How Does ADHD Testing Work?
ADHD (or Attention-Deficit/Hyperactivity Disorder) has become a popular topic in the news. As knowledge of symptoms of ADHD are disseminated, more and more people are interested in getting tested for it. In addition, as the research builds on topics like symptoms in male-identifying vs female-identifying women with ADHD, the overlap between ADHD and other neurodiversities such as Autism and Specific Learning Disorders, and how ADHD symptoms can fluctuate with age, an increasing number of the population are identifying with this having ADHD.
Words like neurotypical, neurodiverse, neurospicy, and twice exceptional are becoming common words used in non-clinical conversations. More and more groups on Facebook and people on Instagram, TikTok, YouTube etc. are connecting with each other and sharing their experiences with each other.
ADHD testing can come in multiple forms: from individual self-assessment using online questionnaires, to focused ADHD testing, to a full Neuropsychological battery.
Today we will discuss both forms of testing.
Why provide ADHD testing?
Many parents come to me with their children whom they suspect may have ADHD. Maybe parents have seen signs or symptoms sprinkled around the house (a very forgetful child, a spacey child, an intensely active child, or a child who cannot contain their impulses). Quite possibly a teacher has reached out to a child’s parents to note what they have seen in the classroom in terms of ADHD behaviors. Sometimes pediatricians notice symptoms and encourage the child’s parents to get them evaluated. In most cases ADHD testing for children has the goal of not only identifying ADHD, but the important goal of gaining school accommodations (like extended time on tests or preferential seating).
Adults who want ADHD testing have a variety of reasons they want to be tested. Occasionally they have a child diagnosed with ADHD, and they see some of the child’s symptoms mirrored in themselves, and, after reflection, are curious to know if they have ADHD as well. And because ADHD has a genetic component, often children who have ADHD have parents with ADHD (and vice versa). Adults often want to be tested because they are struggling at work or at home, and a friend, partner, or family member has suggested that they get tested. Some adults with ADHD feel like “they just don’t fit in with everyone else” but are not sure why. Some adults want workplace accommodations, and they need proof that they have ADHD to receive these.
Regardless, ADHD testing is incredibly informative, and can have an immense impact on one’s school experience, workplace setting, or interpersonal relationships.
When to be tested for ADHD?
It’s always a good idea to be tested for ADHD once you’ve noticed that the symptoms are not transitory and that they are sticking around for a while. According to the American Academy of Pediatrics, children as young as 4 can be accurately assessed for ADHD. However most children present for testing between the end of elementary school through middle of high school; whenever the task demands become too much, and the child cannot hide (or “mask”) their symptoms any longer. Transitional adults through late adulthood can also be tested for ADHD; there is no age that is too old to be tested.
Who can provide ADHD testing?
Assessments are often conducted by PhD/PsyD level Psychologists, Medical Doctors, or others who specialize in Neuropsychology. With regard to a neuropsychological assessment, it is critical to identify if the assessor has significant experience or training credentials in this area.
How does ADHD testing work?
There are two types of testing that I provide: Psychological and Neuropsychological Assessments. Regardless of the type of testing, it is important that the assessor use clinically-validated, research-backed assessment instruments. Psychological testing tends to be focused solely on ADHD (although I always screen for comorbid disorders such as Anxiety, Depression, Autism, or Obsessive-Compulsive Disorder). It usually lasts for one in-person session that includes a diagnostic interview as well as a targeted ADHD test battery. It is important to gather information about the client from multiple domains: teacher reports (if applicable), report cards/family history, and input from family, friends, or other loved ones. Classroom observations (for school-aged students) or teacher interviews can provide important input and perspective about a child. Identifying when the symptoms of ADHD started is critical to a diagnosis; it must be present before the age of 12. Typically the ADHD-targeted assessments end with a diagnosis (or not), a debrief (or multiple debriefs if you want to debrief parents and children separately), and a report going into more detail about what the testing showed as well as accommodations (for school or work). For school this can result in generating a 504 or IEP plan.
Neuropsychological assessment for ADHD generally includes all the same content and process as a psychological assessment, but it occurs because there might be broader concerns about overall functioning. Some people want to get assessed because they are worried about their memory as well as ADHD. Some people want their children to be assessed for verbal comprehension or dyscalculia (a mathematics learning disability) as well as ADHD. Those situations demand both a broader assessment as well as a deeper-dive into specific areas of cognitive functioning (such as visual-spatial reasoning, memory, or dyslexia).
When I work with these cases, I typically spend more time with the client than for a ADHD-targeted assessment and use a broader array of instruments. Reports summarizing broad cognitive functioning, ADHD, and social-emotional functioning take a good deal of time to write, so the process takes longer. It should always end with a diagnosis (if appropriate), a description of symptoms and how they are related to areas of the brain, suggested accommodations (again, if appropriate), and a deeper debrief. Oftentimes when I work with people with ADHD, they may have lower processing speed and therefore can’t think on the spot and simultaneously process information during the debrief. That’s why I encourage my clients to contact me with follow-up questions once they have had time to sit with the information and let it sink in.
Conclusion
Regardless of what type of testing you are interested in: ADHD--targeted, or a broader Neuropsychological assessment it is important to research the clinician performing the assessment and to meet them in advance. You will be spending a fair amount of time, putting in a good deal of trust, and paying sometimes substantial sums to the assessor: you should be comfortable with all these things in advance of working with that person.
I wish you the best and feel free to reach out to me with questions at kim [at] eastbayadhd.com.