Assessment and Diagnosis

A clinical assessment is different than establishing an "administrative diagnosis". The latter may be needed if you are going to seek accommodations from a school or workplace, or for testing for academic admissions. An administrative diagnosis is usually done by a licensed psychologist with standardized psychometric tests. It can be costly and time consuming. The advantage is that it also tests for many other dimensions of intellectual functioning, including learning disabilities. An administrative diagnosis is often not very definitive for ADHD itself. You will have to have another provider do an administrative diagnosis, but I can recommend people that you can ask.

Another situation can arise if you are already decided about doing a trial with medication. Often a physician who is going to prescribe will want to do their own assessment. I can offer some supporting information, but it may not save you much time or effort. In those cases I sometimes recommend going ahead and doing an assessment for a medication trial with the prescribing physician. After you have shown a physician that you are a candidate for medication, my clinical assessment can often be simplified.

A clinical assessment is useful to answer the question of whether or not you have ADHD and to outline treatment options that might make sense. This is the most important goal of an assessment — to lay the ground for you to make a plan to live most successfully with ADHD.

To do a clinical assessment usually takes two or more meetings. The first is for 75 minutes and the second and subsequent meetings are 50 minutes. The assessment usually includes a formal screening test for symptoms of ADHD in adults, (the "Brown ADD scales for Adults"), and several clinical interviews.

The diagnosis is most reliable when it is founded on an in-depth history of symptoms from childhood to the present. It can also be helpful to get an independent view of your history. If a parent or someone who knew you as a child is available, it might be very helpful to have me speak with them. Sometimes an interview in person or on the phone with a spouse or partner can also provide a valuable perspective. I will also look at school records from your childhood if you have those available.

Occasionally just two meetings are not enough to make a definitive diagnosis and we are left with needing to keep open another "rule out" diagnosis. If you are in ongoing treatment we will refine the diagnosis over time.

If indicated, you may be referred for medical evaluation to rule out medical problems that can mimic ADHD or make it worse. If you have not had a physical exam in some time, it might be a good idea to get a routine check up now.

There are a number of online screening tools for adult ADHD that you can look at to see if it makes sense to pursue this further. A screening gives you an idea of whether ADHD is a likely possibility.

For more information on getting an assessment, call or e-mail from the contact information page.


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