How to get an ADHD evaluation as an adult [2023 guide]
Today, you will learn about the steps you can take to get evaluated for ADHD as an adult.
These include:
How to get an evaluation
What the evaluation process looks like
Steps to take after an evaluation
My evaluation story
In 5th grade, my parents and teachers became concerned.
I consistently lost or forgot my belongings, had difficulty following verbal directions, and appeared to always be, “with his head in the clouds.”
I underwent a comprehensive evaluation. The results showed my reading, writing, and executive functioning skills were well below grade level and there was a high likelihood that I had ADHD.
Luckily, I worked with a phenomenal specialist who taught me the skills I needed to be more successful.
Later in life, I took the time to learn how my brain works and develop systems to keep me organized.
Without undergoing an evaluation, I worry that I would have been perceived as simply “not smart” by my teachers, peers, and myself.
If you are an adult who believes might have ADHD, read on to learn exactly how to get an ADHD evaluation.
Let’s dive in.
How do I know if I need an evaluation?
As a child, if school was extremely difficult for you, you lost friends due to your impulsive behavior, or a teacher once said, “You might have ADHD”, these could be signs.
As an adult, have you experienced overwhelming life events like:
Getting fired from your job or put on an improvement plan
Failing classes or being put on academic probation
Struggling with impulsive behaviors in relationships leading to friction
Missing bill payments or struggling with personal financial management
Quite often, adults with ADHD are not aware of their symptoms. According to WebMD,
Several studies suggest less than 20% of adults with ADHD are aware that they have it.
If other people mention that you are:
Consistently late
Are disorganized
Or do not pay attention while they are talking
It might be time to find out if you have ADHD.
Where do I start?
Begin by educating yourself about ADHD. If you are reading this blog, you are already starting the process!
There are many misconceptions about ADHD and because very few adults have an ADHD diagnosis, finding information can be difficult.
Later on in this article, I outline common symptoms of ADHD.
What is the first step?
The first step typically involves a conversation with your healthcare provider.
Talk to your healthcare provider to determine if your symptoms fit the adult ADHD diagnosis.
If your symptoms align, ask your doctor for a list of specialists who can conduct a comprehensive evaluation.
You can also use our comprehensive directory of ADHD-friendly specialists and filter by "assessment" to see if someone there feels like a good match.
How do I find a specialist that can conduct an evaluation?
Comprehensive evaluations can be performed by licensed professionals such as:
Psychiatrist
Neurologist
Primary care physician
Clinical psychologist
Clinical social worker
You can also contact your insurance company and request a list of professionals who conduct adult ADHD evaluations.
Regardless of the choice of a specific healthcare provider, it's crucial to inquire about their background and experience in dealing with adults who have ADHD.
Questions you can ask a prospective evaluator:
What metrics or criteria do you use to diagnose ADHD in adults?
How do you differentiate ADHD from other conditions that may have similar symptoms?
What is your experience in evaluating ADHD in the adult population?
Do you use any specific assessments or tools for ADHD diagnosis?
How do you keep up-to-date with the latest research and guidelines on adult ADHD evaluation?
Often, the professional's depth of understanding and expertise in adult ADHD holds greater significance in ensuring an accurate diagnosis and the development of an effective treatment plan than the specific type of professional degree they hold.
Competent practitioners typically offer details about their training and their history of working with adults with ADHD.
Suppose a healthcare provider hesitates or declines to provide such information in response to reasonable inquiries. In that case, it may be prudent for the individual to consider seeking services from a different professional.
Can ADHD be self-diagnosed?
The short answer is no.
There is no single evaluation tool used.
ADHD cannot be diagnosed from a quick chat with a doctor or a quick checklist.
Guidelines for adult ADHD diagnosis are created by the American Psychological Association and outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
There are adult ADHD self-rating scales that can be found for free, online, and completed on your own.
These rating scales are not evidence-based and should not be used to self-diagnose.
However, if you feel like you might have ADHD as an adult, this can be a good starting point.
You can fill out the Adult ADHD Self-Report Scale (ASRS) to determine if your difficulties align with common ADHD symptoms.
What are the common symptoms?
There are three types of ADHD outlined in the DSM-5.
The three types are
ADHD predominantly inattentive
ADHD predominantly hyperactive
ADHD combined
Below is a list of inattentive and hyperactive symptoms as outlined in the DSM-5.
Inattentive ADHD Symptoms
Case study: Jane
Jane often finds herself daydreaming during meetings and struggles to complete tasks on time. She frequently misplaces her phone and keys, and has a hard time organizing her workload. Despite being intelligent and capable, she finds it challenging to focus on details, leading to avoidable errors. Her inattention affects both her work performance and daily life, yet she isn't hyperactive or impulsive.
Hyperactive ADHD Symptoms
Case Study: John
John constantly fidgets during conversations and meetings, finding it almost impossible to sit still. He often interrupts others and has a habit of blurting out answers before questions are completed. He takes on multiple tasks but struggles to finish them, as he quickly loses interest. Despite his energy and enthusiasm, his hyperactivity makes it difficult to focus and complete tasks in a structured manner.
ADHD Combined Type
Case Study: Sarah
Sarah finds it difficult to sit through an entire meeting without fidgeting or daydreaming. She often starts multiple projects with enthusiasm but struggles to see them through to completion. In conversations, she both zones out and interrupts others, making it challenging to sustain a coherent dialogue. Her disorganization extends from her workspace to her time management. Sarah exhibits both inattentive and hyperactive-impulsive symptoms, affecting various aspects of her life.
Who qualifies for an adult ADHD diagnosis?
A healthcare professional typically establishes an ADHD diagnosis after assessing three areas:
quantity and severity of symptoms
the duration of these symptoms
the extent to which they impact daily life
This evaluation considers their influence on different aspects of one's life, including home, school, or work performance, relationships with friends and family, and participation in various activities. According to WebMD,
It’s estimated that adult ADHD affects more than 8 million adults (or up to 5% of Americans).
It's worth noting that it's feasible to fulfill the diagnostic criteria for ADHD even in the absence of hyperactivity and impulsivity symptoms.
What happens during an adult ADHD evaluation?
While practitioners may take different approaches, a comprehensive evaluation is needed in order to fully assess whether or not someone has ADHD.
A comprehensive evaluation will include:
A diagnostic interview
Participation of loved ones
Standardized behavior rating scales
Screening for other psychiatric disorders
And a medical examination
The comprehensive evaluation begins with a diagnostic interview of adult ADHD symptoms.
Diagnostic interview
The specialist will ask a standardized set of questions in order to gain a detailed sense of your struggles.
The goal of the diagnostic interview to is determine which, if any, ADHD symptoms are present by learning about your personal history and assessing your difficulties today.
Your childhood plays a key role in the diagnosis process. ADHD symptoms must have appeared before the age of 12.
In fact, according to Healthline,
Symptoms of ADHD typically first appear between the ages of 3 and 6.
These symptoms may remain the same or have evolved as you transition into adulthood.
Participation of loved ones
For an accurate evaluation, it's crucial for the clinician to interview an individual's close associates, such as a spouse, family member, or partner, who can provide additional insights.
This process aims to gather more information, not question the individual's honesty.
Many adults with ADHD may have hazy recollections of their past, especially their childhood. Therefore, clinicians may request parents to complete an ADHD profile detailing childhood behavior.
Furthermore, adults with ADHD might not fully grasp how their behaviors affect themselves and others.
When assessing married or cohabitating couples, interviewing them together can help the non-ADHD partner better understand the impact of ADHD symptoms on the relationship.
This can pave the way for relationship improvement post-diagnosis.
If direct interviews are not feasible, having associates complete symptom checklists is a viable alternative.
Standardized behavior rating scales
Your practitioner can use one or more standardized behavior rating scales during the comprehensive evaluation.
The questions use questions, based on research, that compares the behaviors of adults with ADHD to adults without.
The scores on the rating scales are not used specifically to diagnose. Instead, scores are used to ensure other parts of the evaluation are accurate and objective.
Often, the person being evaluated and their spouse or co-living partner will complete separate rating scales.
Diagnostic interview: screening for other psychiatric disorders
ADHD often occurs alongside other psychiatric disorders. According to CHADD,
more than two-thirds of people with ADHD have one or more co-existing conditions.
Co-existing conditions can have symptoms that resemble ADHD, potentially leading to misdiagnosis, making this part of the comprehensive evaluation critical.
In cases where ADHD symptoms result from another psychiatric disorder, misdiagnosis can lead to incorrect ADHD treatment.
Common conditions prevalent in adults with ADHD include:
depression
anxiety disorders
learning disabilities
substance use disorders
Medical examination
If the person being evaluated has not undergone a medical physical exam in the past year, a medical examination will be issued.
The medical examination is not used to diagnose ADHD but is used as an important tool for ruling out any other underlying conditions that could be causing ADHD symptoms.
What happens after the comprehensive evaluation?
The clinician will review and consolidate all of the data they gathered.
Next, they will prepare a written report and share diagnostic findings related to ADHD.
The report includes any identification of other psychiatric conditions or learning disabilities that may have arisen during the evaluation.
Lastly, the report may explain possible treatment options.
How is adult ADHD treated?
Everyone is different making it important to consult with your evaluator and healthcare provider to determine the best treatment option for you.
The most common treatment options for adults with ADHD are:
Medication: consult with your healthcare provider to learn more about different ADHD medications.
Lifestyle changes: developing routines for your personal well being are important. Lifestyle changes often begin with improving sleep, nutrition, and daily exercise.
Therapy: working with a therapist to help you gain more control over your thoughts and emotions can be helpful.
Adult executive function coaching: adults with ADHD typically lack strong executive function skills. Working with a professional who can coach you in developing skills will help you feel more organized and less stressed.
How should I prepare for my ADHD evaluation?
If you've read this far, you now have a thorough understanding of what the evaluation process entails, which will help you navigate it without any surprises.
It's completely normal to feel a bit self-conscious or uneasy when addressing the topics discussed here.
Please be ready for these emotions, and remember that being open and honest is crucial.
During the evaluation, you may need to share personal and intimate details from your past.
Keep in mind that the accuracy of the evaluation and the quality of treatment recommendations are dependent on your candor. The more open and honest you are, the better the quality of care you'll receive.
Your healthcare provider is here to support you. Your well-being is their top priority and you are protected by doctor-patient confidentiality laws.
Conclusion
You now know the essential steps for undergoing an ADHD evaluation as an adult.
From recognizing potential signs to the importance of professional assessment, you understand the initial phases, and significance of avoiding self-diagnosis, and gain insights into common ADHD symptoms.
The evaluation process includes a diagnostic interview, input from loved ones, behavior rating scales, screening for co-existing conditions, and a medical examination. After the evaluation, you'll receive a report with diagnostic findings and potential treatment options, such as medication, lifestyle changes, therapy, or executive function coaching.
Remember to be honest and forthcoming throughout the process. It is the key to an accurate diagnosis and effective treatment. Your healthcare provider is there to support you, with your well-being as their top priority.
Stay Engaged
About the author
Eric Kaufmann, M.Ed is a Professional Educational Therapist and Certified Executive Function Coach. He is the Co-founder of UpSkill Specialists, an online adult executive function coaching company designed to guide adults in overcoming disorganization, procrastination, and productivity roadblocks so they can unlock their potential. Eric is also the founder of Elevate Learning Solutions, an Educational Therapy practice located in San Clemente, CA, that guides students with neurological differences toward becoming independent and confident students and self-leaders.