ADHD Evaluation
An evaluation is required to determine whether a person is suffering from ADHD. A diagnosis is based on the presence of symptoms that started before age 12 and significantly affect school, work or social situations.
Rating scales are widely used instruments for assessing ADHD. The CAARS-L-S is a self rating instrument with established validity. The version for observers (CAARS-L O) also has good validity.
Symptoms
Many children have trouble sitting still or waiting their turn, they are frenzied and act impulsively. If these problems interfere with the daily functioning of a child, and cause them to be unhappy at school, at home as well as in their activities and in their relationships, they might be diagnosed with ADHD. Health professionals rely on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 5th Edition Text Revision (DSM-5) guidelines to establish a diagnosis of ADHD. The symptoms must be present for at minimum 6 months and affected the person in more than one place such as at home and at work. They must also affect social, academic or professional success.
The physician will ask the patient about their current health issues and if they began before the age of 12. A detailed mental health history is conducted. The doctor will speak to the person's teachers, parents and other people who know them well about their current behavior and past school experiences. The doctor will also look for signs that other illnesses or conditions could be causing the person's symptoms, including learning disorders, mood disorders, thyroid conditions and head injuries.
Symptoms of ADHD are divided into three subtypes: inattentive, hyperactive-impulsive and combined. In adolescence, a person's symptoms may shift from one subtype to the other depending on their the passage of time and the demands of their environment.
In the inattentive type one may struggle to pay attention to minute details, making careless errors or staying focused on their job and activities. People may also struggle with following directions, paying close to details, or retaining information over time. This kind of ADHD is most common in young children.
The hyperactive-impulsive subtype of ADHD is less common in young children. They may have difficulty understanding the boundaries of social interaction, or waiting for their turn during games or conversations. They might interrupt others frequently or engage in risky behaviors like using drugs or engaging in unsafe sexual activities.
The subtype that is combined is more prevalent among adolescents and adults. People with this presentation have at least six symptoms from each of the inattentive and hyperactive-impulsive categories. They may lose some of their hyperactivity as they age however, they continue to battle with restlessness and inattention.
Family History
Parents who suffer from ADHD may have a higher likelihood of passing the disorder on to their children, but genetics alone isn't enough to tell if an individual child will develop the disorder. The environment a person is in can also affect how likely they are to develop mental health issues and how these symptoms appear in their lives.
A doctor can use a family background of ADHD to determine the probability that a child will have the disorder. The disorder can impact the performance of a child at school and at work and can cause issues in relationships. If the child's parent or sibling is suffering from the disorder, the physician may recommend testing to determine if medication can improve functioning in the classroom as well as at home.
If the child is diagnosed with ADHD, the doctor can help manage the symptoms through psychotherapy or medication. If the child is diagnosed with severe ADHD the child may be eligible for the Section 504 or Individuals with Disabilities Education Act plan. Students can enhance their abilities to learn by using behavioral training, study skills as well as classroom modifications and alternative methods of teaching.
Researchers are committed to identifying the underlying cause of ADHD and developing better treatments. Therapy can include the modification of behavior, education for parents and medication. Educating both parents and students about the condition is important to dispel stigmas and increasing awareness, while also encouraging early diagnosis and treatment.
ADHD can be different in girls and boys. For example, hyperactive-impulsive ADHD is more common in males than in females, while inattentive ADHD is more commonly seen in girls.
In a number of studies, it was found that families with ADHD have a specific pattern in their family histories as well as their developmental histories. This profile is distinct from the non-referred samples of ADHD individuals and appears to be influenced by gender. In one study, a clinical routine interview was employed to collect information on family and developmental history. There were also rating how much does an adhd assessment cost to evaluate the characteristics of a disorder.
Physical Examination
During the physical exam, the examiner will observe the patient's movements and look for signs of injury or illness. The examination can be conducted in a variety of ways by different people, such as physicians, nurses and other health professionals. It may involve observations, auscultation, and palpation which are methods to listen and touch the patient. It should be performed in a relaxed setting, with privacy and peace as much as possible. Examiners should make use of appropriate lighting and dim the room during certain parts of the test. They should also supply water and other drinks.
Adults are typically diagnosed with ADHD by primary care doctors or mental health professionals. They can refer patients to a thorough assessment by a psychiatrist or a clinical psychologist. The evaluation could also involve interviews with the person as well as their family members, close friends, and colleagues as well as a review of the medical and mental health history, and psychoeducational tests. The tests are usually designed to test working memory, executive function (abilities such as making decisions and planning) as well as spatial and visual abilities (related to spatial space), and reasoning.
It is important that the person being evaluated is able to discuss their symptoms and experiences with their health care provider. The physician will likely inquire about the way that the symptoms impact the quality of life and wellbeing of a person at the workplace, at home or in school as well as their relationships and interests. The doctor will also want to rule out any other conditions that can cause similar symptoms, including mood disorders, learning disorders, head injuries or thyroid problems.
People with inattentive ADHD may have trouble staying still, following directions or waiting for their turn, concentrating during conversations or tasks and forgetting particulars. They can be easily distracted by activities that are not of a high priority or other events, like conversations on the phone, a television show, or a phone call. They may have difficulty organizing their belongings or keeping on top of deadlines, or they might always be late for appointments. People with hyperactive-impulsive ADHD may fidget or have trouble playing or engaging in leisure activities quietly, blurt out answers before they are finished or have trouble waiting to take turns in games.
In general, people suffering from ADHD are more troubled in the areas of attention and concentration than they do in impulsivity and hyperactivity. They are more susceptible to anxiety and depression, as well as having difficulty learning. They are more prone to being injured due to their impulsiveness, or inability to organize their lives. They may also have issues with addiction to substances and self-medication such as alcohol and drugs.
Psychological Testing
To establish a diagnosis of ADHD, a patient must undergo psychological tests. This helps healthcare professionals rule-out cognitive disabilities that may cause problems in treatment and even worsen the issue. It also helps them determine other mental health issues that could be associated with ADHD.
Psychological tests may include memory, intelligence, attention and language assessment. They could also include broad-spectrum scales to check for psychiatric disorders like depression and anxiety. In certain instances a psychologist may ask family members, colleagues and friends about the person's behavior. This is called an indirect interview, and it can be very helpful in establishing an accurate picture of the symptoms.
A patient could also undergo a neuropsychological examination like TOVA which comprises auditory and visual tests. The test requires the participant to look at two simple geometric shapes and press an electronic microswitch each time they notice them. The test measures how well a person is able to pay attention and respond to visual clues.
The doctor will inquire about the person's daily routine, including how symptoms affect their school and work. They will inquire whether the patient is unable to remember appointments, loses items or has trouble following through with their plans. They will also ask about their relationships and whether they have difficulty to manage their emotions.
The doctor will then conduct an examination of the body. The patient must wear comfortable clothes and not wearing jewelry. The clinician will conduct a medical history and look for signs of anxiety, depression or ADHD.