ADHD Assessment - What Happens When a Doctor Diagnoses ADHD?
To determine an ADHD diagnosis, doctors examine your symptoms to see if they meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-V). The majority of professionals also conduct a clinical interview with one or more standardized ADHD rating scales.
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Signs and symptoms
If your pediatrician is evaluating you for ADHD the doctor will ask questions about your symptoms and past history. He or she will also examine you to determine the root cause of your problem. This could be a vision problem, hearing loss or a medical condition.
The main sign of ADHD is the difficulty in staying focused or paying attention. This can lead to impulsive mistakes and inability to finish tasks (e.g. chores or schoolwork). psych assessment for adhd and children who suffer from ADHD often have trouble listening to others and seem distracted or even daydreaming. These issues can cause issues in the workplace, at home, and in relationships among adults with ADHD.
Another ADHD sign is the inability to sit still or remain still for long periods of time. People who suffer from ADHD are prone to fidget, pacing or squirm as they wait for others to arrive, or during meetings. They also talk too much and interrupt others often.
Doctors rely on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5-TR(tm)), to help them diagnose. They assess whether a person has at least six traits of inattention or hyperactivity/impulsivity to determine what type of ADHD they have.
To determine if you have ADHD Your pediatrician will examine how you behave in different situations, including at school or in other social activities. He or she will talk to you and your family members, teachers and other caregivers about your behavior. The doctor will utilize checklists and scales to assess ADHD symptoms.
Your child could also be subjected to a physical examination or blood tests to rule out any other medical issues, such as a thyroid disorder, a vision problem or hearing loss. A mental health professional may also test your child's ability to follow directions, concentrate and complete tasks.
Neuropsychological tests aren't used to diagnose ADHD but they could help in certain situations. It involves measuring brain activity, such as beta waves with an EEG scan or a magnetic resonance image (MRI). Some studies suggest that individuals with ADHD have lower beta wave activity in the frontal lobes of their brains and that they generate too many theta waves.
Diagnosis
A doctor can diagnose ADHD by looking at the symptoms of a patient and family history and the results of a range of screening and assessment tools. These include rating scales, continuous performance tests and neuropsychological testing batteries (Table I). For each instrument it is essential to understand its sensitivity and specificity - the likelihood that the test is able to identify those with the disorder and those who don't.
The first step to determine ADHD is to conduct an interview with the patient. It is a one- to two-hour meeting with the doctor that will ask questions about the patient's symptoms as well as his or her experience with them. A specialist might also ask teachers' assistance and other caregivers in gathering information, especially when diagnosing children. The doctor will look over the medical and school records and also ask the child or teenager to complete questionnaires completed by parents and educators.
For adults being assessed for ADHD the doctor might also request past school records to see if the person's symptoms started in childhood. He or she may also talk with the person's spouse, siblings and other friends about their experiences with the person. A specialist may also decide to speak with other people who are familiar with the individual, such as Scout leaders and religious leaders or former teachers, in order to gain insight into how the individual interacts in various environments.
For an adult or adolescent be diagnosed with ADHD, the person must show a range of symptoms in a variety of environments, including home, work and school. These symptoms must interfere in the ability of the individual to perform and cannot be explained by other illness. For adolescents, symptoms must have been present in the early years and remain consistent over time. For adults, he or she must have at least five ongoing symptoms and have suffered from them for at minimum six months. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5) offers criteria for diagnosing the disorder.
Treatment
There are a variety of options for treatment when your child or adult is diagnosed with ADHD. This could include therapy, medication or the combination of both. Your doctor and you will determine what is best for you based on the many symptoms your child has and how long they've been experiencing them for. Your doctor will also rule other factors that could be causing the symptoms, for instance mental health issues like depression and anxiety or medical conditions like thyroid issues.
It is important to talk to your child's teacher if you or are having difficulties at school. Teachers can spot ADHD symptoms in kids and determine if it's ADHD or something else.
Your assessment could include a conversation with a clinician, the completion of ADHD symptom lists and other questionnaires as well as psychological tests, details about your family and friends, and medical history. It's important to provide as much detail regarding the issues you or your child is experiencing as you are able to. This will allow your doctor to understand the complexities of your situation and provide an accurate diagnosis.
Adults and older teens will undergo a similar procedure of evaluation, but their symptoms will be evaluated differently because they are usually connected to their work and other activities. Your psychiatrist or psychologist might also ask you to describe the problems and how they affect your life. For example, do the problems interfere with your work or social relationships? How much, if at all? This information will be used by your physician to determine if your symptoms are moderate or mild.
Psychosocial treatments are more effective than medication for adults suffering from ADHD. These treatments can help you and your family discover better ways to deal with your issues. Cognitive behavioral therapy (CBT) for instance, can teach you to reframe negative thoughts and manage emotions. Group and family therapy can help you develop new skills and strategies to improve your relationship with your spouse or partner. Before trying any medication, behavior-training should be tried with children and adolescents. This includes parent training on managing behavior for children younger than 6 years old and other forms of training and therapy for adults and teens.
Follow-up
As with any diagnostic process, the results of an adhd evaluation should always be interpreted and a qualified clinician. This ensures the person receives the appropriate treatment for their condition. It also reduces the chance of false positive results, where a test indicates that someone has ADHD but they do not. This could happen when the test used for an evaluation is not validated or the examiner does not have sufficient experience to interpret the results correctly.
When interpreting the results of an adhd assessment the physician will look at whether the symptoms are consistent with the patient's history and if they are sufficiently disruptive to their lives. They will also consider the onset and persistency of the symptoms and examine them against a mental age estimation (i.e. is the patient's behavior in a way "below" or "above" for their age).
In addition to interviews with a psychologist and observations, neuropsychological testing can be beneficial in the assessment of ADHD symptoms. Certain tests were designed specifically to assess the most important ADHD symptoms: inattention hyperactivity and impulsivity. The Quantified Behavior Test for children (6-12 years) and the Qb+(c) for adults (12 years and over) are two such tests. These tests utilize motion tracking systems to measure head movements and create measurements of activity (i.e. the amount of time spent moving over 1 cm/s), distance and surface covered by movement, as well as microevents (i.e. small movements above 1 mm). They also generate estimates of commission errors and omission errors, the two components of ADHD's executive dysfunction.
It is important that the clinician is able to conduct a thorough examination. They will ask about the person’s health and development history, including their childhood history, work and school experiences, family life, and drug and alcohol usage and other factors that may contribute to the symptoms. The SWAN, parent or patient ratings and cognitive tests that are objective are used to arrive at the diagnosis.