Is there a test or brain scan for ADHD?
No. There is no single medical, physical or genetic test for ADHD, and there are no specific blood tests or routine imaging for diagnosing it. An evaluation is a process of gathering information from several sources and seeing whether they fit together.
A short office visit alone cannot settle it either. CHADD, the national ADHD resource center, points out that ADHD cannot be accurately diagnosed just from brief observation or simply by talking with someone, partly because symptoms may not appear during the appointment. A person can sit calmly and focus well for an hour in an office and still have real trouble elsewhere.
What actually happens in an evaluation?
The order and the details vary from one provider to another, but a thorough adult evaluation generally includes these parts. They do not all have to happen in one visit.
- A clinical interviewExpect questions about what led you to seek an evaluation, what you notice now, and your personal, medical and psychiatric history from childhood to the present.
- Childhood historySymptoms must have started before age 12, so a diagnosis relies heavily on past reports of behavior. A provider may look at school reports or other childhood records.
- Rating scales and checklistsYou, and often someone close to you, fill out standardized questionnaires. Scores are not a diagnosis by themselves. They are one source of information among several.
- Input from othersWith your permission, a provider may talk with a partner, parent, sibling or longtime friend who has seen you in different settings.
- Ruling out other causesYour mood and past and current health are reviewed to rule out other diagnoses and to spot conditions that occur alongside ADHD.
- Putting it togetherThe provider weighs the number and severity of symptoms, how long they have lasted and how much trouble they cause, then shares impressions and reviews options with you.
Why would a provider want to talk to someone who knows me?
Many adults with ADHD have gaps in their memory of childhood, or they downplay their symptoms, sometimes out of embarrassment. They may also not fully see how their habits affect the people around them. Someone who has watched you over the years can fill in details you would never think to mention.
This is not a test of your honesty, and it should not happen without your agreement. If a conversation is not possible, a checklist completed by that person can be a good alternative. If nobody from your childhood is available, tell your provider. Old report cards may help, and the evaluation can still go ahead on what you can provide.
What other conditions does a provider need to rule out?
This step is what separates an evaluation from a checklist. Stress, sleep disorders, anxiety and depression can cause symptoms similar to ADHD. Substance use, learning disorders, head injuries, thyroid conditions and some medications such as steroids can also mimic it. Treating ADHD when ADHD is not the cause is unlikely to work.
It can also be more than one thing. ADHD rarely occurs alone, and a co-existing condition that goes untreated can make ADHD treatment less effective. See our page on sleep problems and our guide on telling ADHD and anxiety apart if either sounds familiar.
CHADD recommends a medical exam if you have not had a recent physical, within about 6 to 12 months, because some medical conditions can look like ADHD. An exam cannot confirm ADHD, but it can help rule out physical causes. Ask us, or your primary care provider, whether a check-up makes sense for you.
What can an online ADHD quiz tell me, and what can it not?
An online quiz can be a reasonable place to begin. It may give you words for what you have noticed and a reason to book a visit. Mental Health America makes the same point about screening tools generally: a mental health test cannot provide a diagnosis, but the results can help you organize your concerns and start a conversation with a provider.
A quiz cannot check when your symptoms began, whether they cause real problems in at least two areas of life, or whether something else explains them. Many of the listed behaviors are ones most people show at times. Feel free to bring your results to a visit, but try not to treat a high or low score as an answer.
What should I gather before an ADHD evaluation?
None of this is required, and missing records should not stop you from going. Bring what you can find without much effort. Our guide on how to prepare for a first psychiatric visit covers more general preparation.
- Old report cards or school reports, especially teacher comments
- Any earlier evaluations or records of treatment for attention, learning or mental health concerns
- A list of everything you take, including over-the-counter medicines, vitamins and supplements
- A few recent, specific examples of problems at work, at home, with money or in relationships
- Family health history, including anyone diagnosed with ADHD or a mood or anxiety disorder
- The name of someone who knows you well and would be willing to share what they have seen
- Your questions
What does an evaluation look like at DanShalom Behavioral Clinic?
You meet with Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner for whom ADHD is one of the main areas of experience. Before the first visit, you complete intake forms in a secure patient portal. The first visit, a psychiatric evaluation, is about 60 minutes. Follow-ups are about 30 minutes, and the same provider sees you each time.
We cover your current symptoms, medical and mental health history, medications, family history and daily life, and we use standard screening questionnaires where they are useful. We then share our impressions and talk through options with you. Sometimes more information is needed before a diagnosis is clear. If you want to read more first, our ADHD page describes the care we provide.
Visits happen in person in Sugar Land, or by secure video if you are physically in Texas, Idaho, Arizona or Maryland at the time. We see patients ages 5 to 65. To begin, use the request form. We accept many major insurance plans, which differ by state, and also offer self-pay and a sliding scale.
We are not an emergency service. If you are in crisis or thinking about suicide, call or text 988. In a life-threatening situation, call 911.
Questions patients ask
Do I need psychological or neuropsychological testing to be diagnosed?
Not always. Testing is used as needed, depending on the person. These tests do not diagnose ADHD directly, but they can show strengths and challenges and help identify learning disabilities or other conditions. Whether testing would be useful in your case, and where it could be done, is a question to ask us at your visit. A referral to another professional may be needed.
Can you complete paperwork for school or work accommodations?
Ask us before your visit if you need this, and tell us what the school or employer has requested. We cannot promise any particular paperwork or result in advance. People whose ADHD causes problems at work may qualify for reasonable accommodations under the Americans with Disabilities Act, and the employer or school can explain what documentation they need.
What if I was diagnosed as a child but have no records?
Tell your provider what you remember, including who diagnosed you and any treatment you had. If you can, ask your parents or former providers for copies of records. Lack of paperwork does not end the conversation, because a new evaluation can review your history and how you are doing now. Symptoms can also change with age.
What if the evaluation says it is not ADHD?
That can still be useful. If another condition explains your symptoms better, you have a clearer direction, and it can be treated on its own terms. Sometimes the answer is that more information is needed. If you see your symptoms differently, say so, and ask what led to the conclusion. Asking for another opinion is also reasonable.
Will I be pushed toward medication if I am diagnosed?
No. Common treatments include medication, therapy and practical strategies, often combined. Medication decisions come after the evaluation and are made with you. Not every medication can be prescribed at every kind of visit, some may require an in-person appointment, and we explain what applies to you. Read about medication management. Talk with your prescriber before changing anything you already take.
References
- ADHD in Adults: 4 Things to Know (National Institute of Mental Health)
- Attention-Deficit/Hyperactivity Disorder: What You Need to Know (National Institute of Mental Health)
- Diagnosis of ADHD in Adults (CHADD, National Resource Center on ADHD)
- What is ADHD? (American Psychiatric Association)
- What to do if your child opens up about their mental health (Mental Health America)
Reviewed by Victor Onodjacha, MSN, PMHNP-BC, . This page is general information, not medical advice or a diagnosis.