Is it ADHD?
ADHD describes a particular cluster of executive functioning challenges that have substantial impact on various aspects of everyday functioning. Many people, however, struggle with some aspects of executive functioning but do not have the full range of symptoms that are characteristic of ADHD.
Across social media, there are descriptions of “ADHD symptoms” that are not truly symptoms of ADHD. Indeed, many describing their experiences of ADHD and many clinicians who claim to treat ADHD describe challenges that are experienced by individuals with a number of other mental health concerns.
So what is ADHD?
ADHD is a childhood onset (neurodevelopmental disorder) that impacts attention, impulsivity, and/or hyperactivity. As many as two-thirds of children with these challenges continue to struggle in adulthood. Attention concerns can include difficulties initiating tasks requiring sustained attention, distractibility and sustaining attention on tasks, completing tasks, paying attention in conversations, organization (time, space/belongings), misplacing and losing items, forgetfulness in daily activities, and attention to detail and making careless mistakes. Impulsivity and hyperactivity concerns can include difficulties with patience (e.g., waiting your turn/in lines, interrupting others, completing others’ sentences or answering questions before they are fully asked), excessive talkativeness, excessive noisiness, fidgeting and difficulties sitting still, leaving seat when expected to remain seated, restlessness or inappropriate behaviour, excessive energy or activity (being continually “on the go” difficulties stopping). Very rarely do people experience all of these symptoms. The symptoms must also be associated with interference in functioning in two or more domains of daily functioning (such as work, school, relationships, driving, etc.).
How is ADHD Assessed?
Assessment of ADHD for most people is a complex, and involved process. Often ADHD co-occurs with other concerns, and often other conditions can look like ADHD. There are lots of brief assessments for ADHD offered by practitioners from various backgrounds (physicians, nurse practitioners, psychiatrists, psychologists), but brief assessments many not answer your questions adequately. The type of assessment you seek ideally needs to be aligned with your reasons for seeking an assessment. Are you primarily focused on access to medication? Do you suspect learning difficulties or additional mental health concerns? Are you seeking accommodation? Do you want to understand what therapies might best address your concerns?
Interview-Only Assessments: As ADHD has become an increasingly common question for people, brief online assessment services have proliferated. For some, these services are an effective low-cost way of accessing diagnosis and treatment while for others these assessments have fallen far short of their needs. These assessments often involve interviews without gaining collateral information and use short public domain screening questionnaires with high rates of false positives (i.e., indicating ADHD when it is not present, such as when the symptoms are caused by other conditions). But, they are not likely ideal for individuals with complex mental health concerns and histories. These assessments can provide access to pharmacological treatment. However, they are often not considered sufficient by educational institutions or many employers for accommodations purposes.
A Minimum Standard: A reasonable assessment of ADHD includes assessment of current as well as childhood functioning through interview, standardized questionnaires, and collateral information (e.g., parent ratings of childhood, others’ ratings of your current functioning, review of documentation, such as teacher comments on report cards, previous assessments, therapy notes). These types of assessments may or may not address other mental health concerns. They do not address possible learning disorders.
The Gold Standard: A considerably thorough assessment also includes assessment of possible confounding or commonly co-occuring concerns, such as gifted intelligence, intellectual impairment, memory deficits, learning disabilities, anxiety disorders, mood disorders, trauma, etc. This type of assessment also can provide a sense of areas of possible strength and weakness, specific accommodation needs, and treatment needs. The results can be provided to your physician to help access pharmacological treatment. For those in grade school and post-secondary seeking accommodations, this is considered the best approach and the approach that is most likely to be accepted for accommodation supports.
Should I Get Assessed for ADHD?
Do you remember clearly struggling with a number of the symptoms of ADHD described above when you were a child? Did those symptoms show up in at least two types of situations (like at home, school, and/or relationships)? Do you experience at least five of those inattentive symptoms now OR at least five of those hyperactive/impulsive symptoms now? Do these symptoms impact you in at least two areas of functioning (e.g., work, school, relationships, driving, etc.)? If the answer is ‘yes’ to each of those questions, an assessment for ADHD is likely worth pursuing. If you also struggle with nervousness, worry, low mood, learning, and/or memory, or if you have experienced trauma, or if you are exceptionally bright, a more in-depth, comprehensive assessment is important.
