When trying to determine if a child or teen is experiencing attention-deficit hyperactivity (ADHD), it is important to obtain an accurate diagnosis and sense of how he or she is functioning in different domains. This can help guide treatment and other interventions.
As parents begin the process of determining if a child or teen has ADHD, many wonder what is entailed in a formal evaluation by a psychologist—and what benefits it may provide. As a psychologist who provides evaluations to diagnose ADHD and treats the issue through psychotherapy, I thought I could shed some light here. The methods used vary from professional to professional, but here is a general overview of a formal evaluation for ADHD, as completed by a psychologist.
In-Depth Clinical Interview
The time frame may vary somewhat, but on average this lasts one to two hours and provides the clinician with an opportunity to gather comprehensive background information about the child or teen, current symptoms, and other difficulties. The psychologist generally spends time meeting with the child or teen and his or her parents, together and/or separately.
Consultations with Relevant Professionals
Many psychologists consult with other service providers working with the child/teen, including mental health therapists, speech/language therapists, occupational therapists, and psychiatrists. In a lot of cases, the clinician will endeavor to complete a school observation and interview teachers. (Depending on the circumstances and the comfort level of those involved, this may not always be warranted or feasible.)
Formal Testing
The exact measures used and amount of time needed to complete testing vary, to some degree, for a variety of reasons. On average, formal testing for ADHD lasts between four and nine hours. Many clinicians opt to break up testing into two or three sessions on different days.
A variety of standardized measures involving direct interaction between the psychologist and child/teen—computerized measures, self-report and parent/teacher report questionnaires, and other types—are used to look at several areas of functioning, including cognitive functioning, academic achievement in a variety of domains, reading/language skills, attention/impulsivity, visual-motor skills, and emotional functioning.
Completed Report/Formal Feedback Session
Reports can take several weeks to complete; it takes considerable time to carefully review/interpret results and document it all.
The feedback session is an opportunity to learn about the results of the evaluation and begin talking about specific recommendations to assist the child/teen in improving areas in which he or she is struggling.
Diagnosing ADHD in children/teens is often not as simple as one might think; many issues, such as depression, anxiety, sensory issues, learning difficulties, auditory processing disorder, and even autism spectrum issues, have symptoms that can mimic ADHD. A formal evaluation is helpful in ruling out other issues to ensure an accurate diagnosis.
Nonetheless, depending on the presenting issues, an evaluation doesn’t always lead to definitive conclusions about diagnoses. In these cases, a parent still would come away with a clear sense of how the child/teen is functioning, and would have recommendations to assist him or her.
Benefits Beyond Diagnosis
Aside from obtaining an accurate diagnosis, here are a few possible benefits of having a formal evaluation conducted:
- Good understanding of the child/teen’s strengths and limitations
- Recommendations for teachers at school
- Recommendations for helping the child/teen at home (suggestions to improve organization, time management, behavior, etc.)
- Information and specific recommendations to help current and future service providers (psychiatrists, mental health therapists, etc.) best assist the child/teen
- Documentation of the issue that may qualify the child/teen for special education services in the form of a 504 plan or individualized education program (IEP). This may entitle the child/teen to accommodations such as extended time, private or small group testing environment to reduce distractions, use of a word processor in class, etc. Older teens may qualify for accommodations on college board exams as well as services in college. (Not all public school systems/private schools use outside evaluations in the same way, so depending on the school system, ADHD alone may not qualify a child for services.)
If you believe that your child/teen has ADHD and he or she is struggling academically, socially, or in other areas, it is important to get a clear sense of his or her difficulties, determine if it is indeed ADHD, and obtain appropriate treatment.
Disclaimer: The preceding article is intended as general guidance based on the author’s professional opinion, does not constitute an established professional relationship, and should not replace the recommendations of a psychologist or other licensed professional with whom you initiate or maintain a professional relationship.
© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Carey Heller, PsyD, ADHD: Inattention, Impulsivity, and Hyperactivity Topic Expert Contributor
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.
Smartphone Apps to Improve Self-Monitoring in Teens with ADHD
Therapists Must Be Activists When Counseling ADHD-Impacted Couples
What If My Husband and Child Both Have High-Functioning Autism?