Untreated ADHD can impact many aspects of life. ADHD may cause judgment for behaviors, and adults with ADHD that is left untreated may struggle with deadlines, focus, and relationships. An ADHD assessment is key to an ADHD diagnosis and treatment. An ADHD evaluation may also identify whether an individual is living with co-occurring conditions, such as an anxiety disorder. Below, we discuss ADHD assessment for children, adolescents, and adults, and how to manage symptoms.
The importance of ADHD assessment and evaluation
What is ADHD?
Previously called attention deficit disorder (ADD), attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can cause significant impairment to an individual’s mental health, physical well-being, and ability to function. Difficulties maintaining attention, filtering out distractions, making careless mistakes, and controlling impulsive behavior can be challenging, but an ADHD test or assessment may be the first step toward diagnosing ADHD in adults and treating the symptoms you have. If you're an adult considering assessments to diagnose ADHD, you're not alone. Over 360 million adults worldwide experienced symptoms of ADHD in 2020.
ADHD is one of many mental health conditions mentioned by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and an accurate diagnosis may help you find treatment, services, benefits, controlled trials, and recommendations for support groups and coping strategies. Note that this article focuses more on ADHD in adults than on an ADHD diagnosis in teens.
It can be important to speak to a healthcare provider who can provide an accurate diagnosis after a thorough diagnostic process. This can determine whether you are living with ADHD, an anxiety disorder, or any medical disorders. Keep in mind that, for a child’s diagnosis, the child’s behavior must be affected by symptoms in two or more settings.
Behavioral and mental health symptoms
A common mental health myth about ADHD is that only children can experience ADHD, which is not the case. Although individuals might have their first mental health symptoms as a child, adults can also struggle with hyperactivity, impulsivity, and difficulty with focus. Many cases of ADHD persist into adulthood, and not all children get diagnosed early. Undiagnosed ADHD symptoms can interfere with an individual's ability to keep a job, make and manage interpersonal relationships, spend money wisely, and take care of physical health, among other activities. Being diagnosed with ADHD may help you understand which support tools will be useful in your life.
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Symptoms in adults & children
When left untreated, symptoms and signs of ADHD may fluctuate throughout the day, depending on demands and stimulation from a person's environment or relationships. Often, adolescents, adults and children diagnosed with ADHD have trouble paying attention, organizing their time and space, controlling their emotions (using emotional regulation skills), and finishing projects they’ve started. Individuals with ADHD may feel restless, have difficulty unwinding, and experience hyperactivity, which can cause them to feel like they’re being driven by a motor. Children may have difficulty waiting their turn and frequently interrupt conversations. They may also experience inattentive symptoms, which can affect a child's behavior and ability to pay attention in class. If someone lives with a co-occurring anxiety disorder or any medical disorders, they may experience other symptoms and life challenges as well.
Although many people experiencing ADHD might have difficulty concentrating on certain projects, they can exhibit a strong, sustained focus when they’re engaging in an activity that interests them. For example, they may abandon a school-related task to hyper-focus on and pay close attention to stimulating activities, such as video games, or other activities they feel passionate about.
ADHD in children and adolescents
An adolescent’s or child’s behavior and symptoms may indicate which type of ADHD they have: predominantly inattentive, predominantly hyperactive-impulsive, or combined presentation. School performance, family reports, and symptoms experienced in two or more settings may all play a part in the diagnostic process. A thorough diagnosis can also distinguish between ADHD and other conditions, like an anxiety disorder that has been left untreated, which may share some symptoms with ADHD.
Causes
ADHD is thought to be partially caused by low levels of dopamine and norepinephrine in critical areas of the brain responsible for controlling behavior and attention. ADHD is a mental health and cognitive condition that may require treatment to be managed. Family history can also play a part in ADHD, as receiving an ADHD diagnosis is 74% hereditary or reliant on genetic factors. Individuals with family members who live with ADHD are at an increased risk of developing ADHD themselves. Many people may not receive a diagnosis of ADHD until they are teens or adults due to stigma or misunderstandings about how ADHD functions.
Diagnosing ADHD attention-deficit/hyperactivity disorder (ADHD)
To receive a proper diagnosis of ADHD, an individual typically must consult with a licensed mental health professional who can provide a comprehensive ADHD evaluation. The healthcare professional will likely administer ADHD screenings, a physical exam, and other ADHD assessments to ensure there is not a medical condition or another mental health condition causing symptoms to arise. The effects of certain health concerns (e.g., a physical health condition that causes hearing impairment) can mimic ADHD symptoms. Additionally, common symptoms of depression (a mood disorder) and anxiety can resemble ADHD symptoms.
What happens after an ADHD test?
Once the provider has completed their assessment and ruled out a physical health condition, they may then compare the individual’s symptoms with the diagnostic criteria for ADHD. There typically must be at least five symptoms present (of the nine symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition or DSM-5)for healthcare providers to diagnose ADHD. According to the Centers for Disease Control and Prevention (CDC), children up to age 16 may need to have six or more symptoms of inattention.
The medical community recognizes three types of ADHD that an adult may have:
- Primarily inattentive (ADHD-PI)
- Primarily hyperactive-impulsive (ADHD-HI)
- Combined type (the most common form of ADHD)
A healthcare professional may include one of the above specifiers when providing an ADHD diagnosis (e.g., “ADHD-predominantly inattentive presentation”; “ADHD-combined presentation”). They may also screen for comorbid neurological, developmental, or mental health disorders, such as autism spectrum disorder or seizure disorders, as part of an ADHD assessment.
How to get tested for ADHD
People may seek an ADHD diagnosis when their ADHD symptoms interfere with their lives in one or more areas. You may have tried several techniques for time management, getting organized, impulsive behaviors, or other areas without finding a potential strategy. In these cases, getting an ADHD diagnosis could be beneficial. You might be able to find ADHD assessments in the following ways:
- Through an ADHD, hyperactivity, or neurodivergence clinic
- Through an ADHD neuropsychologist skilled in conducting an ADHD assessment
- With a psychiatrist who specializes in ADHD
- With your therapist
- Through your school or university
- Through a vocational program
If you think you may have ADHD, seeking a formal ADHD diagnosis from a qualified healthcare provider could help you understand your symptoms. Your ADHD test or assessment results may be given as a written report or through an online portal. You might be able to show it to doctors, therapists, and family to get services that benefit you.
Those who perform assessments to diagnose ADHD may be psychiatrists, neuropsychologists, psychologists, or another type of medical professional. In some cases, a family doctor or primary care physician may be able to provide a diagnosis as well after ruling out a physical health condition. Some doctors might label themselves "ADHD specialists." Depending on their role, they may or may not prescribe medication or additional services after your ADHD diagnosis.
Some people worry that an ADHD diagnosis means they'll be labeled or judged. They might think their ADHD symptoms are a personal flaw. However, these thoughts could lead to mental burnout and depression. Seeking a full assessment doesn't necessarily guarantee an ADHD diagnosis, and it may be used to understand your symptoms more profoundly.
Online ADHD test for adults
If you're curious whether you have ADHD, you can take an ADHD assessment online as a first step. An ADHD online assessment does not substitute for a doctor's diagnosis or professional services. However, it may help push you toward a formal ADHD diagnosis if you're unsure. It could also help you cope with your feelings and validate your experiences. Consider bringing your screening results to your appointment with your provider. There are several different online ADHD tests available, including the Adult ADHD Test from the Attention Deficit Disorder Association or the ADHD test and assessment diagnosis criteria from the CDC.
Who can perform an ADHD evaluation?
An ADHD evaluation may be performed by a psychiatrist, psychologist, clinical social worker, or another behavioral health professional. A medical doctor (e.g., your primary care provider) may also be able to perform an ADHD evaluation for diagnosis. Some insurance companies may require that you visit a psychiatrist for certain forms of treatment, such as ADHD medications.
Many providers on BetterHelp now accept major insurance carriers. In many states, certain therapists on BetterHelp may be in-network with certain insurance plans. Coverage depends on your plan, provider, and availability.
When sessions are covered, members typically pay an average copay of about $19 per session. Check your in-network status on the BetterHelp site. Coverage varies by state and provider availability.
Adult ADHD evaluation
While every doctor may have a different evaluation process, there are general steps you might expect when going to your assessment to diagnose ADHD. Prepare for your appointment by writing down your concerns and questions. Your doctor may request your medical records before your appointment. If you see a physician, you may check your blood pressure and heart rate or get blood assessments done.
During an ADHD assessment, your doctor may interview you to gather information about your symptoms and medical history. They might ask how your ADHD symptoms affect your daily life, work, and relationships and how long you've been experiencing them. This may help them determine whether you have ADHD. Bring your notes and have an open conversation with your doctor.
After an interview about your potential symptoms of ADHD, you might also partake in assessments involving IQ, memory, inkblots, mental health, sensory sensitivities, and ADHD symptom self-reports.
A frequently utilized assessment for ADHD screening is the Adult ADHD Self-Report Scale, which measures the frequency with which an individual experiences 18 different potential ADHD symptoms, like difficulty concentrating or feeling restless or fidgety. The inventory consists of a series of questions—for example, “How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?”—that require an answer of “Never”, “Rarely”, “Sometimes”, “Often”, or “Very Often”.
Several conditions can present with symptoms similar to ADHD, such as depression and anxiety. There are comorbid conditions associated with ADHD as well, such as autism and dyslexia. Additional medication or therapy may be recommended if a comorbid condition is identified.
When should I get tested for ADHD?
If you're unsure if you should get an ADHD assessment, ask yourself about your ADHD symptoms. For example, if you're experiencing hyperactivity frequently, you might ask yourself some questions like the following:
- Do you struggle with hyperactivity during work, school, or at home?
- Do you experience hyperactivity that causes overwhelm or anxiety?
- Does this hyperactivity impact your ability to function?
Suppose, however, you feel that you have a handle on disorganization, distractibility, or impulsiveness and don't think you would benefit from a formal ADHD diagnosis or treatment. In that case, you do not have to meet with a provider.
However, if you feel that your ADHD symptoms are getting in the way of your ability to be successful and causing you significant stress, a professional ADHD screening may allow for more treatment opportunities and accommodations. You might also feel relief to determine the name of what you have been experiencing. Many research-backed treatments can minimize the impact of ADHD on your life.
You may be able to receive ADHD accommodations for work or school under the Americans with Disabilities Act, as ADHD is considered a disability. For example, you may be granted extra time on testing, quiet testing environments, or assistive technology. For more information about ADHD accommodations, you may visit the Health and Human Services website or the National Institute of Mental Health site.
Why proper assessment matters
Proper assessment matters because treatment can be tailored to the particular mental health concerns a person is struggling with, whether that’s an anxiety disorder, depression, substance use disorder, ADHD, or behavioral problems. Effective treatment can promote improved life outcomes compared to a situation in which mental health disorders are left untreated.
What to expect during an ADHD assessment
During an ADHD assessment, a healthcare provider typically uses standardized tools to determine whether a diagnosis is appropriate, playing close attention to the official diagnostic criteria. These tools usually involve questions about family history, the child’s or adult’s behavior, and whether symptoms are present in two or more settings. A medical exam may also be recommended to rule out certain medical disorders.
Differential diagnoses: Ruling out other conditions
Many conditions have overlapping symptoms with ADHD. Some of these include the following:
- An anxiety disorder like generalized anxiety disorder (GAD)
- Certain medical disorders
- Depressive disorders
- Sleep disorders
- Autism spectrum disorder (ASD)
Treating ADHD in adults
ADHD symptoms may cause difficulty with daily habits and lifestyle, which is why it’s not recommended to be left untreated. A comprehensive treatment plan can help most adults with the practical, emotional, and cognitive challenges ADHD symptoms often present. Eating habits focusing on protein, fruits and vegetables, and whole grains, combined with regular exercise, may decrease the severity of ADHD symptoms you experience. Other lifestyle challenges, like getting plenty of sleep and practicing coping skills during times of stress, can also be helpful.
However, the most effective treatment known for ADHD combines multiple strategies. ADHD treatment often includes stimulant medication, cognitive-behavioral therapy (CBT), and eating and exercise adjustments. Your doctor or mental healthcare provider may give you specific recommendations to help manage your ADHD, particularly if you live with a co-occurring condition like an anxiety disorder.
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Medication options
Stimulant ADHD medication is effective in up to 70% of cases of adult ADHD. Stimulants may work by increasing the amount of dopamine and norepinephrine in the brain. They are often monitored due to their potential for dependency. You may also take these ADHD medications daily. Often, doctors will start these medications at the lowest dose and monitor clients for side effects until the optimum dosage is reached.
Support from a mental health professional
If you're considering online therapy, evidence has shown that online therapy can be effective in treating ADHD symptoms. A literature review of 11 articles pointed toward improved outcomes for participants who sought treatment options online. Participants were also satisfied with the delivery mode for this type of treatment. Online therapy also effectively treats mental health conditions, such as anxiety and depression. If you're interested in internet-based therapy, platforms like BetterHelp can connect you with a licensed, experienced therapist to help reduce any negative impacts on your lifestyle and relationships.Getting started with BetterHelp is simple:
- Take a short questionnaire. Answer a few quick questions about your goals, preferences, and the type of therapist you’d like to work with.
- Get matched quickly. In most cases, you can be matched with a licensed provider in as little as 48 hours.
- Start therapy on your terms. Schedule sessions by video, phone, or live chat, and join from anywhere you have an internet connection.
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Find your matchTakeaway
Being evaluated for ADD/ADHD (attention-deficit disorder, now referred to as attention-deficit/hyperactivity disorder) can be a proactive step if you're experiencing symptoms or have concerns about your child’s behavior. If you receive an ADHD diagnosis from a professional, you might begin to use the tools available to minimize the impact of symptoms on your life, career, and relationships. When left untreated, ADHD symptoms can contribute to mental health challenges, particularly if they co-occur with other conditions, like an anxiety disorder. Don’t hesitate to seek the support you deserve. Help is available in person or online.