Steps to get Assessed for ADHD

[Jewelz81]

I understand your frustration with being told you definitely do NOT have adhd, even by people who somewhat know you or really know you. I've still not even tried to get diagnosed, but will be seeing a master's student in supervision for an initial appointment on Wed. There are licensed counselors and other post graduate full licensure hours-seeking counselors there as well, and I was told they could diagnose me for adhd. I'll be lucky if I can afford the $20/session for this graduate student counselor intern girl... .

[Bouncingonwalls]

Should I be concern if my doc did not ask any of my family member to fill out a question-air? He just asked me a bunch of questions and then told me he was pretty sure I have ADHD. He sent me to see a neurologist to do further testing. When I went to see the neurologist and was told that I definitely have ADHD combined and he would not recommend me to do any further testing. So, should i be concern how i was assessed for ADHD?

[KronarTheBlack]

I wouldn't be concerned at all if I was you. Be grateful that you have what seems to be intelligent doctors working on your case. If you try every single ADHD medication and none of them work then you should be concerned.

[Jerome_Morrow]

Originally Posted by livinginchaos

- an IQ test does not diagnose ADHD

So, I recently went in to the psychological testing center at my local university and went through a bunch of testing for ADHD. They had two questionnaires for me to fill out through the process and one that my mom filled out, and they seemed to be asking the right questions (about attention, etc.). But the actual testing they did seemed more like an IQ test than anything else. I had to do a bunch of pattern recognition things, recreating designs using blocks, picking out what's wrong/missing in a picture, do the Tower of Hanoi, etc. And it was all very fun!

I'm a little concerned though because none of the testing outside the questionnaires seemed to deal with attention-span, forgetfulness, organization, distractability, etc. And like I said, I really enjoyed the tests they had me do because I really really like puzzles, and that's all they were, so focusing on them was not a problem at all. In addition to enjoying them, I also feel like I did rather well on them, so I'm scared they're going to say, "This guy has above average IQ, so there's no way he's got ADHD."

I still haven't gotten the results/had the feedback session, so I don't know what they're going to say... but it just seemed like the majority of the testing they did was for IQ and not ADHD.

Should I be concerned?

[mctavish23]

Jerome,

I'm definately impressed with your insight and intuition on this.

Since I don't practice on the net, I will respond as "generically"

as possible:

While it always pays to wait and see what happens, it also is

important to safe guard against "surprises."

Here's the deal with testing & diagnosis:

NOWHERE on planet earth is it okay to diagnose solely on the

basis of a test score or batteries of tests.

There are many posts in the FORUM on this;some of the best

by Dizfriz, with one or two by yours truly.

To be prepared for "surprises" of the arrogant / misguided kind,

here's some ideas:

http://www.greatschools.net/pdfs/2200_7-barktran.pdf?

(See pages 8 & 9 under "Appropriate Assessment")

Barkley, R.A.(2006) Attention Deficit Hyperactivity Disorder :
A Handbook For Diagnosis And Treatment (Third Edition),New
York, Guilford

(See Chapters 8 & 9 under Section II : ASSESSMENT)

In particular,Chapter 9:Tests and Observational Measures
is a comprehensive literature review on EVERY type of
test used in conjunction with ADHD.

The number of tests found to be deemed appropriate
for the sole purpose of diagnosing ADHD was ZERO.
(i.e.,absolutely NONE,including ALL intelligence tests,
neuropsych batteries,and computerized continuous
performance tests(CPT's).

Here's the quickest explanations as to why this practice

is deemed inappropriate the world over:

1) Poor Ecological Validity-taking a test in a quiet room
with an examiner does NOT equate with being in a class-
-room, being on the job, driving, doing chores,etc.

2) Small Sample Sizes- the populations upon which these
tests were normed (developed) are historically so small
that you can't generalize the results out into the "real
world" and compare them to people with the disorder

3) Poor Construct Validity- just because the Wechsler
Intelligence Scales has a Working Memory Index (WMI),
doesn't mean that measures the Executive Function
impairment (Executive Dysfunction) of the same name
(It DOES NOT).

In fact, on page 75 of the Technical Manual of the
Wechsler Intelligence Scale for Children-Fourth Edition
(WISC-IV), the author David Wechsler, states that you
may NEVER use those (subtest/index) scores for diag-
-nostic purposes.

There's lots more to this, so you might want to look at
ANY or ALL of the Clinical Guidelines on the Diagnosis
and Treatment of ADHD, from AMA, the American
Academies of Child & Adolescent Psychiatry, and Pediatrics,
The Center of Disease Control (CDC), the American Psychiatric
Association (the "other" APA), and the US Surgeon Generals
Report.

Also, CHADD and ADDA have their own, which coincidentally
are identical to the above.

There's lots more here, but I need to run.

Excellent insight & common sense displayed in your question.

THANK YOU for raising it.

Good Luck.

tc

mctavish23

(Robert)

[Jerome_Morrow]

Thanks for the info!

[Faramir]

This thread was very informative. I'll make an appointment with a psychiatrist this week and make sure he specializes in ADD.

[WorkAholic]

What is the DCM IV?

I've never had any professional testing but after readin someone's comment about the price w/out insurance I'm concerned...plus I've tried Ritalin, Adderall, Dexedrine, Vyvanse and none of them work

[SourceV]

I was diagnosed by a pediatrician, although its been quite a while since I was a child. The assessment included interview, questionnaire and a Continuous Performance Task (CPT). It is an ADHD test online, that is very useful both as self service pre-diagnosis screening, as well as, a form of monitoring the effectiveness of the treatment.

[adhdscotuk]

i done a neuropsychiatric tests last week both easy and hard

[radioman]

I am 44 yo and have struggled most of my life in school... I do suffer with anxiety and have had depression. However I would always procrastinate getting things done, I have had so many jobs I can't keep count. I would get frustrated reading a book because I would start reading it and then have to read the same paragraph on sentence again to even understand what I read. I started college 15 years ago did not finish. Now that I have started to take classes I am reliving the same struggles. Went to my family physician for an unrelated matter and explained to him about what was going on he asked how I did in school and I said I struggled almost did not graduate and prescribed Adderall 5 mg I did not want to take it... I was already going to a Physiatrist and he said he would set me up for testing. Testing was performed by another dr specialist and the outcome was 50% chance of having Adult add but would benefit from a stimulant medication. The 50% was explained that I have accomplished some things in my life so I guess that what that off sets it? I would like to know do I have it or not... They would like to see me take the med but I would like to feel more confident. I guess I need to be satisfied with their expertise and move forward with my talk therapy and take the med... Any thoughts?

[Marbles]

It's very odd to find out that people can be diagnosed through their schools/universities. Here in the UK, I've had to literally wait for nine months to go through the whole process. First, a doctor's appointment. Then, a referral to a nearby clinic. Then, a visit to a mental health hospital to determine a diagnosis. I was on the waiting list for six months.

My appointment didn't go to plan, either. I was sent away with a diagnosis of several types of anxiety issues. I couldn't believe it. Even though I may suffer from slight anxiety, I know that it isn't the main issue of my inattentiveness. Anyway, the assessment was poor. It was the DSM-IV criteria, but the nurse who had to record my answers to the questions for the criteria, misinterpreted almost everything I said, and my problems were not noted. I scored 9/9 on the same criteria at the clinic that I was referred to, and on all online tests. The hospital made a huge mistake, which then meant they couldn't diagnose me, because I didn't score high enough. That meant I was sent away with a diagnosis of anxiety, in the hope that I'd be happy with an "explanation".

I really cannot express how awful it all was, and how diappointed and angry I am. Self-diagnosis even seems a lot less dangerous than receiving a diagnosis from these doctors.

Anyone else had a similar experience? I am being sent back to the hospital for a neuropsychological assessment, and a second appointment to go over the incorrect answers. Once I complained, it was realised that a mistake was a made. I was sent a conclusion with my report, and my consultant actually stated that she predicted a further diagnosis, and that I should try a trial period of medication after I've treated my anxiety. It actually states it in clear words. I don't know why this would all be said, if ADHD was not seen in me. They just couldn't diagnose me because of this flipping criteria, which had been recorded incorrectly.

But yes, I am just on the waiting list AGAIN - and I will probably have to wait for a further six months. Sigh.

[alisha99]

ADHD can manifest with or without hyperactivity or Behaviour Disorders. Assessment of ADHD begins with a diagnosis based on behaviours. Thanks for this good post.

[MartinR]

Well, it depends in which country you live. It's very hard to get diagnosed with ADHD outside US/Canada/UK and maybe Germany and Australia.

I personally have been to more than a dozen psychiatrist and psychologists and only my last one knew what it was all about. The rest had no idea what ADHD and Ritalin mean.

One time told I psych that I assume I had ADHD, and he googled it in front of me and red me the first sentence from Wikipedia and assumed that it is only a childhood disorder.

[evilfeline007]

I never had to do any attention tests.

I went to my school psychologist that looked at my grade history, did a uber-long questionaire (that was overwhelmingly indicating ADHD behaviour) and then did a reading comprehension test (which I aced)

Then my GP did blood tests to rule out thyroid issues, etc. and referred me to a psychiatrist.

after one session of talking, he said I met the DSM criteria for ADHD-PI but wanted to treat my GAD first to see if that alleviates my symptoms.

During the second session he prescribed ritalin. I had to wait 8 months to see this doc.

I live in BC, Canada.