Diagnosed With ADHD as a Child: When an Adult Re-Evaluation Makes Sense

Why a childhood diagnosis may not be enough today

Many people were told they had ADHD in elementary or middle school and then rarely thought about the paperwork again. Years later, a situation comes up where that history needs to be shown, and the file is gone, thin or out of date.

These are some of the most common reasons adults look into an updated evaluation:

• The original records were lost, or the provider who wrote them has retired or closed
• A new prescriber wants to understand your history before making treatment decisions
• A college, licensing exam or employer has asked for documentation of how ADHD affects you now
• Your daily life has changed so much that you want a fresh picture of your strengths and challenges
• You wonder whether something else, such as anxiety or low mood, is now part of the picture

How ADHD can change between childhood and adulthood

The National Institute of Mental Health (NIMH) says symptoms continue into adulthood for many people with ADHD, but they may change with age. It notes that inattentive symptoms often persist as people get older, while hyperactivity and impulsivity are more likely to decline.

The CDC describes a similar shift. In adults, hyperactivity may decrease or show up as extreme restlessness, and symptoms may become more severe as the demands of adulthood increase. A child who could not stay in their seat may become an adult who feels restless inside, misses deadlines or struggles to keep appointments.

This is one reason a childhood report may not describe you well anymore. It captured how ADHD looked in a classroom. An adult evaluation looks at how it shows up at work, at home and in relationships.

What an adult re-evaluation looks at

The criteria change a little in adulthood. NIMH explains that adults and adolescents over 16 must show five symptoms of inattention or of hyperactivity and impulsivity, instead of the six required for younger children. Symptoms still need to have started before age 12, which is where your childhood diagnosis becomes useful evidence.

NIMH says a provider evaluating an adult may use clinical interviews, behavior rating scales or symptom checklists, and may ask to talk with people who know you well. Some evaluations include tests of thinking skills such as memory and planning, to identify strengths, challenges and possible learning disabilities. A provider will also ask about your mood and your current and past medical conditions, to rule out other explanations.

That last step matters for adults. NIMH notes that ADHD often co-occurs with other mental disorders, and that sleep problems are especially common. A re-evaluation can look at the whole of what is going on now, not only whether the old label still fits.

Records worth gathering before you book

MedlinePlus says a provider may consider the results of past ADHD tests and school reports, and may ask to see old school records to check whether symptoms began in childhood. You do not need a perfect file. Anything you can find helps.

1. 1Look for the original evaluationAsk a parent or guardian whether they kept a copy. If they did not, the school district or the original provider may be able to tell you how to request old records.
2. 2Find school documentsReport cards with teacher comments, an Individualized Education Program (IEP) or a Section 504 plan can all show what school was like for you.
3. 3Note past accommodationsWrite down any extra time, quiet rooms or other supports you received on tests, at school or at work, and when.
4. 4Ask someone who knew you thenA parent, sibling or longtime friend may be willing to share what they remember, with your permission.

When a new evaluation may not be needed

Before paying for anything, ask the organization what it will accept. Sometimes the answer is less than you expect.

For standardized and high-stakes exams, the Department of Justice's ADA guidance says proof of past testing accommodations on similar exams is generally sufficient to support a request for the same accommodations. It also says that if your most recent IEP or Section 504 plan included testing accommodations and you certify that you still need them, a testing entity should generally grant the same accommodations without asking for more documentation.

For workplace requests, the Equal Employment Opportunity Commission says an employer may ask for reasonable documentation about a disability and its functional limitations when they are not obvious, and only what is needed for that decision. Colleges and prescribers set their own requirements, so ask them directly. This is general information, not legal advice.

How we can help

If you do need an updated picture, Locascio Wellness offers an adult ADHD evaluation by secure video for people who are physically located in Pennsylvania, West Virginia or Arizona during appointments. It usually involves an intake appointment, then one or two sessions, then a written report, and the findings are explained in plain language. We cannot say how any organization will respond to a report, so share its requirements with us before you book.

Evaluations are private-pay, with a sliding scale available, and you can read about what evaluations cost. The first step is the short evaluation request form, where you can mention any deadline, or a free 15-minute consultation on our booking page.

Many adults find that understanding their ADHD as it is today opens up new ways to work with it. Therapists on our team offer ADHD therapy by video as a separate service. If you are in crisis, call or text 988 or call 911. Locascio Wellness does not provide emergency services.