD diagnosis.
  • Diagnosis of ADHD is classified into combined, predominantly inattentive, or predominantly hyperactive/impulsive types based on DSM-5 criteria and symptom patterns over the past six months.

Components of ADHD Evaluation

An ADHD evaluation examines symptoms, considers other possible conditions, and determines suitable treatment options. It involves collecting detailed medical history, behavior, and cognitive function information.

1. Initial Consultation

The process starts with a consultation with your healthcare provider, such as:

  • Primary care doctor
  • Psychologist
  • Psychiatrist

This session focuses on gathering a detailed medical and behavioral history to understand symptoms and how they affect daily activities.

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2. Behavioral Assessments

Behavioral assessments measure behaviors linked to ADHD. Clinicians use standardized tools like behavior rating scales to gather information from parents, teachers, or other caregivers. These scales evaluate the individual's behavior across various settings.

DSM-5 for ADHD

The DSM-5, or Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is only one of the many questionnaires used during screening to identify ADHD symptoms and behavioral patterns. It outlines how these symptoms affect functioning and development.

To meet the diagnostic criteria for ADHD, certain behaviors and symptoms must persist for a significant duration and in multiple settings. Below are the requirements based on age and symptom presentation.

Inattentive Type Diagnosis Criteria

The inattentive type of ADHD is characterized by difficulty focusing, forgetfulness, and issues with organization. The following symptoms are commonly observed:

  • Displays poor listening skills
  • Loses and/or misplaces items needed to complete activities or tasks
  • Easily sidetracked by external or unimportant stimuli
  • Forgets daily activities
  • Has diminished attention span
  • Lacks the ability to complete schoolwork and assignments or follow instructions
  • Avoids or is disinclined to begin homework or activities requiring concentration
  • Fails to focus on details or makes thoughtless mistakes in schoolwork or assignments

Hyperactive/Impulsive Type Diagnosis Criteria

This type of ADHD includes symptoms of excessive activity and impulsiveness, which can be categorized into hyperactive and impulsive behaviors.

Additional Requirements for Diagnosis

For an accurate diagnosis, symptoms must meet additional criteria to rule out other potential causes and ensure the behaviors align with ADHD. These include:

  • Symptoms initially began prior to age 12 years.
  • Symptoms must not be better accounted for by another psychiatric disorder (e.g., mood disorder, anxiety disorder).
  • Symptoms should not occur exclusively during a psychotic disorder (e.g., schizophrenia).
  • Symptoms must not be exclusively a manifestation of oppositional behavior.

Classification

ADHD can be classified into specific subtypes based on the presence of inattentive and/or hyperactive/impulsive symptoms. Each subtype reflects a unique combination of behaviors.

  1. Combined Type: This classification is given when the patient meets both inattentive and hyperactive/impulsive criteria for the past six months.
  2. Predominantly Inattentive Type: Patients falling under this category meet the inattentive criterion but not the hyperactive/impulsive criterion for the past six months.
  3. Predominantly Hyperactive/Impulsive Type: In this subtype, patients meet the hyperactive/impulsive criterion but not the inattentive criterion for the past six months.

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3. Cognitive Testing

Cognitive testing uses computer-based tasks to measure:

  • Attention
  • Response time
  • Ability to manage distractions

These tests evaluate how quickly a person reacts to specific stimuli, their error rates during repetitive tasks, and their focus over time.

4. Medical Examination

A medical examination identifies physical conditions that might cause inattention or hyperactivity. Doctors check vision, hearing, and overall health to rule out issues like hearing problems or sleep disorders that could affect behavior and attention.

5. Post-Evaluation Process

The post-evaluation phase involves reviewing all data to determine a diagnosis and plan future steps.

Information from behavioral assessments, cognitive tests, medical exams, and observations from caregivers is analyzed to provide a complete understanding of the individual’s condition.

Diagnosis

A diagnosis is based on DSM-5 criteria, requiring a consistent pattern of inattention or hyperactivity-impulsivity for at least six months in two or more settings.

These symptoms must affect social, academic, or work-related functioning and not stem from another condition.

Treatment Planning

After diagnosis, a personalized treatment plan is developed. This may involve medication, psychotherapy, and other behavioral strategies. Providers discuss the available options, outlining each approach's potential effects and goals to support informed decisions.

In Summary

An ADHD evaluation involves several steps, including an initial consultation, behavioral assessments, cognitive testing, and medical examinations. The process concludes with a diagnosis based on DSM-5 criteria, providing a clear understanding of the condition and a foundation for developing personalized treatment plans.

If you suspect that you or someone close to you might have ADHD, the first step is to consult a qualified healthcare provider. They can help determine ADHD and work with you to explore the best management options. Early assessment and intervention can address challenges effectively and support personal growth.

FAQs about ADHD Evaluation

How long does an ADHD evaluation take?

An ADHD evaluation typically takes 1 to 3 hours, depending on the specific assessments and the individual being evaluated. The process might extend over several days or weeks if additional testing is required to rule out other medical or psychological conditions.

What should I prepare before an ADHD evaluation?

Before an ADHD evaluation, bring a list of current medications and be ready to discuss personal and family health history, behavior, and school or work performance. Wear comfortable clothing with minimal jewelry in case a physical exam is required.

Is it necessary to involve family members or teachers in the evaluation?

Yes, involving family members or teachers is often necessary for an ADHD evaluation, especially for children. Parent and educator questionnaires provide valuable insights into behavior and progress, helping clinicians diagnose accurately.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...
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