Shrewsbury Borough ADHD Testing
Empowered Learning Transformation Centers
Although there is no single medical, physical, or genetic test for ADHD, a diagnostic evaluation can be provided by a qualified mental health care professional or physician who gathers information from multiple sources. These sources include ADHD symptom checklists, standardized behavior rating scales, a detailed history of past and current functioning, and information obtained from family members or significant others who know the person well. Some practitioners will also conduct tests of cognitive ability and academic achievement in order to rule out a possible learning disability. ADHD cannot be diagnosed accurately just from brief office observations or simply by talking to the person. The person may not always exhibit the symptoms of ADHD during the office visit, and the diagnostician needs to take a thorough history of the individual’s life. A diagnosis of ADHD must include consideration of the possible presence of co-occurring conditions.
Clinical guidelines for a diagnosis of ADHD are provided by the American Psychiatric Association in the diagnostic manual Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These established guidelines are widely used in research and clinical practice. During an evaluation, the clinician will try to determine the extent to which these symptoms currently apply to the adult and if they have been present in childhood. In making the diagnosis, adults should have at least five of the symptoms present. These symptoms can change over time, so adults may fit different presentations from when they were children.
The DSM-5 lists three presentations of ADHD—Predominantly Inattentive, Hyperactive-Impulsive and Combined. The symptoms for each are adapted and summarized below.
ADHD predominantly inattentive presentation
· Fails to give close attention to details or makes careless mistakes
· Has difficulty sustaining attention
· Does not appear to listen
· Struggles to follow through with instructions
· Has difficulty with organization
· Avoids or dislikes tasks requiring sustained mental effort
· Loses things
· Is easily distracted
· Is forgetful in daily activities
ADHD predominantly hyperactive-impulsive presentation
· Fidgets with hands or feet or squirms in chair
· Has difficulty remaining seated
· Runs about or climbs excessively in children; extreme restlessness in adults
· Difficulty engaging in activities quietly
· Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor
· Talks excessively
· Blurts out answers before questions have been completed
· Difficulty waiting or taking turns
· Interrupts or intrudes upon others
ADHD combined presentation
The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations.
These symptoms can change over time, so adults may fit different presentations from when they were children.
A diagnosis of ADHD is determined by the clinician based on the number and severity of symptoms, the duration of symptoms and the degree to which these symptoms cause impairment in various areas of life, such as home, school or work; with friends or relatives; or in other activities. It is possible to meet diagnostic criteria for ADHD without any symptoms of hyperactivity and impulsivity. The clinician must further determine if these symptoms are caused by other conditions, or are influenced by co-existing conditions.
Several of the symptoms must have been present prior to age 12. This generally requires corroboration by a parent or some other informant. It is important to note that the presence of significant impairment in at least two major settings of the person’s life is central to the diagnosis of ADHD. Impairment refers to how ADHD interferes with an individual’s life. Examples of impairment include losing a job because of ADHD symptoms, experiencing excessive conflict and distress in a marriage, getting into financial trouble because of impulsive spending, failure to pay bills in a timely manner or being put on academic probation in college due to failing grades. If the individual exhibits a number of ADHD symptoms but
they do not cause significant impairment, s/he may not meet the criteria to be diagnosed with ADHD as a clinical disorder.
Internet self-rating scales
There are many Internet sites about ADHD that offer various types of questionnaires and lists of symptoms. Most of these questionnaires are not standardized or scientifically validated and should not be used to self-diagnose or to diagnose others with ADHD. A valid diagnosis can only be provided by a qualified, licensed professional.
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