From the Guidelines
To evaluate for ADHD, start by consulting a primary care physician who can conduct an initial screening and refer you to appropriate specialists, such as psychiatrists, neuropsychologists, clinical psychologists, and neurologists who specialize in ADHD. The evaluation process typically involves clinical interviews, standardized rating scales (such as the ADHD Rating Scale, Conners' Rating Scales, or ASRS for adults), medical history review, and sometimes neuropsychological testing 1. For children, information is gathered from multiple sources including parents and teachers, as recommended by the American Academy of Pediatrics 1. The assessment process usually requires 1-3 sessions and evaluates symptoms across different settings, ruling out other conditions that might mimic ADHD.
Key Considerations
- Early assessment is beneficial as proper diagnosis enables appropriate treatment, which may include medication (such as stimulants like methylphenidate/Ritalin or amphetamine/Adderall, typically starting at low doses and titrating up), behavioral therapy, educational accommodations, and lifestyle modifications 1.
- The evaluation process is thorough because ADHD symptoms overlap with other conditions, and accurate diagnosis is essential for effective treatment.
- Insurance often covers these evaluations, though coverage varies.
- If a primary care clinician feels uncertain about making a diagnosis or continuing with treatment, a referral to a pediatric or mental health subspecialist should be made, as noted in the clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents 1.
Referral to Specialists
- The most qualified professionals for comprehensive ADHD assessment include psychiatrists, neuropsychologists, clinical psychologists, and neurologists who specialize in ADHD.
- Referral to specialists is recommended when the primary care clinician is not confident in their ability to diagnose or treat ADHD, especially in complex cases or when coexisting conditions are present 1.
From the Research
Evaluating for ADHD
To evaluate for Attention-Deficit/Hyperactivity Disorder (ADHD), a comprehensive clinical history and evaluation are required, including:
- Patient symptom and function assessment using tools such as the Adult ADHD Self-Report Scale or Conners Adult ADHD Rating Scales 2
- Gathering of collateral information
- Consideration of other mental disorders in the differential diagnosis due to the substantial overlap of symptoms and ADHD concurrence with anxiety/stress, mood, personality, impulse control, and substance use disorders 2
Referral for Tests
Referral to a primary care physician or a specialist such as a psychiatrist or psychologist may be necessary for a comprehensive evaluation and diagnosis of ADHD 3.
- Primary care physicians can play a crucial role in evaluating and managing adult ADHD in the primary care setting 3
- Specialists such as psychiatrists or psychologists may also be involved in the diagnosis and treatment of ADHD
Diagnostic Criteria
A diagnosis of ADHD requires a comprehensive clinical evaluation and meeting the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria for ADHD 2.