What questions do they ask to see if you have ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity that interferes with daily functioning. ADHD is typically diagnosed in childhood but can persist into adulthood.

The diagnostic process for ADHD involves a comprehensive evaluation by a mental health professional such as a psychologist or psychiatrist. This evaluation includes taking a detailed history, interviewing the patient and people close to them, conducting psychological testing, and ruling out other possible conditions.

Some common questions that may be asked during an ADHD evaluation include:

Inattention Symptoms

– Do you have trouble paying attention to details or make careless mistakes?
– Do you have difficulty staying focused during tasks or play?
– Do you seem not to listen when spoken to directly?
– Do you struggle to follow instructions and finish tasks?
– Do you have difficulty organizing tasks or activities?
– Do you avoid, dislike or feel reluctant to engage in tasks that require sustained focus?
– Do you frequently lose or misplace things?
– Are you easily distracted by external stimuli like sounds or visuals?
– Do you frequently forget daily activities or events?

Hyperactivity Symptoms

– Do you seem restless or fidget frequently?
– Do you have trouble sitting still for extended periods of time?
– Do you run around, climb excessively or have difficulty playing quietly?
– Do you talk excessively or interrupt conversations frequently?
– Do you feel constantly “on the go” or like you have boundless energy?

Impulsivity Symptoms

– Do you have difficulty waiting your turn during activities or conversations?
– Do you interrupt others often or intrude on their activities?
– Do you engage in dangerous activities without considering the consequences?
– Do you have trouble controlling your impulses?
– Do you have outbursts, react emotionally or have difficulty regulating emotions?

Onset of Symptoms

– When did you first notice these symptoms emerging?
– Can you recall signs in early childhood before age 12?
– Have the symptoms been present for at least 6 months?
– Have the symptoms occurred across multiple settings like home, work/school, and social environments?

Impact on Functioning

– Are the symptoms impacting your relationships or causing issues with family members, friends or coworkers?
– Are the symptoms negatively affecting your performance at work or school?
– Do symptoms interfere with your ability to complete tasks and achieve goals?
– Have you had any legal issues or accidents due to impulsive behavior?
– Has disorganization or forgetfulness caused significant impairment?

Differential Diagnosis

To distinguish ADHD from other possible conditions, the evaluator may ask:

– Do you have any other neurodevelopmental, psychiatric, or medical conditions?
– Have you ever experienced depression, anxiety, trauma, sleep disorders, thyroid dysfunction, seizures, substance abuse issues, or other conditions?
– Are you taking any medications that might contribute to symptoms?
– Have you undergone any neurological testing like IQ testing, neuropsych evaluations, or EEGs?
– Is there any history of ADHD, mental health disorders, or neurological conditions in your family?

Daily Functioning

To understand the pervasiveness of symptoms, questions may include:

– How do the symptoms impact your daily routines like getting ready, commuting, work performance, schoolwork, meals, chores, and bedtime?
– What types of tasks or situations seem to exacerbate the symptoms?
– Are there times of day when symptoms seem worse?
– Do symptoms interfere with your ability to initiate or complete tasks you want or need to do?
– How do symptoms affect your interactions with family, friends, coworkers, classmates, etc?
– What coping strategies or accommodations, if any, have you developed to manage the symptoms?
– Overall, how are the symptoms impacting your quality of life?

History

Questions about early life experiences aim to identify possible symptom patterns:

– As a child, how did others like parents, teachers, or peers describe your behavior and temperament?
– Did anyone note concerns about activity level, impulsivity, attention span or learning early on?
– Were you an active child, had difficulty sitting still, or got in trouble often for not following rules?
– Did you have any speech, language, reading, writing, or learning difficulties as a child?
– Were you diagnosed with ADHD or any other conditions in childhood? If so, were you treated and how effective was treatment?

Treatment History

If previously treated, the provider may ask:

– Have you received any prior treatment or support services for ADHD symptoms?
– If so, what types of interventions were tried (medications, therapy, school accommodations, etc.)?
– How helpful were these interventions in managing symptoms?
– Have you been prescribed ADHD medications in the past? Which ones and what was your response?
– Have any close family members been diagnosed or treated for ADHD?

Substance Use

Questions about substance use aim to identify complicating factors:

– Do you use tobacco, nicotine, alcohol or recreational drugs? If so, how often and what types?
– Have you ever felt you wanted or needed to cut down on substance use?
– Does substance use seem to worsen or reduce ADHD symptoms?
– Have you experienced any legal, health, occupational or social problems related to substance use?

Mood Symptoms

To identify co-occurring mood disorders, the provider may ask:

– Do you experience depressive symptoms like sadness, low energy, changes in sleep or appetite, feelings of worthlessness, or suicidal thoughts?
– Do you have excessive worries, fears, panic attacks or compulsions that interfere with functioning?
– Have you ever been diagnosed with or treated for depression, anxiety, or obsessive compulsive disorder?

Cognitive Screening

Cognitive screening questions identify possible thinking or memory deficits:

– Are you having any trouble with your memory or concentration?
– Do you have difficulty learning new information or skills?
– Do you feel your thinking is foggy or muddled?
– Have you noticed any word-finding problems or confusion?
– Have you or others noticed cognitive changes compared to your past functioning?

General Health

To assess general medical status, the provider may inquire about:

– Your current physical health status and any medical conditions
– Sleep patterns and any sleep disorders
– Appetite and eating habits
– Exercise habits
– Developmental, neurological or mental health history
– Family medical and mental health history
– Social functioning and relationships
– Job performance and employment history
– Coping abilities and sources of support

Diagnostic Criteria

To make a diagnosis, the clinician will determine if ADHD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are met:

A. Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development:

Inattention: At least 6 symptoms of inattention have persisted for at least 6 months:
– Failure to pay close attention to details
– Difficulty sustaining attention
– Does not seem to listen
– Difficulty following instructions
– Poor organization
– Avoids tasks requiring sustained focus
– Loses things
– Easily distracted
– Forgetful

Hyperactivity and Impulsivity: At least 6 symptoms have persisted for at least 6 months:
– Fidgety
– Leaves seat when should be seated
– Runs about or climbs inappropriately
– Unable to play quietly
– “On the go”
– Talks excessively
– Blurts out
– Trouble waiting turn
– Interrupts others

B. Symptoms present before age 12 years.

C. Symptoms present in two or more settings such as school, work, home.

D. Symptoms interfere with functioning.

E. Symptoms not better explained by another disorder.

Based on the patient’s reported symptoms, onset, duration, level of impairment, and exclusion of other explanations, the provider determines if the criteria are fully met for diagnosis.

Diagnostic Testing

Formal testing may include:

– Medical exam to identify any physical cause of symptoms.

– Vision and hearing screen to rule out sensory deficits.

– Cognitive and achievement testing to identify learning disabilities or cognitive weaknesses.

– Personality testing to assess personality traits and psychopathology.

– Behavioral checklists completed by parents, teachers, spouse to quantify ADHD behaviors.

– Neuropsychological testing to evaluate executive functions like attention, memory, planning which are often impaired in ADHD.

Results help determine diagnosis, identify comorbidities, and guide treatment planning.

Informant Input

The clinician will also seek input from spouses, parents, teachers, or other close contacts who observe the patient in daily life. They may inquire about:

– When they first noticed symptoms
– Symptoms observed at home, work, school, socially
– Consistency of symptoms vs. fluctuation
– Severity and pervasiveness of symptoms
– Functional impairment related to symptoms
– Family history of ADHD or related disorders

Information from informants provides critical clinical context about the patient’s behaviors and functional challenges.

Making the Diagnosis

Based on:

– Patient history and interview responses
– Input from informants
– Behavioral checklists and rating scales
– Results of diagnostic testing
– Application of DSM-5 diagnostic criteria

The provider analyzes all gathered information to determine if criteria for ADHD diagnosis are met.

Conclusion

ADHD evaluation involves a comprehensive clinical interview exploring:

– Core symptoms of inattention, hyperactivity, impulsivity
– Onset and duration of symptoms
– Severity and impact of symptoms
– Symptoms across settings
– Co-occurring conditions
– General medical and mental health
– Substance use
– Social and family history
– Prior treatment and response

Information from informants and diagnostic testing complement the interview data. The provider analyzes all data to establish whether formal DSM-5 criteria for ADHD diagnosis are fully met. If so, ADHD diagnosis can be made to guide appropriate treatment.

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