What is an ADHD Evaluation?
Over the years, new patients have frequently called asking for….well, they’re really not sure what they’re asking for, and aren’t really sure what they need, just that something’s wrong. It can be confusing and complex information when searching for an answer to help explain all of the difficulties a child or adult may be experiencing. Parents have called seeking as to whether we offer “ADD testing” or “psychological testing” in trying to figure out what’s at the core of the presenting issues. My objective is to try to simplify this and offer some direction on how to find the answers and conclusions to confidently receiving the proper diagnosis of ADHD.
The best way to diagnose ADHD is through a thorough diagnostic interview. This may sound oversimplified; however, with a skilled evaluator who knows what they’re doing, this is the best way to collect data that exists across a variety of settings. A diagnostic interview should include a meeting with the identified patient (either an adult or child), as well as others who are good reporters of observations and history — this is usually a spouse, significant other or parent, respectively. In addition to a structured interview, which will include detailed questions about the person’s history of the presenting problems, it includes an assessment of ADHD symptoms, as well as an assessment of symptoms that often overlap with ADHD but are actually other disorders like depression, bipolar disorder, or anxiety disorders. In assessing symptoms, the evaluator may be using a structured format, such as a scorable questionnaire for people to report on their own experiences, and also questionnaires for others to complete. There are many standardized questionnaires that assess symptoms of ADHD and the evaluator will select those that best fit the reason for the initial referral. Teachers, coaches, bosses, work colleagues, and spouses are great sources of collaborative information. Other important pieces of information include report cards, standardized test scores, job performance reviews, and any other formal or informal academic or vocational feedback. The diagnostic interview also reviews family information, medical history and other relevant pieces of psychosocial history.
In addition to completing a diagnostic interview, some people may choose to pursue additional formalized “testing” which can provide valuable supplementary information, however, is not “necessary” to make the diagnosis of ADHD. Neuropsychological testing provides a wealth of data that can help us understand the way the brain functions, what your cognitive strengths and weaknesses are, and whether there are any specific brain-based cognitive deficits are that might be contributing to the patient’s struggles. It also provides valuable information on
intelligence, executive functioning, processing, attention, memory, visual-spatial functioning, communication/language skills, emotion and mood, personality, sensory integration/processing, motor skills and academic skills. When there are specific questions related to any of these topics above, one should consult a neuropsychologist who is trained to administer and interpret these tests.
There is also another testing battery called “Psychoeducational Testing,” which measures some of the same information as neuropsychological testing, but is more geared to academic and educational environments. It seeks to answer questions about specific learning differences and disorders, and whether or not special education interventions will be useful in improving a student’s academic achievement. Psychoeducational evaluations are often needed when a student is seeking academic accommodations like a 504 plan or Individualized Educational Plan (IEP).
A couple of additional resources include —