What Does an Adult ADHD Evaluation Look At?

A pattern, not a single moment

Everyone forgets an appointment or drifts off in a long meeting now and then. The National Institute of Mental Health (NIMH) explains that in adults with ADHD these behaviors are more severe, frequent and persistent, occur across multiple situations, interfere with daily life and last at least 6 months.

That is why an evaluation is built around a pattern. MedlinePlus notes that there is no single test that can diagnose ADHD. Instead, the evaluator gathers several kinds of information and looks at whether they fit together. The areas below are the ones the major health agencies describe.

Your history before age 12

ADHD is considered a developmental condition, and NIMH states that adults must have shown symptoms much earlier, starting before age 12. The CDC says the provider will determine whether symptoms were present before that age.

This is often the hardest part for adults, because childhood was a long time ago. NIMH notes that diagnosing ADHD in adulthood relies heavily on past reports of behavior. Expect questions about how school went, what teachers said, how you handled homework and chores, and whether family members noticed anything.

A missing childhood diagnosis does not count against you. NIMH lists several reasons adults reach adulthood undiagnosed, including adults around them not recognizing it, or a supportive environment that helped them manage.

Symptoms across more than one setting

MedlinePlus explains that, for a diagnosis, symptoms must happen in two or more settings, for example at home and at work or school. For people 17 and older, it says there must be at least five ongoing symptoms of inattention or hyperactivity and impulsivity.

So an evaluator will ask about different parts of your life separately. Trouble focusing only in one job you dislike tells a different story from trouble focusing at work, at home, with bills and in conversations with friends.

How much it affects daily life

Having symptoms is not enough on its own. They must clearly get in the way of functioning at work, at school or in social situations. NIMH lists some of the ways this shows up in adults:

• Disorganization, procrastination and poor time management
• Trouble remembering daily tasks, or frequently losing things
• Trouble focusing on a large task, following instructions or finishing projects
• Restlessness, interrupting others or choosing immediate rewards over later ones

What other people and old records add

Because memory of childhood is patchy, outside information helps. NIMH says a provider may ask to talk to people who know you well, such as a partner, family members and friends, to learn about your behavior in different situations and during childhood. MedlinePlus adds that for adults this may include co-workers and family members who knew you as a child.

Records can help too. Old report cards, teacher comments and any earlier evaluations can show whether difficulties were already visible years ago. MedlinePlus notes that your provider will tell you which records to gather. This step happens only with your permission.

Mood, sleep and health

A careful evaluation also asks whether something else fits better, or whether more than one thing is happening. The CDC says a medical and psychological exam may be needed to rule out other health problems that can cause symptoms like ADHD or that are often present with it, such as anxiety, depression, sleep problems and learning disabilities.

NIMH describes reporting on your mood and your current and past medical conditions, and taking psychological tests that look at memory, planning, decision-making and reasoning to identify strengths, challenges and possible learning disabilities. MedlinePlus mentions that a physical exam may include vision, hearing and thyroid tests. If ADHD is found, it says the results usually name the type, inattentive, hyperactive-impulsive or combined, and may describe how mild or severe it is.

How we can help

Our adult ADHD evaluation covers these areas by secure video, for people who are physically located in Pennsylvania, West Virginia or Arizona. It usually involves an intake appointment, then one or two sessions to complete the evaluation, then time for the written report. At the moment, the report is usually ready about a month after the first evaluation appointment. If you have a deadline, say so on the request form.

Evaluations are private-pay, and a sliding scale is available. You can read about what evaluations cost, and other kinds are described on our psychological evaluations page. The first step is the short evaluation request form or a free 15-minute consultation on our booking page.

If what you learn suggests you would like support with focus, planning or mood, therapists on our team offer ADHD therapy by video as a separate service. In a crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Understanding your pattern clearly is often where practical change begins.