ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
ASSESSMENT AND DIAGNOSIS FOR ADULTS
If you are concerned that you may have Attention Deficit Hyperactivity Disorder (ADHD) and are interested in having an assessment, Questa is able to help. We have a multi-disciplinary team who are experts in assessing ADHD and other neurodevelopmental conditions and can offer valuable advice and guidance as well as signposting you to services that may be able to meet your on-going needs following the assessment.
What is ADHD?
ADHD is usually first diagnosed in childhood and often lasts into adulthood. You may not have been diagnosed as a child but may now be experiencing something that you recognise as ADHD behaviour. It may be that you are not thriving or reaching your potential because of the difficulties caused by your symptoms.
ADHD can cause difficulties at work, at home, or with relationships.
A person with ADHD may:
have difficulty paying attention in conversation
find it hard to focus for sustained periods of time
be disorganised and forgetful
experience poor working memory
have trouble controlling anger and frustration
experience difficulty sleeping normally
make careless mistakes
take unnecessary risks
These symptoms may persevere into adulthood may lead to depression, anxiety or substance abuse if not recognised.
Types of ADHD
There is some debate about how persistent ADHD is in adulthood but it can be as many as two thirds of children who have ADHD will be diagnosable as adults. There are three different types of ADHD, depending on which types of symptoms are strongest in the individual:
Predominantly Inattentive Presentation: difficulty organising or finishing tasks, paying attention to details, following instructions or conversations. The person is easily distracted or forgets details of daily routines.
Predominantly Hyperactive-Impulsive Presentation: fidgeting and talking a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless or agitated and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
Combined Presentation: Symptoms of the above two types are equally present in the person.
Because symptoms can change over time, the presentation may change over time as well.
What are the benefits of a diagnosis?
Getting a timely and thorough assessment and diagnosis may be helpful because:
It provides a framework for understanding yourself better.
Getting the right diagnosis means accessing the right help or helping others understand your needs.
It means that workplaces, colleges and universities can make reasonable adjustments for you to make the environment more user-friendly.
A diagnosis can also help you make sense of your experiences.
It is up to you whether you decide to seek a diagnosis; some people are happy to remain un-diagnosed. The only way to know for sure whether you have ADHD is to have a formal diagnostic assessment.
The assessment process:
There are structured phases in the formal diagnostic process. Some of the diagnostic stages are carried out over video link, while some can be offered face-to-face:
1. Initial Assessment appointment:
You will meet with one of our team members for an in-depth discussion about the experiences in your life and the behaviours that you think may be associated with autism. At the initial appointment we aim to discuss things more broadly to ascertain whether other things may explain your concerns. Although we are unable to assess all other possible causes, we would expect that our initial assessment will give you a better understanding of your unique experiences and enable you to decide whether a full autism assessment is worthwhile for you. We will also ask you to complete screening questionnaires to help with this initial part of the assessment. *
This stage is carried out online.
*If you are recommended both an autism and ADHD assessment, only one initial assessment is needed for the clinician to provide suitable recommendations about how to proceed. However, at Questa we do not carry out combined assessment but prefer to assess the diagnoses separately.
2. Detailed diagnostic interview:
The detailed diagnostic interview
gathers further information from questionnaires and builds on the assessment information already gathered. The diagnostic process is split into three parts. Part 1 requires you to complete further questionnaires as well as attending an interview with a member of the multidisciplinary team or assistant psychologist. It is recommended that a person who knows you well also attends the interview, or alternatively books their own interview, so that the clinician gathers as much information as possible from multiple parts of your life.
This appointment lasts up to 2 hours.
3. Detailed diagnostic interview Part 2:
You will be asked to complete a test called QbCheck, a web-based test with motion tracking which objectively measures the three core symptoms of ADHD: activity, attention, and impulsivity. It also measures the likelihood for ADHD. By providing quantitative measures of your activity level, ability to pay attention, inhibit impulses and a likelihood of ADHD, QbCheck can aid our clinicians in the assessment process.
This stage can either be carried out face-to-face or online.
4. A feedback session
You will be invited to a feedback session with your clinician to go over the assessment, outcome and report. The full report includes detailed recommendations designed to meet your needs, details of resources and other services that provide relevant support.
This stage is carried out online.
5. Further consultation
If the assessment outcome is a diagnosis of ADHD, we can offer additional further post-diagnostic support. At Questa our team is able to offer support, guidance and advice to address any on-going needs you may have. We can also offer consultation to colleges and universities to assist them in providing you with appropriate support or environmental adjustments.
6. Therapy and Coaching support
We can offer coaching and/or psychological therapy interventions for any behavioural or emotional concerns you may have (such as anxiety, depression, low self-esteem) or assistance with organisational, emotional or social skills.
7. Further assessments
Further observations may be needed if there is any doubt about the observer reports. Also, the assessment may highlight that additional assessment is needed or beneficial. For example, a cognitive assessment to help clarify a learning profile and intellectual ability, strengths and weaknesses.
Please note: For medication, you will need a psychiatric consultation. That would include medical examination along with titration of medications. At Questa, we are a group of psychologists who can do the assessment and diagnosis. However, we do not have the resources to investigate how you will respond to medication or how long the titration process would be. We would therefore send all our reports to your psychiatrist for further assessment.