ADHD Evaluation
To determine if someone is ADHD, an assessment is required. A diagnosis is made based on symptoms that started before 12 years of age and cause significant disruption to school, work or social situations.
Rating scales are commonly used instruments to assess ADHD. The CAARS-L-S is an self-rating instrument with established validity. The observer version of the CAARS:L:O has also been confirmed to be valid.
Signs and symptoms
Many children have trouble sitting still or waiting their turn, are anxious and behave impulsively. If a child is suffering from these issues to the extent that they hinder his or her daily functioning and cause problems at home, at school, in activities and in relationships, they could meet diagnostic criteria for ADHD. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision DSM-5 guidelines are used by health care providers to diagnose ADHD. The symptoms must have been present for at minimum 6 months and impacted the person in more than one place such as at home and at work. They must also affect academic, professional or social success.
The physician will ask the patient about their current symptoms and if they started symptoms before 12 years old. A thorough mental health history is taken. The provider will speak to the person's teachers, parents and other relatives who know about their behavior and history of schooling. The doctor will also search for signs that indicate that other conditions or illnesses may be responsible for the symptoms of the person including thyroid issues, mood disorders, learning disorders and head injuries.
Symptoms of ADHD are divided into three subtypes: inattentive, hyperactive-impulsive and combined. As a teenager, a person can experience symptoms that change from one subtype into another, depending on their age and their environment.
In the subtype that is inattentional one may have trouble with paying attention to specifics, making mistakes, or focusing on tasks and activities. People may also struggle in following instructions, paying close attention to detail or remembering information over time. This type of ADHD is most common in young children.
The hyperactive-impulsive subtype of ADHD is less common in young children. They may struggle to understand social boundaries, or waiting their turn during conversations or games. They may interrupt others often or engage in risky behaviors such as taking drugs or engaging in sexually involving in a risky way.
The combined subtype of ADHD is more prevalent in adults and adolescents. People with this presentation have at least six symptoms from each of the inattentive and hyperactive-impulsive categories. As they age, they could lose some hyperactivity but still struggle with restlessness and inattention.
Family History
Parents with ADHD are more likely to pass on the disorder to their children. Genetics alone can't tell whether or whether a child will suffer from the disorder. A person's environment can also determine how likely he she is to have mental health conditions and how they manifest in their life.
A doctor may use a family history of ADHD to determine the possibility that a child is likely to suffer from the disorder. The disorder can affect performance at school and work and cause problems in relationships. If like it has a parent or a sibling suffering from the condition and the doctor recommends testing to determine if medications can help improve the functioning at home and in school.
If a child is diagnosed with ADHD, the doctor can help to manage the symptoms by psychotherapy or medication. If a child is diagnosed with severe ADHD, they may be eligible for a Section 504 or Individuals with Disabilities Education Act plan. Students can enhance their learning capabilities by implementing behavioral training, study skills classroom adjustments, and alternative methods of teaching.
Researchers are committed to finding the cause of ADHD and implementing more effective treatments. Alongside medication treatments, they can also include behavior modification and parent education. Educating both parents and students about the condition is crucial in removing stigmas and increasing awareness, as well as encouraging early diagnosis and treatment.
The way in which ADHD manifests varies by gender, and may appear different for girls and boys. For example, hyperactive-impulsive ADHD is more common in males than in females, while inattentive ADHD is more commonly seen in girls.
A number of studies have shown that families of individuals with ADHD experience a specific pattern in their families and the development histories. This profile is different from non-referred sample of ADHD individuals and may be influenced based on gender. In one study, a clinical routine interview was employed to gather information about the family history and developmental history. Scales of rating were utilized to assess disorder-specific characteristics.
Physical Exam
During a physical examination, the exam doctor will be able to observe how the patient moves as well as look for indications of illness or injury. The exam can be done in many ways and by different people, including nurses, doctors and other health care professionals. It could include observations, palpation and auscultation, which are techniques of touching and listening to the patient. It should be conducted in a calm, comfortable environment, with privacy and, as much as possible, a good amount of silence. The examiner must use appropriate lighting, darken the room for some parts of the examination and offer water and other drinks.
Adults, primary health care providers and mental health professionals often diagnose ADHD. They may refer individuals to a thorough assessment by a psychiatrist or a clinical psychologist. The evaluation may also include interviews with the patient and their family members or friends, as well as colleagues as in addition to a review and review of their medical and mental health histories. The tests typically look at working memory as well as executive functioning (abilities like making decisions and planning), visual and spatial (related to space) and reasoning abilities.
It is important for the person being examined to talk about their symptoms and experiences with the health care professional. The doctor will likely ask questions about the way that the symptoms impact the quality of life and wellbeing of a person at home, at school or at work, as well as relationships and hobbies. The provider will want to rule out any other conditions that can cause similar symptoms, such as learning disorders, mood disorders, head injuries or thyroid problems.
Inattentive ADHD can cause people to have trouble being still and waiting for their turn, or keeping focus on tasks or conversations. They may also forget important details. They can easily be distracted by low priority activities or other events, like a phone conversation, TV show, or a telephone call. They may have trouble organizing their lives, keeping track of deadlines, or being constantly late to appointments. People with hyperactive-impulsive ADHD may fidget or have trouble playing or engaging in leisure activities quietly, blurt out answers before they are finished or have trouble waiting to take turns in games.
In general, those with ADHD are more troubled in the areas of concentration and attention as opposed to hyperactivity and impulsivity. They are more likely to suffer from difficulty with learning and to suffer from anxiety or depression. They are at greater risk of injury due to their impulsive behaviour or lack of organizational skills, and they may have trouble dealing with self-medication (such as taking drugs and alcohol) and addiction to substances.
Psychological Testing
To determine if a patient has ADHD, a patient will be required to undergo psychological testing. This allows healthcare professionals to rule-out cognitive disabilities that may make treatment more difficult and worsen the issue. It also enables them to identify other mental health issues that could be co-existent with ADHD.
Psychological tests could include intelligence, memory and attention and language assessment. They can also comprise an extensive scale that tests for mental disorders like depression and anxiety. In certain instances psychologists will inquire from family members, colleagues, and acquaintances about the individual's behaviour. This is referred to as a collateral interview and it can be very useful in establishing a clear picture of the symptoms.
A patient might also be given a neuropsychological test like TOVA which is comprised of both auditory and visual tests. The person takes the test by looking at two simple geometric figures and then clicking a microswitch every time they see the figure appear. The test tests how well a person is able to pay attention and respond to visual signals.
The clinician will also ask about the individual's work and school performance, and how symptoms interfere with their daily routine. They will be interested in knowing whether they tend to miss appointments, lose items or have difficulty executing on their plans. They will also ask about their relationships, and whether they find it difficult to manage their emotions.
The doctor will then perform a physical exam. The patient should wear comfortable clothes and without jewelry. A medical history will be taken, and the clinician will look for indications of anxiety or depression that may co-exist with ADHD.