Reviewed by Lauren Guilbeault
Do you get distracted, disorganized, or often find yourself disoriented and wonder if attention deficit hyperactivity disorder (ADHD) is the issue? Or you have a hyperactive, fidgety child and suspect it might be ADHD? Before you make any assumptions, you need to understand that ADHD diagnosis is not often that straightforward. Independently, none of the signs of attention deficit disorder is out of the blue. It is normal for people to be disorganized, disorderly, or restless sometimes. Chronic hyperactivity and rambunctiousness do not always mean ADHD. That begs the question, who diagnoses ADHD?
There is no specific medical, physical, or related test for ADHD diagnosis, but many studies suggest that genes play a major role. To know if you or a child is dealing with ADHD, a doctor or a health professional will need to be consulted. Note that it is easy to confuse symptoms of ADHD such as concentration issues, and hyperactivity can be mistaken for other disorders and medical conditions such as learning impairment and emotional troubles, which demand different treatments entirely. A condition is not necessarily ADHD because it shares the same symptoms, so getting a thorough assessment and diagnosis is crucial.
The diagnosis is made only after a comprehensive assessment of the patient’s behavior. They may use various tools, including a checklist of symptoms, questions about past or current problems, or a medical exam to eliminate other potential causes of the symptoms. The process starts formally with the evaluation, which may or may not produce a diagnosis. If there is a diagnosis, it may not be ADHD. The process will start with an assumption of health and general wellness. The assessment will start to uncover exceptions to the assumption. The deviation from healthy norms guides the diagnostic procedure. It also provides solutions to conditions that may be detected and identified, such as ADHD.
Who Can Diagnose ADHD?
Before delving into the criteria used for making an accurate diagnosis, the team of medical professionals can be involved in making a diagnosis.
Parents Or Primary Caregivers
The child’s caregivers are usually the first to notice the signs of hyperactivity and impulsivity. The signs of inattention are harder to notice. While the parent or caregivers may notice the child’s behavior, they usually do not have a guide to compare. Therefore, although the caregiver will notice the behavior, they may not fully understand the issue’s extent.
Even if caregivers or parents are the first to notice, the first responders are usually teachers. The signs of ADHD are most conspicuous and observed in restrictive settings such as school. Children need to be able to sit gently and stay attentive for extended periods. Unlike most parents, however, teachers have a reference point to work with. Teachers regularly monitor many children throughout the day. Therefore, they will quickly notice atypical behaviors.
Teachers are often the first to notice inattentiveness or distraction. It is more noticeable in an academic environment. School-age discovery of inattention is also convenient because it is more apparent in older children. Judging the attention span of young children is more challenging because inattention is developmentally normal for younger children. On the other hand, hyperactive and impulsive behaviors are easier to notice.
Aside from parents and teachers, various medical professionals work to decide if an ADHD diagnosis is a right call:
These are the only mental health clinicians with the required training and expertise in all areas of psychological assessments. Therefore, it is important to find a psychologist who diagnoses ADHD and has experience handling ADHD to administer the complete range of tests required. Due to the significant impact that ADHD can have on a child’s performance, the school district may pay for the testing. Generally, caregivers have the choice of using the school’s psychologist to provide educational testing.
Alternatively, parents can consult a private child psychologist to perform the testing aspect of the ADHD assessment. The specific combination of tests chosen depends on the medical professional and the child’s needs. The tests may include:
- Personality and problem-solving methods
- Intellectual functions
- Present fears and worries
- Executive functions
- Continuous, sustained performance measures
- Test of learning impairment or other psychiatric disorders are sometimes included too
Also called school psychologists, these are trained members of the school staff. Their responsibility is to augment student learning by aiding the efforts of the teachers. These professionals have unique training with a focus on education and psychology. They provide academic, emotional, and behavioral support for students.
Their specialized knowledge and skills help ensure educational success for children. However, they have specific training to help those with special needs. School psychologists can provide education tests, review test scores, and diagnose learning disorders. In some cases, they also provide therapy to help with emotional and behavioral issues. They perform excellently in teams and groups because that is their job. They are often members of the multidisciplinary team that assess a student’s need for special provisions. School psychologists are usually the first mental health professional to attend to a child with a referral for ADHD evaluation. The professionals can help to initiate collaboration with other professionals or specialists if required.
Neurologists are medical doctors who specialize in the diagnosis and treatment of injuries and disorders of the brain and the central nervous system. They can be a vital part of the diagnostic process since ADHD is a neurological disorder. However, they do not usually play an active role. A case where a neurologist may be required is when there are seizures. They may request an EEG to detect the presence of seizures.
However, EEG testing is not always required for routine ADHD diagnosis. Neurologists can request the same tests as other medical professionals, and they can prescribe medications. However, they do not always perform the tests; neither do they provide the needed treatment.
For ADHD diagnosis, the psychiatrist can play a major role. Psychiatrists are medical professionals with a specialty in mental and emotional disorders. They often focus on the use and management of medications. They have the required qualifications and are one of the professionals who can diagnose ADHD. Still, their findings are often the result of clinical interviews alone, instead of more objective test data. Psychiatrists can provide ongoing medication management, but many ADHD patients consult psychiatrists at the first stage of treatment. Once it gets to the effective medication stage, the common practice is to have a family physician take over medication management.
Pediatricians are medical doctors who focus on treating children from birth to 18 years of age. They have an in-depth understanding of the developmental milestones that signal good health in children of different age groups. They are also able to diagnose and prescribe medications for ADHD treatment. Pediatricians can treat any childhood condition, but they may decide to specialize in certain areas.
Pediatricians are physical health professionals, not mental health professionals. However, the nature of their job demands that they study extensively about mental health issues affecting their patients. Although ADHD is not usually an area of specialty for physicians, the general knowledge allows them to evaluate, diagnose, and treat ADHD.
Pediatricians have a good grasp of the science and chemistry of prescription medications. This makes them qualified to prescribe ADHD medications. However, because ADHD treatment is hardly successful with medication only, patients may need a mental health treatment referral. The main benefit of working with a pediatrician is the advantage of working with a professional for an extended period. Families usually have a good relationship with certain doctors. Pediatricians offer the best quality care, especially when they collaborate with a mental health professional.
The Assessment Process
Physicians and licensed mental health professionals can diagnose ADHD. However, getting an accurate diagnosis is a multifaceted process involving many professionals. A typical assessment for adult ADHD diagnosis may take about three hours. Not all mental health professionals utilize the same tools for the diagnostic process. Nevertheless, there are five primary sources of data that can ensure a complete evaluation:
- Detailed interviews with caregivers and teachers
- Information from family members and peers or colleagues
- Medical evaluation and medical history
- Psychological testing
- Symptoms checklist and behavior rating scales
ADHD appears differently in each patient, which means there is a diverse range of measures to aid a successful diagnosis. It is crucial to be transparent and honest with the professional medical handling of the evaluation to provide a precise conclusion.
To get an ADHD diagnosis, the adult or the child needs to show a combination of significant ADHD hallmark signs, including impulsivity, inattention, and hyperactivity. The mental health expert making the assessment will also consider the following factors.
The severity of the symptoms: to get a diagnosis of ADHD, the symptoms need to have adverse effects on the patient’s life. Generally, people dealing with ADHD have major issues in one or more aspects of their lives, such as finances, career, or family responsibilities.
The beginning of the symptoms: because ADHD begins in childhood, the therapist will check how early the symptoms started. For adults, they need to know if they can trace the signs to their childhood.
The duration of the symptoms: to diagnose ADHD, the symptoms need to have occurred regularly for up to six months or more.
When and where the symptoms occur: the symptoms of ADHD need to be apparent in multiple environments, such as home and school. If the symptoms only show in one setting, it is possible that ADHD is not the cause.
You may also need to provide explanations on things like:
- Ease of quitting or procrastinating tasks
- Ease of misplacing things
- Frequency of forgetting appointments and other vital matters
- Trouble with sitting still
- Difficulty with relaxing
- Ease of distraction by things around you
Your medical records are a crucial aspect of the evaluation. If you have not undergone a medical examination recently, the doctor might recommend eliminating medical causes for the symptoms.
Although psychological testing is not utilized as a primary basis for ADHD diagnoses, it may be suggested to back conclusions and ensure a more comprehensive assessment. You may also receive screening for learning disabilities.
Getting A Professional That Can Diagnose ADHD
If you are trying to get professionals around you, an ADHD support group is an excellent place to begin, if any, exist around you. Members of the support groups usually have first-hand information on the professionals around and may be able to recommend a reliable provider. Choosing a specialist may appear confusing, but the following tips can help you find the right person to administer an assessment and provide a diagnosis:
Ask for recommendations: Doctors trusted friends and therapists could provide a referral to a specialist. You can ask questions about the provider and check the recommendation.
Do your research: When you visit the healthcare provider, ask about their professional certifications and academic degrees. Some of these details are often online. Former patients can provide the review you need.
Comfort: You need to feel comfortable with the specialist. Find out if you can be yourself and remain at ease when you visit the office. Ask questions, and be honest with the provided. Sometimes, you may need to talk to multiple specialists before finding a good match for you.
Consider price and insurance: Check how much the healthcare provider will charge and whether your health insurance will cover a part or all of the assessment process. Some insurance policies cover ADHD assessment from one type of specialist but not for others.
It is normal to feel upset or a flood of emotions with a diagnosis of ADHD. However, note that getting a diagnosis is a positive step toward improving your life. Once you are aware of your symptoms, you can start treatment, which means taking control of your life and achieving confidence.
Do not feel like you need to rush into treatment. Give yourself some time to process the result of the assessment before moving on to the next stage. You can take an ADHD assessment test here. When you are ready, you can visit the doctor to know the treatment plan, including therapy, medications, or lifestyle changes.