ADHD Diagnosis - How an Expert Makes a Diagnosis
For adults diagnosing ADHD requires a thorough assessment by a specialist in the disorder. They'll likely ask you about your history and conduct a physical examination. They'll also rule out conditions that could be a cause of ADHD like learning disorders, mood disorders or thyroid conditions.
The doctor will also inquire about your childhood behavior as current American Psychiatric Association guidelines state that adults with ADHD cannot be diagnosed without evidence of signs from childhood. This includes finding school records and getting in touch with former teachers, religious leaders, or coaches.
Symptoms
You could be suffering from ADHD in the event that you or someone you know has trouble keeping track of time at work, school or at home. If they can't remember important dates or appointments, or aren't able to stay organized it is possible that they are suffering from ADHD. A health care professional's assessment can help you determine if this is the case, and if so what the treatment options are.
The symptoms must be evident in at least two environments (school and at home, for instance) and for at least six months to meet the criteria for an ADHD diagnoses. They should also seriously interfere in your ability to function in certain ways, like doing well in classes, forming close bonds, or working in teams. It's important to understand that everyone has problems staying focused and organized at times However, these issues are more serious for those with ADHD.
Your doctor will ask you questions about your behavior, and how it has affected your life. The providers will also look at your family history, and any previous medical or psychological tests that you may have taken. They will search for health issues like thyroid issues and seizure disorders that can cause the same symptoms as ADHD.
Your doctor will ask you whether you've ever experienced symptoms during your childhood (technically prior to the age of 12). Your provider will also want to know how your symptoms affect 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 aid in remembering the symptoms and provide your doctor with a an accurate description of how your symptoms impact you. You may also bring old records, such as old reports or performance evaluations. These documents can help your doctor determine if ADHD is a recent problem or has been present for a long time. They can also help your doctor determine if you have other issues like anxiety or depression which can have the same symptoms as ADHD.
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In the past, ADHD has been viewed as a character flaw. But, with advancements in diagnosis and treatments increasing numbers of children are being diagnosed and the stigma around the disorder is fading away.
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 unable to pay attention or who were unable to focus. He also observed that these signs were more prevalent in boys than girls and were not related to intelligence or the environment in which they lived. Still's report has been considered to be the beginning of formal recognition of ADHD.
The first edition of APA's psychotherapy guideline, published in 1952, didn't include ADHD. In 1955, however, the US FDA approved stimulant drugs which were the main treatment for ADHD. In 1968, the APA published its second edition, which included a list of mental health conditions. It also included symptoms of ADHD even though they were still referred to as hyperkinetic reactions of childhood.
With the release of the fourth edition of the psychiatric manual in 1994, there was a greater awareness 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 says that they may change over the course of a person's life.
NICE (National Institute for Clinical Excellence) has released guidelines on ADHD in adults in 2008. This was the first time that the UK as an entire recognized adults with ADHD and provided them with funding, healthcare assistance and guidance. SIGN (Scottish Intercollegiate Guidelines Network) has also issued advice on ADHD in children. These two documents are the sole official NHS Scotland guidelines on the condition. Private organisations and charities have also produced guidance. In recent years, there has been a rise in interest in the biological causes of ADHD. Researchers have begun to find the genes responsible. This knowledge may help to create better, more targeted treatments in the near future.
Physical Exam
An expert in ADHD conducts an extensive assessment to determine if they have the diagnosis. They will collect information from the past of the patient, including their family, educational and employment history, as well as their social history. They may review the old school records, or speak with teachers, coaches and other professionals who know the person. They will ask questions about the symptoms and how they affect daily life. They will also look at how the symptoms have changed over time.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, lays out the criteria for determining 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. A questionnaire tailored to the situation will be administered by the specialist to interview the patient about their symptoms. They will also use different ratings scales to assess different aspects ADHD symptoms. Some of these ratings are built on the Brown Attention-Deficit Disorder Symptom Assessment Scale for Adults, while others are based on a number of other criteria and include questions like "Do you find it difficult to sitting down?" and "Do you find it hard to manage your time or tasks?"
They will conduct a physical exam. They will check for any medical conditions that could be creating the symptoms or causing them to get worse, like thyroid dysfunction or vision or hearing issues. They will also inquire with the person about their dietary and lifestyle habits in order to determine if these could contribute to symptoms.
Someone who is being evaluated for ADHD as an adult may be asked to fill out the questionnaire with their partner or another close friend. This will help to gain the personal insights that questionnaires and checklists are in no way able to provide. This is especially beneficial for those suffering from multiple disorders like depression or anxiety. They often co-occur with ADHD and can make it difficult to identify the symptoms.
Psychological Evaluation
A health professional who is evaluating a child for ADHD will ask them a series of questions about the symptoms and how they affect their daily lives. They also examine the history of the patient's family and their mental health.
They may ask for an original copy of the student's report card or school records, particularly those from kindergarten to high school. They may also ask for copies of any previous neuropsychological or psychological testing, including results from IQ tests and learning disabilities assessments.
A psychiatrist, psychologist or social worker usually is the person who conducts the interview portion of an adhd diagnostic evaluation. They might also interview friends, family members and teachers as well as employers. It is essential to have a comprehensive evaluation because people who are not treated for ADHD are susceptible to serious issues such as financial issues (impulsive spending) or marital issues, as well as failure in college or other educational institutions.
During the interview, a doctor will typically ask the patient to fill out standardized behavior rating scales designed to help identify ADHD symptoms. These tests are based on research that compares the behavior of those suffering from ADHD with those of those who do not suffer from the disorder. These scores are not an indication of ADHD however they play an important element in the process of evaluating.
It is crucial to assess the individual to determine if there are other conditions that could have similar symptoms as ADHD. These include mood disorders, sleep disorders and substance abuse and also medical ailments such as thyroid diseases or brain injuries. Those conditions are more likely to respond to specific treatments, therefore it is crucial that a correct diagnosis is made and the correct treatment is given.
To be able to be diagnosed with ADHD, either a child or an adult must meet the requirements of the Diagnostic and Statistical Manual of Mental Disorders. They must display symptomatic behavior in at least two settings that include home, school, and work. The symptoms must severely hinder the normal functioning of their lives. The symptoms must have manifested in childhood, and a psychiatrist must verify that the disorder was not caused by an illness of the mind or other comorbid conditions.