To diagnose ADHD, it’s important to differentiate between individuals with situational attention lapses or slight impulsivity and those displaying consistent, clinically significant inattention, hyperactivity, or impulsivity across multiple settings. The diagnostic process involves an interview, a set of tests, and a report of findings. The interview aims to understand the concerns and challenges of the person. The diagnostic process for ADHD begins with an initial consultation, where the patient’s history and background are thoroughly examined. This is followed by a testing session, during which the patient undergoes a series of tests specifically designed to suit their individual needs. These tests aim to determine the causes and extent of the ADHD symptoms, while also ensuring that current issues are not merely a result of stress, anxiety, or environmental factors. The findings are then compiled into a report, which either confirms or dismisses the presence of ADHD. This comprehensive report provides a summary of the diagnostic conclusions drawn from the entire process.
Initial Consultation
An initial consultation is a meeting between a client and a professional to discuss the concerns and determine the best course of action. It is a good starting point to begin discussing everyday problems and areas of struggle at home, work, or other settings. During this meeting, you can provide background information and help get the process started of picking out which testing measures will be most important for your evaluation. This will often be your first visit with the professional and then, if testing is necessary, there will be follow-up standardized forms and clinical assessment.
You can ask any questions you have about the process, the expected outcomes, the costs, and the confidentiality of your information. The professional will listen to your concerns and needs, and offer you feedback, and guidance based on their expertise and experience. They will also explain the benefits and limitations of the testing methods they recommend, and how they will use the results to design a personalized evaluation for you. By the end of the initial consultation, you should have a clear idea of what to expect from the next steps and feel confident and comfortable with working with the professional.
During the consultation with an ADHD- specific testing focus in mind, there are several key points to consider. First, it’s important to identify if the problems occur in two or more settings. Second, there should be some evidence of at least a few ADHD-characteristic problems present during childhood. If possible, gathering information from a parent can help with this. However, it is also important to consider how childhood symptoms might have been hidden by compensatory resources such as a high IQ, high creativity, or social support. This is particularly relevant for individuals who appear to be performing at a high level despite their ADHD.
For those with high-performing ADHD, it’s necessary to assess their compensatory resources. Impairment should be defined as functioning at a level lower than what would be expected given their aptitude, even if their overall level of functioning appears to be above average. It’s common for students who are starting college or moving away from their parents’ homes, and no longer have the support of their parents for daily activities, to experience a decline in their performance, and first become impacted by their ADHD-characteristics.
A good initial consultation will involve:
- The clinician should be as prepared as possible.
- The patient should be as prepared as possible.
- The clinician should know the person before making the person into a patient.
- The consultation should feel unhurried for the patient and clinician.
- The clinician should be able to give undivided attention to the patient.
- There should be ready supply of information into the consultation.
- Confidentiality and dignity should be maintained.
*adapted from The Process of Clinical Consultation
Testing Session
Standardized Forms
Mental health professionals, trained in psychometrics, use a valuable tool in ADHD testing—standardized forms. These forms are employed after a detailed interview to ensure a thorough and accurate assessment of ADHD symptoms. These forms offer the opportunity to answer the question, “ls this common, or is this a bit too much?” and that’s where standardized forms come in. These are like special checklists that can be used to determine if any areas of concern are common or are they clinical? These forms have questions like, “Does your child have trouble sitting still?” or “Do they find it hard to pay attention?” When these questions get answers, they can then be compared to what’s considered typical for their age and this helps professionals determine how severe the symptoms are and whether intervention might be needed. It’s like having a guide that says, “Okay, at this age, most kids can do this, this, and this without any problem.” But these forms
should never be used alone to make any diagnostic decisions.
There are a variety of standardized forms available, but they are all directed at accomplishing the same goal, separating the common from the clinical. This allows for efficient and comprehensive collection of information from areas that are associated with different diagnosis is a good starting point when considering an ADHD diagnosis. These can also be distributed to teachers, grandparents, or even loved one’s to help get a big picture understanding of concerns.
Clinical Assessment
A diverse range of testing measures are available for the in-office testing appointment, typically covering various aspects of mental abilities. The goal is to identify whether any deficits in information processing can predict real-world impairment, and if-so, the severity of the impact. There is no set testing battery because each person has unique challenges that will be addressed during the evaluation, but at Wysocki Psychological Services you can be assured each measure is relevant and helps provide the necessary ADHD clarification, when combined with the initial consultation and standardized forms. This will usually include evaluating attention, memory, executive function, or even academic skills.
This in-office testing is crucial for those who may require accommodations in higher education or important exams. Without face-to-face testing, it becomes very difficult to provide evidence of how the accommodations can lessen the impact of ADHD symptoms. This evidence is essential for the need of accommodations for the fair demonstration of knowledge and skills in these significant exams or assessments, and helping to rule out current difficulties are not a product of the environment or general routine stress.
Reaching Conclusions and Report of Findings
Following the initial consultation, the gathering of standardized forms, and the clinical assessment, these elements are combined into a comprehensive psychological report with findings. Throughout this process, there might be phone calls for clarifying questions or additional information, such as details about auditory processing, insights on medication management, history of concerns, or any other relevant factors that could contribute to providing accurate diagnostic information or clarification. This is often the longest part of the process and can take several weeks to be completed to ensure all Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria are met to diagnose ADHD.
At Wysocki Psychological Services in Jonesboro Arkansas, we follow these guidelines to ensure an accurate diagnosis. Our approach includes an initial consultation, followed by a series of tests, and a report that summarizes our findings. We are confident in the accuracy and efficiency of our method, although we acknowledge that procedures may vary among healthcare providers. If you or a loved one could potentially benefit from our services, we encourage you to reach out to us.
