ADHD Evaluation
To determine if someone is ADHD, an evaluation is needed. The diagnosis is according to the signs that first appeared before the age of 12 and can be a significant hindrance to work, school or social situations.
Rating scales are often used to measure ADHD. The CAARS-L:S self-rating instrument has established validity. The observer version (CAARS-L: O) also has a high degree of validity.
Symptoms
Many children have trouble sitting still or waiting for their turn, are anxious and act impulsively. If these problems interfere with the child's everyday functioning and cause them to struggle at school, home as well as in their activities and in their relationships, they may be diagnosed with ADHD. Health professionals use the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5) guidelines to determine if they are a victim of ADHD. The symptoms have to be present for at minimum six months and have affected the person's life in multiple settings including at home and at work. They must also affect academic, professional or social performance.
The doctor will inquire with the patient about their current symptoms and if they began before the age of 12. A thorough mental health history is conducted. The doctor will discuss with the person's parents, teachers, and other people who know them well about their current behaviour and previous school experiences. The provider will also check for signs that indicate that other conditions or illnesses may be creating symptoms in the individual including thyroid issues as well as mood disorders, learning disorders and head injuries.
Symptoms of ADHD are divided into three subtypes: inattentive, hyperactive-impulsive and combined. In adolescence, a person's symptoms can change from one subtype to the other as they develop with age and the demands of their environment.
In the inattentive type someone may be unable to pay attention to minute details, making careless errors, or staying focused on their tasks and activities. People may also struggle with following directions, paying close attention to detail or retaining information over time. This kind of ADHD is most prevalent in children.
The hyperactive-impulsive subtype of ADHD is less common in young children. A person might have trouble knowing the boundaries of social interaction or waiting their turn during conversations or games. They might interrupt others frequently or engage in risky behaviors like using drugs or engaging in unsafe sexual activities.
The subtypes that are combined are more prevalent among adolescents and adults. People with this presentation have at least six symptoms from each of the inattentive and hyperactive-impulsive categories. They might lose some of their hyperactivity as they age, but continue to battle with restlessness and inattention.
Family History
Parents with ADHD are more likely to pass on the disorder to their children. But, genetics alone cannot predict whether or the child will be affected by the condition. The environment of a person can affect the likelihood they are to develop mental health problems and how they show up in their lives.
A doctor can look at a family history of ADHD to determine the probability that a child will suffer from the disorder. Being diagnosed with the disorder could make it more difficult to perform at school and at work, and could lead to problems in relationships. If a child has a parent or sibling who suffers from the disorder and the doctor recommends testing to determine if medications can help improve the functioning at home and at school.
If a child has been diagnosed with ADHD, he or she can be assisted by a doctor to manage the symptoms with psychotherapy or medication. If a child is diagnosed with severe ADHD, he or she may be eligible to receive special education under the Individuals with Disabilities Education Act or a Section 504 plan. Students can enhance their learning abilities by applying behavior training, study skills classroom adjustments, and other teaching strategies.
Researchers are committed to identifying the underlying cause of ADHD and developing better treatments. Therapy may include the modification of behavior, education for parents and medication. Informing parents and students about the illness is essential in removing stigmas and raising awareness, and encouraging early diagnosis and treatment.
ADHD can manifest differently 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.
Several studies have found that families of people suffering from ADHD have a particular profile in their family and developmental experiences. assessments for adhd differs from the non-referred samples of people with ADHD and is believed to be influenced by gender. In one study, data was obtained through an interview conducted by a clinical professional. Additionally, there were rating scales to determine the specific characteristics of disorders.
Physical Examination
In a physical exam the examiner will be able to observe how the patient moves as well as look for signs of illness or injury. The exam can be done in many ways and by different people, such as physicians, nurses and other health care professionals. It may involve observation, palpation and auscultation, which are techniques to touch and listen to the patient. It should be done in a quiet, comfortable environment with privacy and if possible, a good deal of silence. The examiner should use appropriate lighting, and darken the room during certain portions of the examination, and provide water and other drinks.
Adults are typically diagnosed with ADHD by primary care providers or mental health professionals. They may refer individuals to a thorough assessment by a psychiatrist or clinical psychologist. The evaluation could also comprise interviews with the person, family members or friends, as well as colleagues, as along with a thorough review and analysis of their medical and mental health histories. The tests are typically aimed at working memory and executive function (abilities such as planning and decision making) as well as spatial and visual abilities (related to spatial space), and reasoning.
It is essential for the person being evaluated to talk about their symptoms and experiences in a candid manner with the health professional. The doctor may inquire about the symptoms and how they affect a person at work, school, home, and in their relationships. The provider will want to rule out other conditions that can cause similar symptoms, like learning disorders, mood disorders, head injuries or thyroid problems.
People with inattention ADHD may have difficulty being still, following instructions or waiting their turn, being focused during conversations or work and losing track of details. They can easily be distracted by low-priority activities or other events like the phone call, a TV show or a conversation. They may have trouble organizing their belongings or keeping on top of deadlines, or they might be consistently 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.
ADHD is more common in people who are impulsive and hyperactive than those who have problems with concentration and attention. They are more susceptible to anxiety and depression, and also have difficulty learning. They are more at chance of suffering injuries due to their impulsive behaviour or insufficient organizational skills and they could have issues with self-medication (such as taking drugs and alcohol) and substance abuse.
Psychological Testing
A person suffering from ADHD will need to undergo psychological tests to establish the diagnosis. This enables healthcare providers to identify cognitive impairments that can exacerbate the problem and make treatment more difficult. It also allows them to detect other mental health issues that could be co-existent with ADHD.
Psychological tests can include intelligence, memory and attention and language assessments. They could also include broad-spectrum scales that test for psychiatric issues such as anxiety and depression. In some cases, a psychologist will ask relatives, colleagues, and even friends about the patient's behavior. This is referred to as an indirect interview, and can be extremely helpful in establishing an accurate picture of the signs.
A patient may also be administered a neuropsychological test like TOVA, which consists of auditory and visual tests. The test is conducted by looking at two simple geometric shapes and then clicking a microswitch every time they see the image appear. The test evaluates the ability to pay attention and how quickly they respond to visual signals.
The clinician will ask about the person's daily routine and how symptoms affect their school and work. They'll be interested in knowing whether they tend to forget appointments, lose things or have difficulty executing on their plans. They should also inquire about their relationships and if they have difficulty to manage their emotions.
The doctor will then conduct an examination of the body. The patient will need to wear comfortable clothing and not wearing jewelry. A medical history will be taken, and the clinician will look for indications of anxiety or depression, which can co-exist with ADHD.