Sorry if this is a topic somewhere else or should be in another area. -(please, direct me)

I finally got up the courage today to call an office of a doctor who works with adults with ADD (to see about a diagnosis). They asked me if I had been tested yet. Said I have to be tested first, they recommended another doctor for this and gave me the name. I hate hurdles. I was hoping she could do it all. Oh, well. My Question is what type of testing do doctors usually do for adults? Would a paper test work? I don't see how a test could be an accurate diagnosis.:confused: I'm scared this will be an uphill battle and I'll get nowhere but light in the pocket book.

P.S. this testing doctor needs referral from Primary Care. How do you approach this with PC, I have had weird looks in the past and shot down (I usually break down in tears). It's been several years since I have had guts to persue this issue again. :( I hare feeling like a fool.

You all seem to give could advice.

In any medical case, whether it's cancer, broken bone or ADD/ADHD, the doctors need to examine (test) to rule out other problems. If you went in for a severe stomach ache and the doc gave you antacid without checking anything, wouldn't you be suspect? You have to narrow down problems before treating them.

Also, all doctors work differently...some require referrals, others do not. Some are specialists, others are not. And ALL cases are unique. Your process will be different from everyone else on here, because your background, history, doctors, etc. are unique.

Now, that said, I was diagnosed with ADD at age 41 after a lifetime of struggle. It went like this for me:

Read a book "Driven to Distraction", learned that there are many people like me. >> Searched for an adult ADD specialist >> Went to 4 sessions, took tests >> Received full report and meds recommendation >> Went to primary care doctor, who wrote the prescription.

For me, the tests included a casual chat, where the psych-doc takes your history and asks about your concerns.

Next, a paper test to determine if you have other issues, like bi-polar disorder, etc.

Next, I did a 'concentration' test that is administered with flashing numbers. I failed this miserably.

A week later, I got my report and took it to my PC doc. He wrote the Rx and I was on meds the next day.

And except for a few blood pressure issues, it has been a miracle drug.

It's important to understand that testing is critical..you must rule out other conditions before treating one particular condition.

Not all doctors do this. But mine did, and I'm glad. I feel my treatment is proper and effective.

Good luck!

PS:

Everyone, please listen.

When you hire a doctor, they work for YOU. If you have concerns, tell them about it. They are making good money to take care of you.

If you aren't getting the care you need, ADD or otherwise, FIRE THEM!
If they 'shoot you down', get second and third opinions.

Doctors are not magicians or gods. They are people, and you should not be intimidated by them.

What if your car was making a funny noise and your mechanic 'shot you down' before taking a look at it? You'd fire him.

To get well, you must be proactive. Take control of your problem and find the best help possible. Make calls, ask questions, get educated.

Get well.

I was also shot down by the first psych I went to for diagnosis, got discouraged for about a year before pursuing it again a month ago. If you get weird looks when you only want to be tested, it's because they're ignorant and are not doing their job properly, certainly not because you're a fool. Don't put this on the backburner any more, like I did. Good luck!

I think they can use the adult version of the test they also use in children. There is an adult IQ test and adult WISC called the WAIS III

At the counceling center I go to, they do an intake and the intaker will ask questions to the intakee. After the interview she will make the referal for the appropriate actions needed, whether it is to seek a psychiatrist or talk thereapy or hospitalization...

The only 'test' I did when I initally went to see my dr. was the the dsm-iv criteria thing. Course, I did do a whole bunch of learning assessments at my university's counselling center, and based on those tests it was suggested to me that I had ADD. So my dr. just basically gave the medical confirmation.

They generally use the Neuropsychology battery of tests (eg. Working Memory tests; Executive Function tests)


http://en.wikipedia.org/wiki/Neuropsychological_tests

Neuropsychology is the study of brain function impairment. Thee tests are checking for performance problems. (Some 'deficits are quite subtle, and not discovered by scans or taking a history/inteview, BTW.)

(e.g. ADHD, strokes, head injury, Korsakoff's, dementias, etc)

My ADD "testing" was done after I was physically cleared and deemed healthy. I filled out a questionnaire which I lost twice in the office without getting up from my seat, then my doctor read from a book in a monotone voice I was given an exact copy of teh book and I was supposed to keep up with him. . . . .

I almost went nuts after five minutes, after 20 minutes I feel out well sort slid out of the chair on the floor because I lost my balance (I was holding my butt off the chair using my arms my butt burned from sitting), After 30 minutes he asked what page he was on in the book (what book)

However I did know many tiles were in his ceiling and how many phone calls his secretary answered, the titles to all the book on the shelf behind him but I couldn't for the life of me repeat one thing he said after the first three minutes. . . oh and I knocked some stuff off his desk squirming. . . . . .I think that would be considered the adult version of the TDTO* test . . . . .I was given a label that meant 29 year old female uses chair as jungle gym during psychiatric exam . . . . .commonly referred to as ADHD in 1993 = a attention deficit disorder with hyperactivity or BA** with "H" factor.





*TDTO (Trail of Destruction Through my Office).

**BA { boredom aversion }


There is an adult IQ test and adult WISC called the WAIS III

I am unsure what IQ has to do with ADD, the WAISS III is ????? does this test the attention span or ability to focus?


I think different doctors use different methods. Ruling out possible physical causes is some thing most doctors do. Although they have various testing none have been proven to be able to indicate the presence or absence of ADD. The test may be a tool the doctor uses but to the best of my knowledge there is no test for ADD. . . .They may test attention span, or ability to focus on boring task but I think my doctor pretty well covered those by reading a boring book and a flat tone so I am satisfied with my diagnosis even though I didn’t have to go though any of those formal test

meaning Don't go broke on the formalized testing. . . .

I think different doctors use different methods.

Yes, yes, they do. And everyone seeking treatment should ask in advance the what/when/how of testing and diagnosis before committing to treatment.

At absolute minimum, try to get a basic idea of the procedures and tests, and make your treatment decisions from there.

People with adhd often have a verbal IQ that is significantly higher than their performance IQ.
It is so consistently true that an IQ test is pretty much always part of the suite of tests given to quantify ADHD traits in a person.

To make a long story short, people with ADHD are typically smarter than they seem to be.

Me :D


My ADD "testing" was done after I was physically cleared and deemed healthy. I filled out a questionnaire which I lost twice in the office without getting up from my seat, then my doctor read from a book in a monotone voice I was given an exact copy of teh book and I was supposed to keep up with him. . . . .

I almost went nuts after five minutes, after 20 minutes I feel out well sort slid out of the chair on the floor because I lost my balance (I was holding my butt off the chair using my arms my butt burned from sitting), After 30 minutes he asked what page he was on in the book (what book)

However I did know many tiles were in his ceiling and how many phone calls his secretary answered, the titles to all the book on the shelf behind him but I couldn't for the life of me repeat one thing he said after the first three minutes. . . oh and I knocked some stuff off his desk squirming. . . . . .I think that would be considered the adult version of the TDTO* test . . . . .I was given a label that meant 29 year old female uses chair as jungle gym during psychiatric exam . . . . .commonly referred to as ADHD in 1993 = a attention deficit disorder with hyperactivity or BA** with "H" factor.





*TDTO (Trail of Destruction Through my Office).

**BA { boredom aversion }




I am unsure what IQ has to do with ADD, the WAISS III is ????? does this test the attention span or ability to focus?


I think different doctors use different methods. Ruling out possible physical causes is some thing most doctors do. Although they have various testing none have been proven to be able to indicate the presence or absence of ADD. The test may be a tool the doctor uses but to the best of my knowledge there is no test for ADD. . . .They may test attention span, or ability to focus on boring task but I think my doctor pretty well covered those by reading a boring book and a flat tone so I am satisfied with my diagnosis even though I didn’t have to go though any of those formal test

meaning Don't go broke on the formalized testing. . . .

People with adhd often have a verbal IQ that is significantly higher than their performance IQ.


This holds true for learning disabilities, so how would this be able to differentiate between the two? Although looking for learning disabilities may be applicable for some the IQ test would serve this purpose but not diagnostically necessary for all. This seems like it may depend on the area of impairment and age of person.

Source basis, please note this is child/teen I have not found the adult one yet.

Diagnosis and management of attention deficit hyperactivity disorder in primary care for school age children and adolescents (http://www.guideline.gov/summary/summary.aspx?doc_id=6498)

A learning disability is formally identified by comparing a student's IQ score to his or her scores in achievement areas and identifying a significant discrepancy (usually defined as 1.75 to 2 standard deviations) between the two.***End Quote


It is so consistently true that an IQ test is pretty much always part of the suite of tests given to quantify ADHD traits in a person.

I do not agree with the indicated frequency but what do I know. Besides we may have very different ideas as to the meaning of "pretty much always".

I shall provide a neutral source which should help all see reasonable expectations of an ADD diagnostic evaluation.

Evaluation Algorithm (http://www.guideline.gov/algorithm/4071/NGC-4071_1.html)

Saves typing and may be useful to the discussion as to expectations.This is the medical guidelines for the evaluation as per the goverment.

carebear stare I am unaware of your age nor am I fimular with your insurance coverage. I do know many will not pay for some of this testing and monatary resources are imporatant.

My information source

CIGNA coverage position ADD (http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0231_coveragepositioncriteria_adhd_assessment_a nd_treatment.pdf)


CIGNA HealthCare does not cover the following services, because they are considered educational in nature and not medically necessary for the assessment and/or treatment of ADHD (this list may not be all-inclusive):

Intelligence Quotient (IQ) testing

education and achievement testing

educational intervention (e.g., classroom environmental manipulation, academic skills training,
and parental training)

neuropsychological testing

CIGNA HealthCare does not cover the following procedures/services, because they are considered experimental, investigational or unproven for the assessment and/or treatment of ADHD (these lists may not be all-inclusive):
Assessment:

actometer

computerized electroencephalogram (EEG) (e.g., brain mapping, neurometrics, or quantitative
electroencephalography [QEEG])

computerized tests of attention and vigilance

event-related potentials (i.e., evoked potential studies)

hair analysis

neuroimaging (e.g., computerized tomography [CT], magnetic resonance imaging [MRI], positron
emission tomography [PET] and single-photon emission computerized tomography [SPECT])

revised Nov 11, 2006

***End Quote

So if insurance coverage is an issue it may be wise to consider what your carrier will and will not cover. The list I provided was from CIGNA but covered services may vary from carrier to carrier. A call placed to your carrier may be a wise move to prevent furture unexpected cost

My doc (specialist ADHD doc pschchiatrist..) talked to me for a while...got me totally confused without me even noticing...asked me questions I misheard...listened while I tried to answer questions he didn't even ask..read my old school reports..

that was enough..

I left with the ADHD diagnosis we both knew was inevitable...and now I am happy as Larry :-)

Wow, thank you all very much for the good information. I always feel better after going to this forum. by the way I am 29 and going to be a 30 this year. I will definetly look into my insurance, that is a great idea. My work place decided to to a self funded ppo health alliance plan to save money this year - interesting it is. I'll have to keepin mind I am the one hiring the doctor, I tend to let others walk a bit over me. I don't feel so silly about getting an IQ test now the last time I ventured on this subject. I will look in to the links above. I like the evalution algorithm, nice - it helps to see a "map". This may turn into an adventure...and I love the thrill of researching and finding new thing out (it was always the papers that followed that I hated writing).

I know your insurance will have it's own providers in case you have to go out of net work in this section is a thread that has directories of health care professionals. I have listed the source making those particularly interested in ADD easy to spot.

Don’t feel silly about taking an IQ test apparently this is a fairly common practice that many here feel helped determine their diagnosis. I look up standards of care but some professional may choose for reasons of their own to go beyond this. I do encourage you ask questions. It is the doctors duty to explain why a test is needed, and what they are looking for. They must explain it in a language you understand.

Often times a nurse may be answering your questions, and most are knowledgeable in the reason behind the doctor’s decision especially if the nurse has been working with the doctor for some time.

Glad you recieved the assistence you were needing, this is what this site is all about.