View Full Version : Getting tested for ADD


jdubs32
03-06-17, 12:07 PM
I am currently getting ready to go through ADD testing and I am having a lot of anxiety about it. I am wondering a couple of things and I am hoping that people will be willing to share with me.

I can't find much literature on it, which is usually how I curb my anxiety. How consistent is it? Is it accurate? What happens if you are found not to have ADHD, but you have almost all of the major symtoms? Do you ever have to take it more than once?

The two things that I am the most concerned about are the following:

1. What was the test like? They are telling me it takes hours?!?! I can find almost nothing on this.

2. Have any of you ever needed a second test or second opinion? Do they just stop trying to help you?

THANK YOU so much in advance!!!

Little Missy
03-06-17, 01:27 PM
I have never heard of ADHD testing. Perhaps some of the other members will be helpful.

sarahsweets
03-06-17, 01:44 PM
There are no tests of any kind for adhd.

Swissy
03-06-17, 01:49 PM
I think of it more of an evaluation than a test. I did an online questionnaire, and the results were that I was "highly likely" to have adult ADD. I have no desire to speak with a therapist or psychiatrist, so I went the neurologist route after my primary physician told me I was possibly ADD, but more likely to be bipolar due to the fact I did well in school and career.

After asking me a few questions my neurologist said no way am I bipolar, and that I am indeed ADD. He said ADD people are very intelligent but lack brain chemicals needed to follow through, and that many ADD people do well in school and career. He was frustrated that my primary doctor suggested otherwise.

So to answer your question my "test" consisted of a conversation during which he allowed me to express my concerns/ symptoms and followed up with his own questions. I felt the same anxiety as you do. Some people do seek a second opinion, I believe because some people see doctors who don't see their individual issues, but throw them into a generalized category and move into the next patient. It is important to ask if the doctor has experience diagnosing ADD in adults before going in for a visit. My doctor must have sensed my apprehension because as I fumbled over my words trying to convey my issues he said, "Its ok, just calm down and tell me what you are going through. I believe you and I can help you." Music to my ears! Good luck!

Ps- I did keep a daily log of my ADD symptoms for a few weeks before my appointment because I cannot pull things from the past to express myself properly. I either forget or freak out, lol. He didn't even want to read over it once he heard what I said because I so obviously have it. I also kept a daily log once I started meds so I could look back and evaluate the effects for myself.

aeon
03-06-17, 01:57 PM
You should be anxious about it...you are being lied to, and ripped off.


Cheers,
Ian

dvdnvwls
03-06-17, 06:26 PM
The only test is a face-to-face discussion with a professional who knows ADHD. There might be questions to answer such as "Do you always have trouble staying seated in class" and "Are you constantly distracted by things that don't bother anyone else".

That's it. Other tests don't exist.

Cyllya
03-06-17, 11:52 PM
If they're saying it's a "test" that takes "hours," I'm guessing they are doing a "neuropsychological assessment (https://en.wikipedia.org/wiki/Neuropsychological_test)." If you're in school, it might be more of a psychoeducational assessment, which I think is pretty similar.

There're multiple tests that could be involved in the evaluation, but one of the activities will almost certainly be TOVA (https://en.wikipedia.org/wiki/Test_of_Variables_of_Attention) (or a cheap knockoff thereof) and probably a digit span test (https://en.wikipedia.org/wiki/Memory_span) and Stroop test (https://en.wikipedia.org/wiki/Stroop_effect#Stroop_test). Maybe an IQ test, at least a short version. Probably some other dumb memory-related activities. Maybe some screening questionnaires for mood disorders?

Neuropsych evaluations aren't completely useless for the purpose of diagnosing ADHD, but they tend to be very expensive and are almost always unnecessary. The main ADHD diagnostic method is a patient interview/history, and the neuropsych test results can provide extra info but shouldn't override the interview. I get the impression a lot of practitioners basically try to make people do a neuropsych evaluation because they are looking for an excuse to deny you treatment, which is why some of the above posters sound so hostile to the idea of tests. (Plus the expense of the testing is a barrier for many people with the practitioner intended it or not.)

You are free to get a second opinion from another practitioner. (I recommend a psychiatrist or even a primary care doctor. Not a psychologist.) If the one you're seeing for the tests thinks you don't have ADHD, definitely consider what the have to say, but if it seems like they are letting the test results overrule all other evidence, go get someone else.

The main use for the tests is getting details/clarification on your symptoms when you possibly have some kind of learning disorder.

The results could also provide details on your impairments which could be useful for disability accommodations--both for deciding which accommodations would be useful and for providing "proof" of your condition in case someone tries to demand it. (I've heard some colleges require such documentation for students to be allowed stimulant therapy, which they will otherwise consider "cheating" even if it's prescribed by a doctor. Not sure if it's true though. Besides being incredibly stupid, it seems like it should also be illegal.) Also, the results might be mildly interesting, in roughly the same way that internet personality quizzes are interesting.

I was diagnosed with ADHD twice, first by my PCP and later by a psychiatrist. Took less than an hour both times. (It was covered by my health insurance with the regular office visit co-pay. I think if I didn't have insurance, the out-of-pocket price would have been less than $300 in both cases.)

aeon
03-07-17, 12:31 AM
I get the impression a lot of practitioners basically try to make people do a neuropsych evaluation because they are looking for an excuse to deny you treatment, which is why some of the above posters sound so hostile to the idea of tests.

If I sounded at all hostile to the idea of tests, it is because tests don't honor the clinical data and known science, and when clinicians do not honor those things I become skeptical to the point of suspicion in that they begin to look to me less like clinicians and more like charlatans and con artists with license to commit highway robbery.


Cheers,
Ian

Letching Gray
03-07-17, 03:57 AM
I am currently getting ready to go through ADD testing and I am having a lot of anxiety about it. I am wondering a couple of things and I am hoping that people will be willing to share with me.

I can't find much literature on it, which is usually how I curb my anxiety. How consistent is it? Is it accurate? What happens if you are found not to have ADHD, but you have almost all of the major symtoms? Do you ever have to take it more than once?

The two things that I am the most concerned about are the following:

1. What was the test like? They are telling me it takes hours?!?! I can find almost nothing on this.

2. Have any of you ever needed a second test or second opinion? Do they just stop trying to help you?

THANK YOU so much in advance!!!


I found the following which seems fairly comprehensive. A number of the tests are for children; however, as you provide the practitioner with your full history, a sense of what those tests would reveal may be anticipated. I had one thorough eval and 2 other doctors gave their opinions. They looked at me like, "Are you serious?" "Are you kidding me? You are a disaster." "You bet you have ADHD."

I didn't understand what they were talking about. I thought most people were just as nuts as I was. I knew I was a reprobate, a lousy, lazy, spoiled, inconsiderate, boring, unmotivated bum and that had nothing to do with some chemical being added to the mix up there in my brain. That wasn't going to do anything. I had to learn how to try harder. That's what I thought they would show me how to accomplish. A little pill is going to help me get my act together? Bull. And then, within 5 minutes of the first dose of Ritalin I ever took ..... Dear God

Attention deficit hyperactivity disorder or ADHD (also known as ADD), is a neuro-developmental condition which impacts attention, impulse control, and behavior; it can also impact learning, social skills, and adaptive functioning.

A thorough evaluation for ADHD should be comprehensive and include assessment of general cognitive skills, specific sensory processing skills, academics, and emotional functioning. The best evaluations also include information (interview and standardized rating scales) from the parents and teacher, and an observation of the child in school.

The following is a partial list of tests used to diagnose ADHD. Read more about the diagnostic process for identifying ADHD.

Continuous Performance tests such as the following: Individual Variables of Attention, Test of Variables of Attention, and Connors Continuous Performance Test. These are computer-based “continuous performance tests” where the child gives a very simple response (e.g. click a button) to a simple stimulus (numbers, letters, etc.) on a computer screen; such tests are long and boring with little feedback. Therefore, kids with ADHD often “drift off” and make many mistakes. Mistakes have patterns which can be analyzed in detail to help understand a child’s individual weaknesses. Children with poor impulse control will show specific types of errors on this test; some of these tasks also measure hyperactivity.

Simpler tasks of continuous performance: Rapidly Recurring Target Figures Test; Digit Cancellation Tasks, etc. These tests are similar to those mentioned above; however, tests in this group are of shorter duration and provide less sophisticated information.

Hyperactivity measures. Hyperactivity can be directly assessed in young children by the Statue test on the NEPSY. The child is asked to stand like a statue, and the number of times the child moves, responds to stimuli, or talks is recorded and compared to expectations based upon the child’s age. This is a simple, yet information-rich measure of hyperactivity.

Basic attention or working memory can be measured using many tasks: Digit Span tests (immediate recitation of digits read to a child); Word Span tests (immediate recitation of a word list); Number Letter recall; simple cancellation tasks in which a student crosses out elements according to specific directions (pictures, digits, or symbols).

Complex Attention, is more demanding than basic attention. Examples of complex attention include holding information in the mind while working on it, such as hearing a list of digits and putting them in numerical order, or recalling a short letter list after being distracted. Examples of the tests used to measure complex attention include Auditory Consonant Trigrams, Digit Span Reversed, Number Letter Sequencing; reciting common lists in reverse (such as months of the year or days of the week). Another good test is the Paced Serial Addition Test (PASAT). In this test, a student must add numbers together. The speed with which the digits are given increases, and the number of errors is counted.

Inhibition is the ability to stop oneself from an expected response by following a new rule. Individuals who have ADHD often have difficulty inhibiting their responses. Inhibition can be tested with the Stroop Color Word Test, the Attention, the Response Set and the Inhibition tests on the NEPSY, and the Stroop tasks on the Delis-Kaplan Executive Function System (DKEFS).

In addition to problems with attention and impulse control, many children with ADHD also have problems with so-called executive functions, higher order mental functions such as planning and organization of tasks.

Task planning can be assessed by a number of Tower tasks, including the Tower of London and Tower of Hanoi, and the Tower task on the DKEFS. Also, the Route Finding subtest on the NEPSY, and Rover on the Kaufman Assessment Battery for Children (KABC).

Abstract thinking and logical reasoning are also executive functions. They can be tested by the 20 Questions task, Similarities task, absurdities tasks, and Word Reasoning on the Wechsler Intelligence scales. The 20 Questions task is like the game “I spy” and the child is scored on how efficiently they narrow down the choices and their method of reasoning.

Many good individual instruments exist for these various tasks, as above, but there are also more comprehensive batteries. The NEPSY-II and Delis Kaplan Executive Functions Scale (DKEFS) are excellent batteries which include tests for mental flexibility, inhibition, complex attention, task planning and other skills.

A number of rating scales can be used as well; it is important to use a broad measure rating scale rather than just an ADHD scale. Many ADHD scales may be elevated even in children with other conditions (this is especially true with Tourette’s Syndrome and Central Auditory Processing Disorder (CAPD).

Rating scales which are broad-based include the Connors Rating Scale (long form); ASEBA Child Behavior Checklist (CBCL); Behavior Assessment Scales (BASC) and others.

Specific checklists just for ADHD include those by Brown, McCarney, Connors, and others. The BRIEF also rates many executive behaviors in addition to attention and impulse control.

sarahsweets
03-07-17, 10:39 AM
which is why some of the above posters sound so hostile to the idea of tests. (
Why would you say we are hostile? The reason some of us feel this way is because its true- there arent any tests for adhd. There are tests like you mentioned to rule out/diagnose other issues and disorders, but ruling something out isnt the same thing as testing and confirming adhd.

With my kids, they underwent a large amount of testing through the school but that was to determine their IQ, and development level and to see if they had other learning disorders that required other kinds of treatment. My son, for example had an ot/pt issue with the dysgraphia and some of his fine motor skills. He had PT and OT up through the tenth grade.

jdubs32
03-07-17, 06:24 PM
It was a typo... I meant ADD both times. I state that I am taking an ADD test. I have found a tiny bit of info on the computerized ADD tests... but very little about false positive and/or false negative rates.

dvdnvwls
03-07-17, 06:36 PM
It was a typo... I meant ADD both times. I state that I am taking an ADD test.
You can't be taking one, because there isn't one.

namazu
03-07-17, 10:00 PM
You can't be taking one, because there isn't one.
Though I understand your intent, making misleading, black-and-white claims such as this^ is not very helpful to people who are looking for good information about ADHD diagnosis.

There are computerized and/or EEG-based tests marketed (and even FDA-approved*) "to aid in the diagnosis" of ADHD (some of which are included in the list Letching Grey posted) and it is disingenuous to claim otherwise.

The use of specific tests (and even their approval) has been widely criticized, and for many good reasons.

But they do exist, and some clinicians seem to believe they're worthwhile, and that is why people frequently ask about them.

There happens to be very little evidence to suggest that these types of tests improve the accuracy of ADHD diagnosis in meaningful ways in real-world settings. In some cases, these tests may actually mislead (which would make them worse-than-useless).

These tests also add -- sometimes signficantly -- to the cost and time burden of getting a diagnosis and treatment. They cannot replace a thorough evaluation by a qualified practitioner.

A thorough evaluation (which could also be considered a kind of "test") consists of more than a cursory run through a symptom checklist.

This clinical practice guideline from the American Academy of Family Physicians (http://www.aafp.org/afp/2012/0501/p890.html) is a little dated (referring to some old criteria), but it gives the gist of what an evaluation should look like.

You'll notice that it emphasizes history-taking and in-depth assessment of current symptoms and how they affect you.

...And yes, sometimes doing specific tests (yes, tests!) to see if other medical problems might be contributing. ADHD does not present in uniform ways form person to person, and there are other conditions that can mimic or exacerbate ADHD symptoms. As a result, looking into other conditions may be an integral part of the evaluation. An ADHD evaluation that ignores other possibilities is not a thorough evaluation; an important part of diagnosis is excluding other conditions.

You'll also notice that these guidelines do not recommend computerized tests of sustained attention, nor brain-wave tests. These are not considered part of standard practice for diagnosis of ADHD.

Neuropsychological or psychoeducational testing of the variety that Cylla described above is also not considered standard or necessary for diagnosis of uncomplicated cases of ADHD. It may sometimes be required for documentation purposes for accommodations (depending on the institution). It may also be useful in cases where brain injury and/or specific processing problems are suspected. But there is no one "giveaway" pattern on psychoeducational tests that definitively rules in or out ADHD.

My advice to you, jdubs, is to skim through the clinical practice guideline I linked above. If you're comfortable doing so, discuss the rationale with the clinicians that want you to spend hours (and $$$) on computerized or neuropsychological testing -- given that it is unlikely to beat the judgment of a good clinician doing a thorough and very low-tech evaluation. Better yet -- if possible, given costs and availability -- seek out a clinician who doesn't put so much emphasis on costly, unhelpful, and non-standard diagnostic procedures.

Best wishes as you seek an (appropriately thorough, but not needlessly burdensome) evaluation!



*Though the marketers are prone to getting carried away in their quest for profits. (https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2015/ucm463351.htm)

dvdnvwls
03-07-17, 10:41 PM
namazu: I understand what you're saying, and I know that the more extensive information you've provided is useful in ways that my statement is not.

But patients being deflected from legitimate treatment into bogus tests is not a good situation, and I believe people need to know that as well.

Fraser_0762
03-07-17, 11:13 PM
Is there an official ADHD test used for the diagnosis process? No, there isn't.

However, there are a series of tests that can be used to test things such as attention, short term memory and spatial awareness. Although these tests are not used officially for the diagnosis process, they can help to identify specific impairments and to the extent in which they may impair you.

So although these tests aren't a requirement for the diagnosis of ADHD, you can certainly still request them to help you better understand your key areas of strengths and weaknesses.

Having this information can certainly aid you in the treatment process, as you will have a better understanding of which areas of impairment require the most work to improve.

kilted_scotsman
03-08-17, 06:50 AM
It's important to remember that, while there are no "tests" for ADHD/ADD there are several tests for other issues that might be contributing to ADHD like symptoms eg thyroid problems. In addition the psych may do some tests for co-morbids or suchlike.

The reason the evaluation takes so long is because the clinician should be taking a DETAILED history of the client. This is a umbrella that gives the clinician a ROUNDED and holistic view of the person in front of them.

It shouldn't be a "Does this person meet the DSM criteria for ADHD Yes/No?" type process.... because that does us a disservice, regardless of what we may think. We may know a lot about ADHD but we tend to know less about other issues that may be contributing to our issues or be masked by our issues.

As an example.... a clinician may take a blood test..... there isn't a blood test for ADHD, however this may come back with host of info about thyroid kidney & liver function, lymes disease/infections etc. In addition the clinician may get info on recent use of recreational drugs/alcohol in order to validate the answers to evaluation questions.

Letching Gray
03-08-17, 02:23 PM
"Activities that may boost cognition include physical exercise, meditation and spending time in nature. Recent research also finds that some cognitive exercises may also help. Although there are many brain training programs, some of which have over-promised and under-delivered, some scientists believe a new crop of clinically validated programs may soon come online." Psychology Today

To me, this is helpful to know. Whether or not we ever receive an official diagnosis, it appears (there will be or are now) scientifically supported things we can do to help us pay attention.

One diagnostic tool that is really important and that should be fairly clear upon reflection and from the input of family/friends/teachers, is the pattern over time of significant impairment in school and other major activities, you know? If other factors are ruled out, this information should offer a big clue.

A drawback with this is seen when an individual has developed compensating behaviors. She may mask it quite well.

Another "test" which at present cannot be used as a valid approach, is evaluating the response in the tested individual to the medication. Often, there will be a positive, dramatic improvement in the person with ADHD. Again, although it is not an acceptable diagnostic measure, if there is no improvement in the symptomology, not much is lost.

Also, the severity of the disorder and the cognitive adaptability of the person with ADHD, add to the challenges in making an accurate assessment.

dvdnvwls
03-08-17, 09:07 PM
About compensating behaviours and adaptability:

When I am under high stress or my routines are significantly disrupted, then my compensations start to fail and my adaptability decreases sharply.

Cyllya
03-08-17, 11:50 PM
Why would you say we are hostile?
I said you guys seem hostile to the idea of tests mainly because aeon called it a lie/scam but also because you and dvdnvwls contradicted what the OP's mental health provider apparently said, without explanation about why.

The reason some of us feel this way is because its true- there arent any tests for adhd.
Well, yeah, I don't disagree with being hostile to the idea of the tests. I'm just clarifying the reason behind it.

But patients being deflected from legitimate treatment into bogus tests is not a good situation, and I believe people need to know that as well.
Yeah, maybe next time this sort of question comes up, we should make a link to this topic (unless better topic has since been made), because accurately explaining the nuance takes forever to write out.

Swissy
03-09-17, 07:38 AM
While I have been here long enough to know hostility was not intended, To new people who are looking for info, the short answer of "there is no test" with no further explanation might sound a little blunt. Telling them they are being lied to or scammed by being "sold" a test is such a small piece of the puzzle, it makes it sound almost invalid to seek help. A person who asks the question might not know there is no test in the true definition of the word, it almost leads to a conclusion for first time info seekers that it might be hopeless to find out if one has ADD or even if ADD is real. In that sense one might conclude there is a hostile tone in a curt answer regarding tests. To a person who is seeking info for the first time it might sound less "hostile" to inform that while there is no test that will definitely define whether or not they might have ADD, the right professional can administer questions to evaluate the probability of ADD and also ask their own questions to evaluate whether treatment for ADD should be started. That being said, this group has been wonderful to me and I appreciate all of the things you have taught me. I am still new enough to get how easily one can misunderstand info if it isn't complete.

sarahsweets
03-09-17, 08:05 AM
I said you guys seem hostile to the idea of tests mainly because aeon called it a lie/scam but also because you and dvdnvwls contradicted what the OP's mental health provider apparently said, without explanation about why.
I just checked the OP and I cant see how I contradicted what his provider had said. I should have said that there are many tests that can be wonderful to rule out other conditions and disorders but specifically there arent any tests directly for adhd. I say that or bring that up not because I want to be contrary but because there are people goaded into spending money they dont have for testing "recommended by their doctor" when they are merely paying for something that isnt a definite and it makes you wonder- who profits from the hundreds, if not thousands spent on these tests? Its also important to point this out because there are so many "tests" on the internet that people will take and either self diagnose or be absolutely certain about having adhd, then walk into a doctor expecting confirmation.

I am not against self knowledge, anything that encourages someone to seek help to get to the bottom of whatever issue they have is good to me, but I am not a fan of exclusively self diagnosing. Not to say that self diagnosing is wrong, but it should prompt you to see a doctor, not confirm what you think so you can handle the treatment yourself.

dvdnvwls
03-10-17, 02:53 AM
I said you guys seem hostile to the idea of tests mainly because aeon called it a lie/scam but also because you and dvdnvwls contradicted what the OP's mental health provider apparently said, without explanation about why.


Well, yeah, I don't disagree with being hostile to the idea of the tests. I'm just clarifying the reason behind it.


Yeah, maybe next time this sort of question comes up, we should make a link to this topic (unless better topic has since been made), because accurately explaining the nuance takes forever to write out.
Mental health provider? Ugh that term is so patronizing. Anyway... Contradicting someone who isn't telling the truth is a useful service, not a bad thing.

I don't say the doctor was lying, because it may have been unintentional - but "unintentionally speaking untrue things" still needs to be contradicted.

I can see that more information was required because what I said might have sounded "out of left field".

Fortune
03-10-17, 10:16 AM
There are no tests that can serve to provide all the information necessary to diagnose ADHD, but there are tests that help professionals diagnose ADHD. They don't replace clinical judgment, but they do supplement it.

Barbrady1
03-22-17, 04:24 PM
I am to be tested for ADHD later this year. After being diagnosis with an autism spectrum disorder in 2015, I asked my doctor if I could be tested for ADHD/ADD. He stated that there's a clinic in London which can assess me for the condition. I have now been referred, but the waiting times are extremely long. It's now been over 10 months since my doctor referred me.

Whilst I am in no way hyperactive, I believe I have a severe form of inattentive ADHD.

I always make mistakes, and my working memory is dreadful. I cannot organise work or breakdown a task. I never seem to concentrate or focus on one thing for a very long time as I am easily distracted and become bored easily. And I have spent the vast majority of my life gazing absent-mindedly into space. It's almost impossible for me to learn anything!

Everyone else in my family is rather smart; I have always been the dimwitted *******.