ADHD ASSESSMENT INFORMATION

The diagnosis of ADHD is strongly dependent on a clinical interview in conjunction with a variety of formal and informal measures. Since there is no one test, or specified combination of tests for determining ADHD, the diagnosis of an attention deficit/hyperactivity disorder (ADHD) requires a multifaceted approach. Any tests that are selected by the evaluator should be technically accurate, reliable, valid, and standardized on the appropriate norm group. The following list includes five broad domains that are frequently explored when determining a diagnosis. This listing is provided as a helpful resource but is not intended to be definitive or exhaustive.

Clinical interview: The evaluator should: 1) provide retrospective confirmation of ADHD, 2) establish relevant developmental and academic markers, 3) determine any other co-existing disorders, and 4) rule out other problems that may mimic ADHD.

Specific areas to be addressed include:

• Family history

• Results of a neuro-medical history

• Presence of ADHD symptoms since childhoods

• Presence of ADHD symptoms in last 6 months

• Evidence that symptoms cause a “significant impairment” over time

• Results of clinical observation for hyperactive behavior, impulsive speech, distractibility

• Extent of functional impairment across settings (e.g., academic, occupational, social)

• An accounting for periods in which individual was symptom-free

• Presence of other psychiatric conditions (mood or anxiety disorders, substance abuse, etc.)

• Indication that symptoms are not due to other conditions (e.g., depression, drug use, neurological problems)

• Determination of which remediation approaches and/or compensation strategies are and are not currently effective.

• Determination of what accommodations, if any, have alleviated symptoms in the past or in the present setting.
  
  Rating Scales: Self-rated or interviewer-rated scales for categorizing and quantifying the nature of the impairment may be useful in conjunction with other data.
  
  Collateral information: Includes third party sources which can be helpful to determine presence or absence of ADHD in childhood as well as current symptoms.
   

• Description of current symptoms (e.g., by spouse, teachers, employer)

• Description of childhood symptoms (e.g., by parent or older sibling)

• Report cards and transcripts from schools
  
  Cognitive-psychological and psycho-educational testing:
  Cognitive and achievement profiles may suggest attention or information processing deficits. No single test or subtest should be used as the sole basis for a diagnostic decision.
  
  Social and Emotional Functioning: This area is evaluated using both clinical and structured interviews, as well as various standardized questionnaires.
  
  Medical Evaluation: Medical disorders may cause symptoms resembling ADHD. Therefore, it may be important to rule out the following:
   

• Neuroendocrine disorders (e.g., thyroid dysfunction)

• Neurological disorders

• Impact of medication of attention if tried, and under
  what circumstances.