Assessment for an ADHD Diagnosis
Assessment for an ADHD Diagnosis
Written by Erin Mitchell, MSW, LCSW
Welcome to Neurodiversity Week! This week will be filled with information and tips regarding attention-deficit/hyperactivity disorder (ADHD). Webster’s Dictionary defines neurodiversity as the range of differences in individual brain function and behavioral traits, regarded as part of normal variation in the human population (used especially in the context of autistic spectrum disorders). Harvard Medical School further expands that definition to include other neurological or developmental conditions such as ADHD or learning disabilities.
ADHD stands for attention-deficit/hyperactivity disorder. As an aside, the use of the term ADD has been discontinued. It is now considered part of the broader ADHD term, and you do not have to experience hyperactivity to have ADHD. There are 3 different types of ADHD: hyperactive/impulsive, inattentive, and combined type. When people visualize someone with ADHD, they often picture a child (usually a boy) who cannot sit still in a classroom setting. While this can be one way that ADHD presents, it is not the only way it shows up in children. It can also show up as a child who needs to be reminded four times that they need to get their materials out of their backpack to start their day…every day. The diagnosis has nothing to do with a lack of attention. It is not a character flaw. It is a condition that individuals are born with that results in executive functioning issues (otherwise known as executive dysfunction). According to leading expert Dr. Russell Barkley, executive function can be described as:
Not every person with ADHD struggles as significantly in each area, but will have difficulty with most. If you are questioning the possibility of yourself or a loved one (including a child) qualifying for a diagnosis of ADHD then I hope to help you on this journey.
Step 1: I highly recommend that you take a reputable online questionnaire to see if you or a loved one would qualify. I recommend taking this one: https://www.additudemag.com/symptom-checker/
Step 2: Save a copy of your questionnaire results somewhere you can access it again or print it out to take with you. Consider how long these symptoms have been a part of your life. Is this something you have always had trouble with? Or other similar areas?
Step 3: Pursue getting formally diagnosed. This is helpful for seeking treatment (therapy and/or medication). Getting a diagnosis seems like it should be straightforward; however, it needs to be given by a medical doctor (like your primary care provider); a psychiatrist, or a psychologist. Psychologists/Neuropsychologists can perform comprehensive diagnostic testing to make or confirm a diagnosis (if you wish to use insurance for testing, ensure this is covered by your insurance provider). Getting a diagnosis is often one of the most difficult steps to get accomplished. Unfortunately, the medical community has varying levels of comfort with ADHD diagnoses. It may require seeing a psychiatrist. Being able to bring a copy of the ADHD questionnaire results with you may be helpful, but they may have you complete an assessment regardless.
If you are seeking a diagnosis for a child, it will most likely require an assessment by a child psychiatrist. You can get a referral from your pediatrician (if they are not comfortable making the diagnosis themselves). This is a multi-step process, as they will try to get information from others in your child’s life (such as teachers, daycare providers, etc.). This can be very hard to diagnose in children that are not yet in school, but can be accomplished with persistence. Note that this can take some time to get the questionnaires completed by a teacher and back to the psychiatrist. This step will be followed by another appointment with your provider to discuss next steps.
It is likely that you will need to see a psychiatrist for an assessment. You may be able to just see your primary doctor, but don’t be surprised if they refer you out. Sometimes, this can take some advocacy as well. You will want to keep in mind what will fit best with your lifestyle. I know an individual who was diagnosed with ADHD, but was told by their doctor that they should quit their high stress job and find a personal assistant to help them get the tasks done that they were struggling with in their life because that doctor did not like to prescribe ADHD medication. To say that was not a feasible option was an understatement! Luckily, this person did not give up and was able to finally get the help they needed through a different provider.
Unfortunately, there are still people, including professionals, that believe that ADHD is “not real”, “over-diagnosed”, “is something that everyone has”, or “something that you grow out of”. For some, it can seem like an uphill battle to get properly assessed, even though a correctly identified diagnosis can make such a positive difference in someone’s life. If you chose not to get formally diagnosed and just prefer to see a therapist, they can still help with behavioral interventions, but to get an official diagnosis may require one of the options mentioned above.
After diagnosis, you have the option of getting medication and/or therapy. Medication alone can be helpful, but does not address the emotional aspects of ADHD, which is where therapy can prove beneficial.
Neurodiversity reflects the reality that our brains all work in very different ways. Understanding the way that your brain works (or the brain of a loved one) can help you in your life in so many ways. One of the best comparisons that I have come across for ADHD is this: If you tell someone who is nearsighted to “just look harder”, they cannot. That person is not physically capable. That’s the same thing that happens when you tell someone with ADHD to “just try harder” or “it’s not that difficult”. They may not be capable of making that happen in the same way. Getting properly assessed and treated can be an important step in getting help.
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