ADHD Assessment and Treatment
Before starting any treatment, it is important to conduct a thorough evaluation of ADHD. This includes a physician interview, other sources, such as spouse or family members, DSM-5 ADD symptom scales and checklists, and standard tests.
Experts might also see your child's school records and talk with teachers as well as religious leaders, scout leaders or coaches. ADHD symptoms must be present from childhood to be diagnosed at an adult age.
ADHD symptoms
The signs of ADHD vary by age, but children with ADHD are often having trouble staying focused on tasks or paying attention to people. They might fidget and mutter out answers to questions or interrupt other people. They may also have trouble with organization, get easily bored and have a tough time waiting for their turn. The signs of impulsive behavior include a tendency to engage in activities without permission, running around or climbing places they aren't supposed to go. They could also be inclined towards using explosive anger or excitement to stimulate themselves, such as by making others angry or pulling pranks.
In an assessment, a doctor may utilize questionnaires or interviews to determine if a child has ADHD. They can also request that the child's teachers fill out rating scales. They may also perform a physical or neurodevelopmental exam to determine if there are medical issues that could trigger symptoms of ADHD such as thyroid conditions or mood disorders.
The evaluator may also ask whether your child has any other mental disorders such as conduct disorder as well as oppositional defiant syndrome and anxiety disorders. They will also inquire about your family history, for instance, whether anyone else has ADHD or any other psychiatric issues.
Adults with ADHD often have difficulty managing their lives, including home and work responsibilities. They may also have issues getting along with family members or coworkers. These symptoms can result in them being late for appointments or fail to attend social events. The difficulties they face in school could cause academic failure and poor performance.
For an adult to be diagnosed with ADHD, they must have six or more established symptoms of inattention or hyperactivity-impulsivity for at least six months. Doctors will conduct an interview with the patient along with someone who is familiar with them such as a spouse or parent for adults or a teacher, coach, nanny or coach for children. The information gathered will help the doctor determine what, if any, tests might determine if other conditions are causing symptoms of ADHD. They may also employ an assessment tool designed to detect these signs in adults.
Diagnosis
The method of diagnosing ADHD involves a series of appointments with doctors or therapists. The diagnosis is made according to the severity of the symptoms and how they impact the person's daily life. It is essential to get the correct diagnosis to manage symptoms that could hinder the family life and work. The diagnosis is given by a healthcare professional who is specialized in ADHD like a psychologist or psychiatrist.
The doctor will talk about the patient's medical background and symptoms as well as the date they first began to show. The doctor may request an account of the symptoms they experience and how they affect their lives. This can be extremely useful in gaining an exact picture of the issue and assisting in determining which tests or evaluations are needed to determine whether ADHD is the reason behind the symptoms.
The doctor will also use questionnaires in order to assess the severity of symptoms. The doctor might utilize questionnaires for parents and teachers to assess children and an interview with the patient to assess the signs. The questions are often similar to those in the NIMH ADHD diagnostic criteria, which help doctors identify whether a person is exhibiting hyperactive/impulsive or inattentive symptoms.
Some doctors will also do an examination to ensure there isn't any physical issue like thyroid issues or seizures, which could be the cause of the problem. Other tests are also available to determine if there are other issues such as depression or anxiety.
Sometimes, the doctor may require brain scans to rule out possible causes of the symptoms. These tests, which aren't routinely used to diagnose ADHD but can be a useful instrument when other tests for diagnosing the condition have been cleared.
If you or your child suspects they have ADHD or other disorders, it is best to speak with a primary physician. If the person does not have a primary doctor and is looking for a referral to their insurance company for the list of health professionals who are trained to conduct an ADHD assessment.
Treatment options
The first step to treatment is an evaluation by a physician who can determine whether the symptoms are related to ADHD or another mental health condition. A thorough evaluation can include an interview with a child and parent and rating scales that evaluate the child's behavior to people without ADHD.
Many medical conditions can cause symptoms similar to the symptoms of ADHD such as thyroid issues seizures, head injuries and seizures. A physical exam could be required to rule out these causes. A psychological examination is required to determine if the symptoms are due to ADHD or a different mental health issue, such as anxiety.
The signs of ADHD can lead to significant problems in work, school and in relationships. The person being evaluated should be honest and candid with the examiner about the problems they're having. They shouldn't hide their feelings in fear of being judged or shame. They should describe their symptoms as in detail as they can, including how they affect them at home and at school. Parents should be involved in the evaluation process, but not in the decision-making process.
The kind of medication prescribed depends on the underlying condition the symptoms and the age of the child. For example, stimulants are typically prescribed to teens and children with ADHD. They work by increasing brain activity in areas that regulate the behavior and attention. These medications may come in the form of tablets that release immediately or modified-release tablets that release the medication slowly throughout the day. Methylphenidate, which is the most popular medication prescribed for ADHD, is available in tablet form.
Other options for treating ADHD include marital and family therapy or cognitive behavioral therapy which teaches specific methods to transform negative behavior into positive behaviors. Certain adults with ADHD might benefit from these treatments, as well as from educational and occupational accommodations.
The most important aspect of treatment is the follow-up phase, with frequent meetings to examine progress and determine the next steps. Parents should be encouraged to involve teachers and other professionals, including Scout and religious leaders in the process. These professionals can provide valuable information about how the child behaves and function in different situations.
Medication
There are a variety of medications used to treat ADHD. The most popular are stimulants, which work by increasing activity in specific brain areas that control attention and behavior. Methylphenidate is the most widely used stimulant for adults, teenagers and children older than 5 years old. It is taken in tablet form, typically 2 to 3 times per day. It is available in immediate-release (short-acting) or extended-release (taken at least once per day in the morning, and released throughout the day).
Many people report that their symptoms and impairments dramatically improve after some time on medication. These effects are usually seen in school, home and social settings. The effect on performance in these environments is measured using one or more standardized rating scales, which compare behaviors of the individual with the behavior of others. These ratings are not diagnostic in their own right however they provide useful, data that can be used in the evaluation process.
There are many non-medical treatments for ADHD that include the use of behavioral therapy and training for teachers and parents. The American Academy of Pediatrics recommends that parents receive training in behavior management prior to attempting medication for their children. The guidelines also call for psychotherapy and a classroom-based intervention to be part of the treatment program for adolescents and teenagers with ADHD.
Most often, ADHD medication can cause nausea, sleep disturbances and changes in blood pressure or heart rate. Some kids and teens who take stimulants may develop tics that are repetitive movements or sounds like eye blinking or throat clearing. ADHD medication may cause a slight reduction in growth for some adolescents and children, however it's usually minimal and doesn't affect their final height.
These medications have the potential to cause addiction and abuse, but research shows that there isn't a significant risk at the doses prescribed to treat ADHD. Some kids and teens with ADHD are at higher risk for substance use problems, but that is due to the disorder, not the medication.
Another potential negative consequence of ADHD medication is the risk for developing cardiovascular disease (CVD). Recent research found that people who use stimulant drugs to treat ADHD are more at risk of developing cardiovascular disease than those who don't. Researchers looked at data from 278 027 people, including 10 388 people with ADHD. They compared these individuals to 51 672 controls without ADHD. adhd assessments were monitored for 14 years.