What questions should be asked during a check-in with a teenager already diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)?

Key Questions for ADHD Teen Check-in Appointments

During check-in appointments with teenagers diagnosed with ADHD, clinicians should systematically assess medication effectiveness, side effects, functional impairment, and screen for substance use and diversion risk to ensure optimal treatment outcomes and safety. 1, 2

Core Assessment Areas

Medication Effectiveness and Adherence

• How consistently are you taking your medication as prescribed?
• What times of day do you find your symptoms are best controlled?
• Are there specific times when your medication seems to wear off? (e.g., late afternoon/evening)
• How is your medication working in different settings (school, home, social activities)?
• Have you noticed any changes in your ability to focus, complete tasks, or control impulsive behaviors?

Side Effect Monitoring

• Have you experienced any sleep difficulties since our last visit?
• How is your appetite and have you noticed any weight changes?
• Are you experiencing headaches, stomach discomfort, or other physical symptoms?
• Have you noticed any mood changes, irritability, or social withdrawal?
• Are you experiencing any other concerning symptoms since starting/adjusting medication?

Academic and Social Functioning

• How are your grades and academic performance since our last visit?
• Are you able to complete homework and assignments on time?
• How are you managing organization of schoolwork and personal responsibilities?
• How are your relationships with teachers, peers, and family members?
• Are you participating in extracurricular activities? How is that going?

Risk Assessment

• Have you ever used your medication differently than prescribed?
• Has anyone asked you to share or sell your medication? 1
• Have you used alcohol, marijuana, or other substances recently? 1, 2
• Do you drive? If so, do you take your medication before driving? 1
• Have you experienced any symptoms of depression or anxiety?

Special Considerations for Adolescents

Substance Use and Medication Diversion

The American Academy of Pediatrics specifically highlights the importance of assessing for substance use in adolescents with ADHD, as this is a special concern in this age group 1, 2. Questions should directly address:

• Any current substance use (alcohol, cannabis, other drugs)
• Whether others have requested to buy or use their medication
• If medication is stored securely at home and school

Driving Safety

Given the increased risk of motor vehicle crashes among adolescents with ADHD 1, ask:

• "Do you notice your ADHD symptoms affecting your driving?"
• "Does your medication coverage last through times when you typically drive?"
• "Have you had any traffic violations or close calls while driving?"

Treatment Adherence Challenges

Adolescents often struggle with treatment adherence due to increasing independence and concerns about stigma 3. Important questions include:

• "What challenges do you face in taking your medication regularly?"
• "Do you ever feel embarrassed about taking medication at school?"
• "What would help you remember to take your medication consistently?"

Psychosocial Assessment

Behavioral Therapy Engagement

Since combined treatment (medication plus behavioral therapy) offers greater improvements for many adolescents 1, 2, ask:

• "What behavioral strategies have been most helpful for managing your ADHD symptoms?"
• "Are you currently participating in any counseling or therapy?"
• "What organizational systems are you using to manage schoolwork and responsibilities?"

Quality of Life Assessment

• "How satisfied are you with your current treatment plan?"
• "What areas of your life would you like to see improve?"
• "On a scale of 1-10, how would you rate your overall quality of life?"

Monitoring Tools

• Consider using standardized rating scales to track symptoms over time
• Document weight at each visit as an objective measure of medication side effects 2
• Use functional impairment scales to assess impact on daily activities 2

Common Pitfalls to Avoid

1. Focusing only on academic performance while neglecting social functioning
2. Failing to assess for substance use or medication diversion
3. Not addressing driving safety with adolescents who drive
4. Overlooking the need for medication coverage during evening activities and homework time
5. Neglecting to monitor for comorbid anxiety or depression which commonly emerge in adolescence

By systematically addressing these key areas during check-in appointments, clinicians can optimize ADHD treatment outcomes and support adolescents through this critical developmental period.