ADHD Assessment & Diagnosis

Untreated attention-deficit hyperactivity disorder (ADHD) can impact self-esteem and mental and physical health. Additionally, individuals with ADHD may face outside judgment for behaviors or impulses they might struggle to control. Whether someone has difficulty meeting deadlines for work, remembering information in relationships, or struggling to focus and pay attention, the impact of ADHD can be experienced by adults. ADHD is not a children-only issue, and adults may wonder how they can get assessed for ADHD and find treatment for their symptoms, including exploring options like 504 accommodations for ADHD in the workplace or other settings. Below, we’re discussing how to get assessed for ADHD and covering the ADHD’s symptoms, complications, and treatments.

Previously called attention deficit disorder (ADD), attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can cause significant impairment to an individual’s mental health, physical well-being, and ability to function. Difficulties maintaining attention, filtering out distractions, making careless mistakes, and controlling impulsive behavior can be challenging, but an ADHD assessment may be the first step toward diagnosing ADHD in adults and treating the symptoms you have. If you're an adult considering assessments to diagnose ADHD, you're not alone. Over 360 million adults worldwide experienced symptoms of ADHD in 2020. 

ADHD is considered one of many mental health conditions mentioned by the American Psychiatric Association in the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders), and an accurate diagnosis may help you find treatment, recommendations for support groups, services, benefits, and controlled trials. Note that this article focuses more on ADHD in adults than understanding an ADHD diagnosis in teens.

Understanding adult attention-deficit/hyperactivity disorder: Symptoms and causes

A common mental health myth about ADHD is that only children can experience ADHD, which is not the case. Although individuals might have their first mental health symptoms as a child, adults can also struggle with hyperactivity, impulsivity, and difficulty with focus. Many cases of ADHD persist into adulthood, and not all children get diagnosed early. Undiagnosed ADHD symptoms can interfere with an individual's ability to keep a job, make and manage interpersonal relationships, spend money wisely, and take care of physical health, among other activities. Being diagnosed with ADHD may help you understand which support tools will be useful in your life.

Causes 

ADHD is thought to be partially caused by low levels of dopamine and norepinephrine in critical areas of the brain responsible for controlling behavior and attention. ADHD is a mental health and cognitive condition that may require treatment to be managed. Family history can also play a part in ADHD, as it is receiving a diagnosis is 74% hereditary. Individuals with family members who live with ADHD are at an increased risk of developing ADHD themselves. Many people may not receive a diagnosis of ADHD until they are teens or adults due to stigma or misunderstandings about how ADHD functions. 

Symptoms in adults & children 

Symptoms of ADHD may fluctuate throughout the day, depending on demands and stimulation from a person's environment or relationships. Often, adults and children diagnosed with ADHD have trouble paying attention, organizing their time and space, controlling their emotions, and finishing projects they’ve started. Individuals with ADHD may feel restless, have difficulty unwinding, and experience hyperactivity, which can cause them to feel like they’re being driven by a motor. Children may have difficulty waiting their turn and frequently interrupt conversations. Although many people experiencing ADHD might have difficulty concentrating on certain projects, they can exhibit a strong, sustained focus when they’re engaging in an activity that interests them. For example, they may abandon a school-related task to hyper-focus on stimulating activities, such as video games, or other activities they feel passionate about. 

The process of diagnosing ADHD

To receive a proper diagnosis of ADHD, an individual typically must consult with a licensed mental health professional who can provide a comprehensive ADHD evaluation. The healthcare professional will likely administer ADHD screenings, a physical exam, and other ADHD assessments to ensure there is not a medical condition or another mental health condition causing symptoms to arise. The effects of certain health concerns (e.g., a physical health condition that causes hearing impairment) can mimic ADHD symptoms. Additionally, common symptoms of depression and anxiety can resemble ADHD symptoms.

Once the provider has completed their evaluation, they may then compare the individual’s symptoms with the diagnostic criteria for ADHD. There typically must be at least five symptoms present (of the nine symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders) for healthcare providers to diagnose ADHD. According to the Centers for Disease Control and Prevention (CDC), children up to age 16 may need to have six or more symptoms of inattention. 

 The medical community recognizes three types of ADHD that an adult may have: 

• Primarily inattentive (ADHD-PI) 
• Primarily hyperactive-impulsive (ADHD-HI) 
• Combined type (the most common form of ADHD) 

A healthcare professional may include one of the above specifiers when providing an ADHD diagnosis (e.g., “ADHD-predominantly inattentive presentation”; “ADHD-combined presentation”). They may also screen for comorbid neurological, developmental, or mental health disorders, such as autism spectrum disorder or seizure disorders. 

How to get tested for ADHD

People may seek an ADHD diagnosis when their ADHD symptoms interfere with their lives in one or more areas. You may have tried several techniques for time management, getting organized, impulsive behaviors, or other areas without finding a potential strategy. In these cases, getting an ADHD diagnosis could be beneficial. You might be able to find ADHD assessments in the following ways: 

• Through an ADHD, hyperactivity, or neurodivergence clinic
• Through an ADHD neuropsychologist
• With a psychiatrist who specializes in ADHD
• With your therapist 
• Through your school or university
• Through a vocational program 

If you think you may have ADHD, seeking a formal ADHD diagnosis from a qualified healthcare provider could help you understand your symptoms. Your ADHD assessment results may be given as a written report or through an online portal. You might be able to show it to doctors, therapists, and family to get services that benefit you. 

Those that perform assessments to diagnose ADHD may be psychiatrists, neuropsychologists, psychologists, or another type of medical professional. In some cases, a family doctor or primary care physician may be able to provide a diagnosis as well. Some doctors might label themselves "ADHD specialists." Depending on their role, they may or may not prescribe medication or additional services after your ADHD diagnosis.

Some people worry that an ADHD diagnosis means they'll be labeled or judged. They might think their ADHD symptoms are a personal flaw. However, these thoughts could lead to mental burnout and depression. Seeking an assessment doesn't necessarily guarantee a ADHD diagnosis, and it may be used to understand your symptoms more profoundly.  

Online ADHD testing 

If you're curious whether you have ADHD, you can take an ADHD assessment online as a first step. An ADHD online assessment does not substitute for a doctor's diagnosis or professional services. However, it may help push you toward a formal ADHD diagnosis if you're unsure. It could also help you cope with your feelings and validate your experiences. Consider bringing your screening results to your appointment with your provider. There are several different online ADHD tests available, including the Adult ADHD Test from the Attention Deficit Disorder Association. 

Who can perform an ADHD evaluation?

An ADHD evaluation may be performed by a psychiatrist, psychologist, clinical social worker, or another behavioral health professional. A medical doctor (e.g., your primary care provider) may also be able to perform an ADHD evaluation for diagnosis. Some insurance companies may require that you visit a psychiatrist for certain forms of treatment, such as ADHD medications. 

What to expect at an adult ADHD evaluation

While every doctor may have a different evaluation process, there are general steps you might expect when going to your assessment to diagnose ADHD. Prepare for your appointment by writing down your concerns and questions. Your doctor may request your medical records before your appointment. If you see a physician, you may check your blood pressure and heart rate or get blood assessments done. 

During an ADHD assessment, your doctor may interview you to gather information about your symptoms and medical history. They might ask how your ADHD symptoms affect your daily life, work, and relationships and how long you've been experiencing them. This may help them determine whether you have ADHD. Bring your notes and have an open conversation with your doctor. 

After an interview about your potential symptoms of ADHD, you might also partake in assessments involving IQ, memory, inkblots, mental health, sensory sensitivities, and ADHD symptom self-reports.

A frequently utilized assessment for ADHD screening is the Adult ADHD Self-Report Scale, which measures the frequency with which an individual experiences 18 different potential ADHD symptoms. The inventory consists of a series of questions—for example, “How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?”—that require an answer of “Never”, “Rarely”, “Sometimes”, “Often”, or “Very Often”.

Several conditions can present with symptoms similar to ADHD, such as depression and anxiety. There are comorbid conditions associated with ADHD as well, such as autism and dyslexia. Additional medication or therapy may be recommended if a comorbid condition is identified.