ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD need a thorough evaluation from a professional who is well-versed in the disorder. They will likely ask you about your previous experiences and conduct a physical examination. They'll also rule out any conditions that may be similar to ADHD like mood disorders, learning disorders, or thyroid disorders.
The doctor will also inquire about your childhood habits, since current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of signs from childhood. This may include finding your school records and getting in touch with former teachers and coaches or religious leaders.
Signs and symptoms
If you or a loved one struggles to keep up with school, work or at home, is having difficulty remembering important dates or appointments, or can't seem to stay organized, you may have ADHD. A health care provider's evaluation will help you determine if this is true and, if so what the treatment options are.
To qualify for an ADHD diagnosis, the symptoms must be present for at least six months and be apparent in at minimum two different environments (school and home, for instance). The symptoms must also be affecting your ability to function for example in class, creating close relationships, or working as part of a team. It's important to realize that everyone has problems paying attention and staying well-organized at times, but these problems are more serious for those with ADHD.
Your provider will ask you questions about your behavior and how it has impacted your life. The providers will also examine your family history, and any previous psychological or medical tests that you may have taken. They will check for health problems, like thyroid disorders or seizures, which could cause similar symptoms to ADHD.
Your provider will want to know if your symptoms started in childhood (technically, before age 12). They'll also be interested in how your symptoms impact you today and how they have affected you in the past. They'll want to know if you've been diagnosed with ADHD in the past.
It's a good idea to bring a list of symptoms to the appointment, especially when you've written them down. This will help you to recall your symptoms and provide your doctor a complete picture about how they impact you. You may also bring old records such as old report cards or performance evaluations. These documents can help your doctor determine if ADHD is a new issue or has been present for a long period of time. These records can help your provider determine if there are other issues including anxiety and depression that share similar symptoms as ADHD.
History
In the past, ADHD was thought to be a character flaw or lazyness. However, with the advancement of diagnosis and treatment, more children are being diagnosed, and the stigma around the disorder is fading away.
In 1902 Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He outlined his observations regarding children who were unfocused or who were unable to focus. He also observed that these symptoms were more common for boys than girls, and were not correlated with intelligence or home environment. Still's report has been considered to be the first official recognition of ADHD.
The first version of APA's mental health guideline, released in 1952, didn't include ADHD. However, in 1955 the US FDA approved the use of a stimulant drug, which became the preferred treatment for ADHD. The APA released its second edition in 1968, which listed several mental health conditions. It included the symptoms of ADHD even though they were still classified as hyperkinetic reactions of childhood.
With the release of the fourth edition of the manual on psychiatry in 1994, there was an increase in acceptance and understanding of ADHD. Its name was changed to Attention Deficit Disorder with or without hyperactivity and the standard definition of three types of ADHD symptoms was established: mostly inattentive, mainly hyperactive-impulsive, and combined. The current DSM-5 views these as presenting symptoms, not distinct types and states that they may change over the course of a person's lifetime.
In 2008, NICE (National Institute for Clinical Excellence) published guidance on ADHD in adults. It was the first occasion that the UK as an entire recognized adults suffering from ADHD, providing them with healthcare, funding, assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the only official NHS recommendations on the condition in Scotland. Private organizations and charities have also produced guidance. In recent years there has been an increasing interest in the biological causes of ADHD. Researchers have begun to identify the genes that cause ADHD. This information can help develop better and more specific treatments in the near future.
Physical Exam
A specialist in ADHD will conduct a thorough evaluation to identify the problem. If they are a doctor who specializes in mental health (such as a psychologist or psychiatrist) or an individual doctor who is trained in child and youth health (a paediatrician) They will need to gather information about the person's history, including family, educational, work and social history. They might review old school records or interview teachers, coaches, and other professionals that know the person. They will ask questions about the symptoms, and how they affect life. They will also look at how symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria for diagnosing ADHD in children and adults. To meet these criteria, the symptoms of inattention and hyperactivity-impulsivity must be present in multiple settings, cause significant impairment and have started before age 12. The doctor will usually talk to the person regarding their symptoms using an assessment that is adapted to the specific situation. They may also employ different rating scales to look at various aspects of ADHD symptoms. Some of these ratings are based on the Brown Attention-Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a range of other criteria and include questions such as "Do you have difficulty sitting down?" Do you struggle with organizing your work or activities?
They will conduct a physical exam. They will check to see whether there are any medical problems that might be causing or making the symptoms worse, such as thyroid dysfunction or vision and hearing problems. They will also ask the person about their dietary and lifestyle habits in order to determine if these could contribute to symptoms.
A person who is being evaluated for ADHD as an adult may be asked to fill out an assessment with their partner or another close friend. This can help uncover personal insights that questionnaires and checklists are unable to provide. This is especially beneficial for those with comorbid conditions like anxiety or depression. These often co-occur along with ADHD, making it difficult to identify the signs.
Psychological Evaluation
A health professional who is evaluating a child's ADHD will ask them a series questions about the symptoms and how they impact their daily life. They also look into the family history of the patient and their mental health.
They usually request that the person bring in report cards and school records for review, specifically those from kindergarten through high school. They can also request copies of prior psychological or neuropsychological tests, including IQ tests and results from assessments of learning disabilities.
Typically the psychologist, psychiatrist or social worker will conduct the interview portion of an adhd diagnosis evaluation. They may also interview relatives, friends as well as teachers or employers. It is essential to obtain a comprehensive assessment because people who suffer from ADHD who aren't treated can have serious problems. These include financial problems (impulsive purchases) or marital issues, or failure to attend colleges or other educational institutions.
During an interview, a doctor might ask the patient to complete standardized behavioral ratings scales that are designed to identify ADHD symptoms. These questionnaires are based on research that compares the behavior of individuals with ADHD to those of people who do not suffer from the disorder. These ratings are not the diagnosis of ADHD but are an important aspect of the evaluation process.
It is important to also assess the individual to determine if there are other conditions that might be similar to ADHD. These include sleep disorders, mood disorders and substance abuse, and medical conditions like thyroid disease or brain injuries. Those conditions are more likely to respond to certain treatments, therefore it is important to make sure that a valid diagnosis is made and the right treatment is offered.
To be diagnosed with ADHD, a child or an adult must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders. They must exhibit symptoms in two or more environments like school, home and work, and the symptoms must seriously affect their everyday functioning. The symptoms must first be noticed in childhood and a psychiatrist must verify that the disorder is not caused by mental illness or other co-occurring conditions.