ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults who are diagnosed with the disorder, identifying ADHD requires a thorough examination by a professional who specializes in the disorder. They'll likely ask about your history and do a physical exam. They'll also rule out any conditions that could be a cause of ADHD such as learning disorders, mood disorders, or thyroid issues.
The doctor will inquire about your childhood behavior as the American Psychiatric Association's guidelines stipulate that ADHD in adults is not diagnosed absent evidence of symptoms from childhood. This could include obtaining your school records and contacting previous teachers and coaches or religious leaders.
Signs and symptoms
You could be suffering from ADHD in the event that you or someone you know is having trouble keeping up at school, work, or home. If they're unable to remember important dates or appointments, or cannot keep their schedules in order it is possible that they are suffering from ADHD. A visit to an expert in health care will help you determine whether this is the case, and If it is the case, what treatments are available.
The symptoms have to be present in at least two settings (school and at home, for instance) and for at least six months to be able to qualify for an ADHD diagnosis. The symptoms must also be impacting your ability to perform for example, in class, in forming close relationships or in working in a team. It is important to recognize that everyone has difficulty staying on track and paying attention at times, but these problems are more severe with ADHD.
To make a diagnosis, your provider will interview you and ask you questions about your behavior and how it has affected your life. The doctors will also look at your family history, as well as any previous psychological or medical tests that you may have taken. They will look for health issues, like thyroid disorders and seizures, which can cause similar symptoms to ADHD.
Your provider will want to be aware of whether your symptoms began in your early years (technically prior to age 12). Your doctor will also want to know how your symptoms are affecting you now and in the past. They'll want to know whether you've been diagnosed with ADHD in the past.
It's a good idea to bring your own list of symptoms to the appointment, particularly if you have them written down. This will help you to recall your symptoms and provide your doctor a complete picture about 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 just recently. These records can help your provider determine if there are other issues, such as depression and anxiety that share similar symptoms to ADHD.
History
In the past, ADHD was thought to be a personality flaw or a sign of laziness. With advancements in diagnosis and treatment the number of children diagnosed with ADHD is increasing and the stigma around this disorder is diminishing.
Sir George Frederick Still gave a series of lectures in 1902 at the Royal College of Physicians. He shared his observations of children who were inattentive and unable to focus. He also noted that these symptoms were more prevalent in boys than girls and were not related to the home environment or intelligence. Still's report is often credited with the first formal recognition of ADHD.
The first edition of APA's mental health guideline, released in 1952, did not include ADHD. In 1955, however, the US FDA approved stimulant drugs that were used as the primary treatment for ADHD. The APA published its second edition in 1968, which included a variety of mental health issues. It included the symptoms of ADHD, although they were still referred to as hyperkinetic reactions of childhood.
The release of the fourth edition of the psychiatric manual in 1994, there was an increase in acceptance and understanding 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 presentations rather than distinct types and states that they are able to change over the course of a person's life.
NICE (National Institute for Clinical Excellence), published guidelines on ADHD in adults in 2008. This was the first time the UK as a whole formally acknowledged with healthcare support and guidance for adults who suffer from ADHD. SIGN (Scottish Intercollegiate Guidelines Network) has also issued advice on ADHD among children. These two documents are the sole official NHS Scotland recommendations regarding the condition. Private organisations and charities have also issued guidance. In recent years, there has been a rise in interest in the biological cause of ADHD. Researchers have started to find the genes responsible. This information could help develop better targeted, more effective treatments in the future.
Physical Examination
An expert in ADHD conducts an extensive assessment to make the diagnosis. If they are a doctor who specializes in mental health (such as a psychologist or psychiatrist) or a doctor who is also trained in child and youth health (a paediatrician), they will want to gather details about the person's past, including the family, educational, work and social history. They might review old school records or interview coaches, teachers and other professionals who know the person. They will ask questions about the symptoms, and how they affect life. They will also examine how the symptoms have changed over time.
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition of the American Psychiatric Association defines the guidelines for diagnosing ADHD in adults and children. 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 typically interview the person regarding their symptoms with the appropriate questionnaire to the specific situation. They will also use different rating scales to look at various aspects of 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 find it difficult to sitting down?" Do you struggle to organize your work or activities?
They will perform an examination of the body. They will look for medical conditions that could be contributing to the symptoms or causing them to get worse, like thyroid dysfunction or hearing or vision issues. They will also inquire with the person about their dietary and lifestyle habits to determine if these may be contributing to the symptoms.
If a person is being evaluated for ADHD at the age of adulthood, they will be asked to fill out an assessment with a partner or a trusted friend. This allows for a deeper understanding of the individual that checklists and questionnaires can't provide. This is particularly beneficial for those suffering from multiple disorders like depression or anxiety. These often co-occur along with ADHD which makes it difficult to recognize the symptoms.
Psychological Evaluation
A health care professional who is evaluating a child for ADHD will ask them a series questions about the symptoms and how they impact their daily life. They also examine a patient's family history and mental health.
They can request copies of the student's reports or school records, particularly those from kindergarten through high school. They may also request copies of prior psychological or neuropsychological tests such as IQ tests and results from learning disabilities assessments.
A psychologist, psychiatrist or social worker usually will conduct the interview portion of an adhd diagnostic assessment. They may also interview friends, family members and teachers as well as employers. It is crucial to conduct thorough evaluations because those with untreated ADHD are susceptible to serious issues that include financial problems (impulsive spending), marital difficulties or failure at colleges or other educational institutions.
During an interview, a doctor may ask the patient complete standardized behavioral ratings scales which are designed to help identify ADHD symptoms. These questionnaires are based on research that compares the behaviors of people with ADHD and those without the disorder. These ratings do not constitute an official diagnosis of ADHD however they are an important aspect of the evaluation process.
It is crucial to evaluate the individual to determine if they have other conditions that could exhibit similar symptoms to ADHD. These include sleep disorders, mood disorders and substance abuse, and also medical ailments such as thyroid disease or brain injuries. Those conditions are more likely to respond to specific treatments, therefore it is crucial that a proper diagnosis is made and that the appropriate treatment is provided.
A child or adult 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 environments, such as school, home, or work. The symptoms should also significantly interfere with the functioning of their lives. Typically, the symptoms must have started in childhood, and a psychiatrist must be able to determine that the disorder is not caused by a mental illness or comorbid condition.