ADHD Diagnosis - How an Expert Makes a Diagnosis
Adults with ADHD require a thorough assessment by a specialist who is knowledgeable about the disorder. They will likely ask you about your previous experiences and conduct a physical examination. They'll also rule out conditions which could be a cause of ADHD like mood disorders, learning disorders, or thyroid issues.
The doctor will also inquire about your childhood behaviors as current American Psychiatric Association guidelines state that adult ADHD cannot be diagnosed without evidence of signs from childhood. This could include finding your school records and contacting previous teachers, coaches, or religious leaders.
Signs and symptoms
If you or a loved one is struggling to keep up at work, school or at home, and has difficulties remembering important dates and appointments, or is struggling to stay organized or stay on top of things, you could be suffering from ADHD. A health care provider's evaluation can help you determine whether this is the case and, if it is, what treatment options there are.
To be eligible for an ADHD diagnosis the symptoms have to be present for at least six months and be evident in at minimum two different environments (school and at home, as an example). The symptoms should also be impacting your ability to perform for instance, in class, in creating close relationships, or working in a team. It is important to recognize that everyone has problems staying focused and organized at times, but these problems are more serious with ADHD.
In order to make an assessment, your doctor will interview you and ask you questions about your behavior and how it has affected your life. Providers will also review your family history as well as any past medical or psychological tests you may have taken. They will look for health problems, such as thyroid problems and seizure disorders that can cause the same symptoms as ADHD.
Your doctor will want to be aware of whether your symptoms began in your childhood (technically prior to age 12). Your doctor will also be interested in knowing how your symptoms affect you right now and in the past. They'll want to know if you've been diagnosed with ADHD in the past.
It's a good idea to bring a list of symptoms to the appointment, especially when you've written them down. This will help you keep track of your symptoms and give your doctor a complete picture of how they affect you. You may also bring in old records such as old report cards or performance evaluations. These documents can help your doctor determine whether ADHD has been a problem for you throughout your whole life or only started recently. These records can help your doctor determine if there are other issues, such as anxiety and depression that have similar symptoms to ADHD.
History
In the past, ADHD was thought to be a flaw in character or a sign of laziness. With advances in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma associated with this disorder is fading.
In 1902, Sir George Frederick Still presented a series of lectures at the Royal College of Physicians. He outlined his observations regarding children who were unfocused or unable to concentrate. He also observed that the symptoms were more prevalent for boys than girls and were not related to the home environment or intelligence. Still's report is often associated with the start of formal recognition of ADHD.
The first edition of the psychiatric manual, published in 1952 by the American Psychological Association (APA) did not contain ADHD. In 1955, however the US FDA approved stimulant medications that were prescribed as the primary treatment for ADHD. The APA published its second edition in 1968. It included a variety of mental health issues. The second edition of the APA's manual listed several mental health conditions, such as ADHD symptoms.
After the publication of the fourth edition of the manual for psychiatric patients in 1994, there was increased 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 recognizes these as manifestations rather than distinct types and states that they can change throughout a person's lifetime.
In 2008, NICE (National Institute for Clinical Excellence) issued guidelines on ADHD in adults. getting diagnosed with adhd was the first time that the UK as a whole formally recognized with support from healthcare, funding and guidance adults with ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued a guideline on ADHD in children. These two documents are the sole official NHS Scotland guidelines on the condition. Other guidance has been developed by private organisations and charities. In recent years, there has been a rising interest in the biological causes of ADHD and researchers have begun to discover the genes responsible for it. This knowledge will help in the near future in developing more targeted and better treatments.
Physical Exam
An expert in ADHD conducts a thorough assessment to determine if they have a diagnosis. Whether they are a physician who specializes in mental health (such as a psychologist or psychiatrist) or a doctor who is also trained in child and young health (a paediatrician) They will need to gather information about the person's history, including education, family, and social histories. They might review old school records or interview teachers, coaches, and other professionals that know the person. They will inquire about symptoms and how they impact life. They will also examine how symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the criteria for diagnosing 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 doctor will usually talk to the person about their symptoms using a questionnaire that is tailored to the particular situation. They will also use different scales of assessment that examine different aspects of the ADHD symptoms. Some of these ratings are basing on the Brown Attention Deficit Disorder Symptom Assessment Scale for adults, whereas others are based on a number of other criteria. They include questions like "Do you often have trouble sitting still?" and "Do you find it hard to manage your activities or work?"
They will perform an examination of the body. They will determine if there are any medical conditions that may be contributing to the symptoms or causing them to become worse, like thyroid dysfunction or hearing or vision 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 assessed for ADHD in adulthood the person will be asked to complete an assessment with a partner or a close family member. This allows for a deeper understanding of the person than checklists and questionnaires cannot provide. This is especially beneficial for those with comorbid conditions like anxiety or depression. These often co-occur along with ADHD and can make it difficult to identify the signs.
Psychological Evaluation
A health 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 take a look at the family history of the patient and their mental health.
They can request a copy of the student's reports or school records, particularly those from kindergarten to high school. They can also request copies of previous psychological or neuropsychological tests which include IQ tests and results from assessments for learning disabilities.
A psychologist, psychiatrist or social worker typically will conduct the interview portion of an adhd diagnostic assessment. In addition, they could interview relatives, friends and teachers, as well. It is essential to obtain an accurate assessment as people with ADHD who are not treated may face serious issues. These could include financial issues (impulsive purchases), marital difficulties, or failure to attend colleges or other educational institutions.
During an interview, the doctor may ask the patient to 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 individuals with ADHD with those of those who do not suffer from the disorder. These ratings are not a diagnosis of ADHD however they are an important aspect of the assessment process.
It is also essential to evaluate the individual for other conditions that could be similar to ADHD, such as sleep disorders, mood disorders, substance use and medical illnesses, such as thyroid disease or head injuries. Those conditions are more likely to respond to specific treatments, therefore it is essential to make sure that a valid diagnosis is made and that the correct treatment is given.
A child or adult must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders to be diagnosed with ADHD. They must exhibit symptomatic behaviors in at least two settings like school, home, or work. The symptoms must also severely hinder the normal functioning of their lives. Typically, the symptoms must begin in the early years of life, and a psychiatrist must be able to determine that the disorder is not caused by a mental illness or comorbid condition.