Initial Assessment for ADHD
What is ADHD
Attention deficit hyperactivity disorder (ADHD) is the preffered medical term for the biologically-based neurological condition once known as ADD. The symptoms will fall into one of three quantifying categories:
- Primarily Inattentive- disorganization, lack of focus, forgetfulness
- Primarily Hyperactive-Impulsive- Hyper, constantly on the move
Inattentive ADHD children can appear spacey and apathetic with adults being diagnosed with mood disorders and anxiety. People with this form of ADHD often lose focus and are considered forgetful. Some may call them poor listeners as they appear to not hear what people are saying to them or they will completely space out of a conversation.
Symptoms people who suffer from Hyperactive-impulsive ADHD experience are what most think of when looking for symptoms of ADHD. They may appear to bounce of the walls and have unrestrained amounts of energy. But, this description only fits a small percentage of ADHD sufferers.
What ADHD Looks Like in Children
It’s normal for children to occasionally forget things, daydream in class, act without thinking, or get fidgety when things are “boring”. But, when those signs are coupled with inattention, impulsivity and hyperactivity, that may be a sign the child is suffering from ADHD. Some children will be constantly on the move, never listen, never follow instructions, blurt out inappropriate comments at inappropriate times and be labeled a troublemaker or criticized for being lazy and undisciplined. However, they may have ADHD.
ADHD makes it difficult for people to inhibit themselves and this results in spontaneous responses– ranging in everything from speech to motion to attentiveness. Signs and symptoms of ADHD will typically appear before age seven, though it can be difficult to distinguish from typical kid behavior. If the signs and symptoms only appear in some situations, chances are it’s not ADHD. On the other hand, if the symptoms are present across situations, like home, school and play, it may be time to take a closer look.
What ADHD Looks Like in Adults
ADHD is typically considered a “child’s condition” and, as such, the diagnostic tools often focus mostly on children since ADHD treatment in adults is a relatively new science. But, ADHD affects approximately 10.5 million adults in the US, and it’s a real medical condition that can affect more than just the daily life in the workplace. Symptoms can cause issues at home, at work and in social settings throughout the day.
The primary difference between ADHD in children and in adults is how the symptoms manifest themselves. In children, it’s hyperactivity, inattention and impulsiveness. Children may manifest this by moving from game to game while adults manifest this by jumping job to job. Adults may make careless mistakes again and again, like leaving things in the oven for too long or never remembering to shut off the lights. Mundane daily tasks may be started but never finished as they quickly lose focus again and again. Adult ADHD sufferers may lose small items frequently, needing their spouse, significant other or coworkers to help them search for their keys, wallet and cell phone.
Some adults may have a hard time staying focused on the conversation, asking people to repeat themselves multiple times or missing pertinent information. Deadlines may be missed continuously and the adult may avoid preparing reports at work, deciding to push it off for a future date. Even appointments or important meetings may be forgotten– even if the meeting was placed on the calendar and reminders have been sent out. During routine tasks, adult ADHD sufferers may be easily distracted by their own thoughts, and often be caught “daydreaming”.
Adult ADHD sufferers may be described as “constantly in motion”, feet always tapping, fingers fidgeting, or possibly away from their desk walking around as they can’t remain seated. Their feelings of restlessness may overpower their need to finish working.
During their free time, adults suffering from ADHD may be unable to participate in leisurely activities quietly, preferring to play loudly. Going out to eat can be a challenge as they cannot sit still in the restaurant. Bathroom breaks may be frequent and half-eaten food taken home in to-go boxes as they spent too much time moving around rather than focusing on the conversation and task at hand, eating. When they do participate in conversations, friends, family and coworkers may consider them a “motor-mouth”, constantly talking non-stop or blurting things out and finishing other people’s sentences.
Going to the post office or the grocery store can also be a challenge. It’s hard for them to wait their turn at the checkout line, they may even be considered impatient with foot tapping and sighing. But this will go beyond typical impatience, it’s a consistent thing that doesn’t change no matter how long the line actually is.
For both children and adults, we use and interview with family and partners to assess ADHD and its severity.
Preparing for the Interview
Any evaluation for ADHD needs to be comprehensive and multidimensional, going through attitude and behavior in the home, school or work settings and social functioning. The purpose of the initial ADHD assessment is to determine if ADHD may be contributing to an individual’s challenges.
During our comprehensive assessment for ADHD, we will conduct in-depth interviews with both the patient and their support system. For children and teens, these interviews can include the parents and caregivers. For adults, spouses or partners will be interviewed.
The interview will include a thorough history of the patient’s core symptoms. Questions may include:
- What are the specific symptoms?
- When are the symptoms present?
- Do they occur in different situations? Or do they occur in the same ones?
- At what age did the symptoms start?
- Are the symptoms typically pervasive? How long do they last?
- Does anything seem to lessen the symptoms?
- To what degree do the symptoms interfere with routine and functioning?
Other questions will involve the biological and social history of the patient. This history will include prenatal and early developmental history and milestones and other medical history. We will also review family history to uncover any incidents of violence, disruption or separation.
We also want to address any co-concerns that may appear alongside ADHD. We will also screen for depression, anxiety, learning disabilities, anger management issues, and other behavioral issues.