The comprehensive ADHD assessment complies of a number of different stages.
1. Initial Self-Rating Scale
The first step in an ADHD assessment for adults is to have the individual complete an Initial Self-Rating Scale, which is designed to assess potential ADHD symptoms. This self-rating scale will focus on both inattention and hyperactivity-impulsivity, providing a preliminary understanding of the individual’s symptoms and how they impact daily life.
Steps:
- Complete the Self-Rating Scale: The self-rating scale will typically ask the individual to rate how often they experience certain behaviours and difficulties. These questions will cover areas such as forgetfulness, difficulty focusing, restlessness, impulsivity, and organisation.
- The scale may ask for ratings on a frequency scale (e.g., "Never", "Rarely", "Sometimes", "Often", "Very Often").
- It will also ask for examples. The more detail of examples how each area affects your life will aid the overall assessment.
- Review the responses: Evaluate the individual’s responses to identify patterns that may suggest ADHD symptoms, such as frequent struggles with attention, organisation, or impulsivity.
2. Use of ADHD Questionnaires for your relatives, partner or anyone that has known you since childhood.
A supportive information pack in the form of a questionnaire will be sent to you. These are to be filled in by three people that have known you since childhood. Such as; parents, siblings, partners, best friends or people that have known you since childhood. If you are able to also obtain any previous school or professional reports, this would also help the assessment process.
Steps:
- Once completed, send the completed supportive information packs back
- Continue for the formal assessment
3. DIVA 5 Assessment (Diagnostic Interview for ADHD in Adults) via teams meeting
The DIVA 5 is a formal, structured diagnostic interview specifically designed to assess ADHD in adults. This tool is used to gather detailed information about the individual’s symptoms across their lifetime and confirm if they meet the diagnostic criteria for ADHD.
Steps:
- Administer the DIVA 5: This assessment includes questions about the individual’s childhood and adult life, covering a wide range of ADHD-related behaviours. It evaluates both inattention and hyperactivity-impulsivity symptoms, as well as how these symptoms have affected the individual in various settings (e.g., home, work, social situations).
- Focus on childhood symptoms: A core requirement for an ADHD diagnosis is that symptoms must have been present before the age of 12. The DIVA 5 will probe the individual’s early behaviours, asking about school performance, family observations, and any history of difficulties with attention or impulsivity.
- Assess current symptoms: The DIVA 5 also evaluates how symptoms are impacting the individual’s current functioning, such as challenges with work, organisation, time management, and interpersonal relationships.
4. Review of Collated Data and Differential Diagnosis
After gathering all the relevant information through the Initial Self-Rating Scale, information support packs, and the DIVA 5 assessment, the assessor will review the collated data to ensure a comprehensive understanding of the individual's symptoms. This step also includes ruling out other potential diagnoses that might explain the individual’s difficulties.
Steps:
- Review all collated data: Assess the responses from the self-rating scale, information support packs, and the DIVA 5 interview in detail. This includes considering both historical and current symptoms and how they impact various aspects of the individual’s life.
- Evaluate symptom severity and consistency: Ensure that the symptoms meet the diagnostic criteria for ADHD as outlined in the DSM-5, particularly that they have been persistent and present before the age of 12, and that they occur in multiple settings.
- Rule out other possible conditions: Consider conditions that share overlapping symptoms with ADHD, such as anxiety disorders, depression, sleep disorders, and learning disabilities. Ruling out these conditions is essential to ensure that the diagnosis of ADHD is accurate. For example:
- Evaluate for mood disorders (e.g., depression, bipolar disorder) which can mimic symptoms of inattention, restlessness, or lack of focus.
- Assess for anxiety disorders, which may also lead to difficulties concentrating or restlessness.
- Check for sleep disorders that could contribute to poor concentration and irritability.
- Ensure ADHD is the primary diagnosis: Confirm that ADHD is the primary explanation for the individual’s symptoms, ensuring that they cannot be better accounted for by other conditions or external factors.
5. Receiving Full Diagnostic Report
Once all relevant information has been gathered and analysed, the individual will receive a full diagnostic report that includes a detailed explanation of the findings and a summary of the assessment process.
Steps:
- Provide the report: The full report will contain an analysis of the individual’s symptoms, how they meet or don’t meet the diagnostic criteria for ADHD, and any other relevant observations made during the assessment.
- Clear explanation of findings: The report will clarify whether ADHD is diagnosed or if other potential conditions have been ruled out.
- Clarify the next steps: If ADHD is diagnosed, the report will outline potential treatment options. If ADHD is not diagnosed, the report will suggest alternative diagnoses, additional assessments, or next steps in terms of treatment or support.
6. Treatment Advice and Support
Following the assessment and diagnosis, individuals will receive a leaflets containing advice regarding potential treatments, support options, and next steps.
If ADHD is Diagnosed:
- Medication: Information about medication options, such as stimulants or non-stimulants, and the potential benefits and side effects.
- Therapy: Recommendations for cognitive behavioural therapy (CBT) or other therapeutic approaches to help manage symptoms and improve executive functioning.
- Coaching and support: Details on ADHD coaching or support groups to help manage symptoms and develop coping mechanisms.
If ADHD is Not Diagnosed:
- Support and signposting: Provide guidance on what to do next. This may involve referral to other mental health specialists (e.g., for anxiety, depression, or other conditions), suggesting possible therapy or support groups, or offering recommendations for additional assessments or self-help strategies.
- Clarify alternative conditions: Offer advice on conditions that may be causing similar symptoms and provide leaflets for these conditions.