ADHD Evaluation
To determine if someone is ADHD, a thorough evaluation is needed. A diagnosis is dependent on the existence of symptoms that begin prior to age 12 and continue to affect school, work or social situations.
Rating scales are commonly used to assess ADHD. The CAARS-L-S is a self-rating instrument that has been proven to be valid. The version that is a observer (CAARS-L O) also has good validity.
Symptoms
Many children struggle to sit still or waiting their turn, are anxious and impulsively act. If these issues interfere with the child's everyday functioning and cause them to struggle at school, home, in their activities, and in their relationships, then they could be diagnosed with ADHD. Health care providers use the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5) guidelines to make a diagnosis of ADHD. The symptoms must be present for at minimum 6 months and affected the person in more than 1 setting, including at home and at work. They must also interfere in social, academic or career success.
To determine if someone has ADHD, the provider will inquire about the person's current symptoms and if they started before the age of 12. A thorough mental health history will be conducted. The doctor will talk to the person's teachers, parents and other relatives who know about their behavior and history of schooling. The provider will also search for indications that other conditions or illnesses may be causing symptoms, such as mood disorders, learning disorders, thyroid problems and head injuries.
Symptoms of ADHD are divided into three subtypes: inattentive, hyperactive-impulsive and combined. As a teenager, the symptoms may shift from one subtype to the other as they develop with the passage of time and the demands of their environment.
If you are an inattention type one may struggle to pay attention to minute details, making careless errors or focusing on their job and activities. People may also struggle in following instructions and paying attention to detail or retaining information over time. This type of ADHD occurs most often in young children.
The hyperactive-impulsive subtype of ADHD is less common in young children. They may be unable to comprehend social boundaries, or waiting their turn during conversations or games. They may interrupt other people frequently or engage in risky behaviors such as drug use or sexual activity that is unsafe.
The combined subtype of ADHD is more prevalent in adulthood and teens. People with this presentation have at least six symptoms from each of the inattentive and hyperactive-impulsive categories. As they age, they could lose some hyperactivity but still struggle with restlessness and inattention.
Family History
Parents who suffer from ADHD may have a higher likelihood of passing the disorder on to their children however, genetics alone is not enough to determine if an individual child will develop the disorder. The environment a person is in can influence how likely they are to develop mental health conditions and how these symptoms appear in their lives.
A family history of ADHD can aid a doctor in assessing the risk that a child may have the disorder. The disorder can impact the performance of a child at school and at work and can cause issues in relationships. If your child's sibling or parent has the disorder, the physician may suggest testing to determine whether medication can improve functioning in school as well as at home.
If a child is diagnosed with ADHD the child may be assisted by a medical professional to manage symptoms through psychotherapy or medication. If a child is diagnosed as having severe ADHD, they may be eligible to be enrolled in the Section 504 or Individuals with Disabilities Education Act plan. Students can enhance their learning abilities by using behavior training, study skills classroom adjustments, and other teaching strategies.
Researchers are committed to identifying the underlying cause of ADHD and identifying more effective treatments. Alongside medication, therapies can include behavior modification and parent education. It is crucial to educate parents and students about the condition to decrease stigma and increase awareness. This will also promote early diagnosis and treatment.
ADHD can be different for girls and boys. For example, hyperactive-impulsive ADHD is more common in males than in females, while inattentive ADHD is more commonly seen in girls.
Numerous studies have revealed that families of individuals with ADHD have a particular profile in their families and the development history. This profile differs from non-referred sample of ADHD people and is believed to be influenced by gender. In one study, a clinical routine interview was used to gather information about the family history and developmental history. Scales of rating were utilized to determine the characteristics of a disorder.
Physical Exam
During the physical exam, the examiner is able to see how the patient moves and look for indications of illness or injury. The exam can take several forms and be conducted by a variety of people such as nurses, doctors, and other health care professionals. It could involve observation, palpation and auscultation which are methods to listen and touch the patient. It should be conducted in a calm, comfortable environment, with privacy and, as much as possible, a good amount of silence. The examiner should use appropriate lighting, darken the room for some parts of the examination and provide water and other drinks.
For adults primary care providers and mental health professionals typically diagnose ADHD. They may refer the individual to a psychiatrist or clinical psychology for a thorough assessment. The evaluation could also comprise interviews with the patient and their family members or friends, as well as colleagues, as well as a review and analysis of their medical and psychiatric histories. The tests usually focus on working memory as well as executive functioning (abilities such as planning and decision-making) spatial and visual (related to space) and reasoning skills.
It is essential that the person being examined is able to discuss their symptoms and experiences with the health care provider. The physician will likely ask questions about how the symptoms affect the person's health and well-being at home, school or work as well as their relationships and activities. The doctor will want to exclude any other medical conditions that could cause similar symptoms. These include learning disorders, mood disorders and head injuries.
People with inattention ADHD may have trouble staying still, following directions or waiting their turn concentrating during conversations or tasks and losing track of details. They may easily become distracted by non-essential activities or outside events, such as the phone call, a TV show or a conversation. They may have trouble organizing their belongings or keeping track of deadlines, or might always be late for appointments. People with hyperactive-impulsive ADHD may fidget or have trouble playing or engaging in leisure activities quietly, blurt out answers before they are finished or have trouble waiting to take turns in games.
In general, those with ADHD have more problems in the areas of attention and concentration than they do in impulsivity and hyperactivity. what is it worth are more vulnerable to anxiety and depression as well as having difficulty learning. They are at greater risk of injury due to their impulsive behavior or poor organizational skills, and they could have issues with self-medication (such as using drugs and alcohol) and substance abuse.
Psychological Testing
A person suffering from ADHD must undergo psychological testing to establish the diagnosis. This allows healthcare professionals to rule-out cognitive disabilities that may cause problems in treatment and even worsen the problem. It also helps them detect other mental health issues that could co-exist with ADHD.
Psychological tests may include memory, intelligence, attention and language assessment. They could also include broad-spectrum scales that check for psychiatric disorders like depression and anxiety. In some cases psychologists will inquire from family members, colleagues and acquaintances about the individual's behavior. This is referred to as a collateral interview and can be extremely helpful in creating a precise picture of the symptoms.
A patient may also be administered a neuropsychological test such as TOVA which is comprised of auditory and visual tests. The test requires the participant to look at two simple geometric shapes and click an electronic microswitch each time they notice them. The test measures how well a person can pay attention and respond to visual clues.
The doctor will also inquire about the person's work and school performance and how their conditions affect their daily routine. They'll be interested in knowing if they often forget appointments, misplace items or have difficulty executing on their plans. They may also inquire about their relationships, and if they have trouble managing their emotions.
The doctor will then conduct a physical exam. The patient must wear comfortable clothes and should not wear any jewelry. A medical history will be taken and the clinician will search for indications of anxiety or depression, which can co-exist with ADHD.