ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults who are diagnosed with the disorder, identifying ADHD requires a thorough assessment by a specialist who is trained in the disorder. They'll likely inquire about your past and perform a physical examination. They'll also rule out conditions that can mimic ADHD such as mood disorders, learning disorders or thyroid conditions.
The doctor will inquire about your childhood behavior since the American Psychiatric Association's guidelines state that ADHD in adults is not diagnosed without evidence of childhood symptoms. This means finding school records and getting in touch with former teachers, religious leaders, or coaches.
Signs and symptoms
If you or someone you love is struggling to keep up with school, work, or home, has trouble remembering important dates or appointments, or can't seem to get organized or stay on top of things, you could be suffering from ADHD. A health care professional's assessment can help you determine whether this is true and if so, what treatment options there are.
The symptoms have to be present in at least two settings (school and at home, for instance) and for at least six months to satisfy the criteria for an ADHD diagnoses. They must also be a major obstacle in your ability to function in some ways, like doing well in school, developing close relationships, or functioning on teams. It's important to understand that everyone struggles with staying focused and organized sometimes however, these issues are more serious with ADHD.
In order to make a diagnosis, your physician will conduct an interview and ask questions about your behavior and how it has affected your life. The doctor will also review your family history and any previous medical or psychological tests that you may have taken. They will look for health problems such as thyroid issues and seizure disorders, which can cause the similar symptoms as ADHD.
Your doctor will ask you whether you've had symptoms in your childhood (technically prior to the age of 12). Your provider will also be interested in knowing how your symptoms affect you at the moment and in the past. They'll also be looking to find out if you've ever been diagnosed with ADHD before.
Bring your own list of symptoms, particularly if they are written down. This will allow you to keep track of your symptoms and give your doctor a complete picture of how they affect you. You may also bring other records, such as performance evaluations from work or old report cards from school. Having these records can help your provider determine if ADHD has been a problem throughout your whole life or only began recently. They can also assist your doctor to rule out other problems such as depression or anxiety which can have the same symptoms as ADHD.
History
In the past, ADHD has been viewed as a flaw in character. But, with advancements in diagnosis and treatment more children are being diagnosed, and the stigma around the disorder is fading away.
In 1902 Sir George Frederick Still presented a series of lectures to the Royal College of Physicians. He described his observations of children who were irritable and unable to focus. He also noted that these symptoms were more prevalent for boys than girls and were not related to intelligence or home environment. Still' diagnosis of adhd has been credited as the beginning of formal recognition of ADHD.
The first version of APA's mental health guideline, released in 1952, did not include ADHD. In 1955, however, the US FDA approved stimulant medications which were used as the primary treatment for ADHD. The APA published its second edition in 1968, which listed a number of mental health conditions. It also included symptoms of ADHD, although they were still classified as hyperkinetic reaction of childhood.
In 1994, the fourth edition of psychiatric book was published. This led to a greater understanding and acceptance of ADHD. Its name was changed to Attention Deficit Disorder with or without hyperactivity and the standard definition of three types of ADHD symptoms was established: mostly inattentive, mainly hyperactive-impulsive, and combined. The current DSM-5 views these as presenting symptoms, not distinct types, and states that they can change throughout a person's life.
NICE (National Institute for Clinical Excellence) released guidelines on ADHD in adults in 2008. It was the first occasion that the UK as a whole recognized adults suffering from ADHD and provided them with healthcare, funding, assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the sole official NHS recommendations on the condition in Scotland. Other guidance has been developed by charities and private organizations. In recent years there has been a rising interest in the biological causes of ADHD, and researchers have begun to find the genes that cause it. This knowledge may help to develop better and more specific treatments in the near future.
Physical Examination
An expert in ADHD conducts a thorough evaluation to establish a diagnosis. They will collect information from the patient's past, including their family, education and employment history, as well as their social history. They will go through the school records from the past and interview teachers, coaches and other professionals who know the person. They will inquire about symptoms and how they affect life. They will also examine how symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, outlines the criteria for determining ADHD in children and adults. To meet these criteria, the symptoms of inattention and hyperactivity-impulsivity must be present in multiple settings, cause significant impairment and have started before age 12. The specialist will usually interview the person about their symptoms by using the appropriate questionnaire to the specific circumstance. They also employ various rating scales to evaluate different aspects ADHD symptoms. Some of these ratings are basing on the Brown Attention Deficit Disorder Symptom Assessment Scale for Adults, while others are based on a range of other criteria. They include questions such as "Do you often have trouble sitting down?" and "Do you struggle to organize your time or tasks?"
They will conduct an examination for physical health. They will determine whether there are any medical problems that could be causing or making the symptoms worse, such as thyroid dysfunction, vision or hearing problems. They will also inquire with the patient about their diet and lifestyle habits to determine if these may contribute to symptoms.
If a person is being assessed for ADHD in adulthood and is being evaluated for ADHD, they will be asked to fill out an assessment with a partner or a close family member. This will allow for a greater understanding of the individual that checklists and questionnaires do not provide. This is especially useful for people who have co-occurring conditions such as anxiety or depression. These are often associated with ADHD which makes it difficult to recognize the signs.
Psychological Evaluation
A health care professional who is evaluating a child's ADHD will ask them a series questions about the symptoms and how they impact their daily lives. They also review a patient's mental health and family history.
They often request that the person bring in report cards and school records to review, specifically those from kindergarten through high school. They can also request copies of any previous neuropsychological or psychological testing, such as results from IQ tests and assessments for learning disabilities.
Typically an audiologist, psychiatrist, psychologist or a social worker conducts the interview portion in an adhd diagnosis evaluation. They may also interview relatives, friends and teachers as well as employers. It is important to get an accurate assessment as people with ADHD who are not treated can have serious problems. These could include financial issues (impulsive purchases) and marital problems or failure to attend college or other educational institutions.
During an interview, a doctor may ask the patient fill out standardized behavior ratings scales which are designed to help identify ADHD symptoms. These tests are based on research that compares the behavior of those suffering from ADHD to those of people who do not suffer from the disorder. These ratings do not constitute a diagnosis of ADHD however they play an important element in the process of evaluating.
It is important to also examine the person to determine if they have other conditions that might be similar to ADHD. These include sleep disorders, mood disorders, and addiction to drugs, and also medical ailments such as thyroid disease or brain injuries. These conditions are more likely to respond to specific treatments. It is therefore important to determine the correct diagnosis and to get the appropriate treatment.
A person of any age must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must display symptomatic behavior in at least two different settings like school, home, or work. The symptoms must also severely hinder the normal functioning of their lives. The symptoms must have manifested in childhood and a psychiatrist must verify that the disorder wasn't caused by mental illness or other comorbid conditions.