Department of Psychiatry

Penn Behavioral Health

Assessment

Two important points to consider before pursuing an assessment for adult ADHD:

Our assessment approach does NOT meet the current criteria as set forth by the Americans with Disabilities Act (ADA) for students seeking academic accommodations. The diagnosis of ADHD by itself is not sufficient. There must be evidence of specific learning disabilities (or other disabilities). The documentation of learning disabilities requires a specific psychoeducational evaluation, which our program does not currently offer. The explicit criteria for documentation are outlined in the Student Disabilities Services’ section of each educational institution’s website. 
 
The initial assessment is just that – an evaluation to determine if a diagnosis of ADHD is supported by the developmental and clinical evidence or not. In some cases the results of our evaluation will NOT support a diagnosis of ADHD. Our assessment may reveal other explanations for the presenting problems and symptoms that led someone to seek an assessment. Hence, there will be cases in which the result of the evaluation is that there will be a referral provided for another program or type of care. Moreover, in some cases, even though a diagnosis of ADHD is indicated, there may be other clinical factors that are considered a higher priority to be addressed and may not be within the realm of expertise of our program. In these cases, referrals will be provided.

No single test can definitively prove whether someone has ADHD. We conduct a comprehensive assessment, including a thorough history of a person's functioning since childhood. Standardized ADHD behavior checklists and symptom rating scales help specify problematic behaviors in childhood and in adulthood. Ratings from others who have observed the patient's behavior in different settings also are used.

Our assessment for ADHD also includes neurocognitive screening that provides measures of cognitive skills, such as organizational abilities, time perception and management, emotional regulation, working memory, cognitive processing speed, and the ability to sustain attention. No test is adequate for identifying symptoms or life impairments associated with ADHD but can be useful in identifying areas of strength and weakness that may contribute to some life difficulties as well as, in some cases, potential indications that more extensive testing is necessary.

We also consider and look for other psychological and medical problems that may, in fact, produce ADHD-like symptoms. These include, among others, sleep disorders, thyroid hormone imbalances, and prior head injuries.

We also evaluate for the presence of co-morbid conditions that may accompany ADHD such as anxiety, depression, and substance use. In some cases, it may be determined that such conditions are the primary cause of a person's difficulties rather than ADHD.

The assessment process itself takes about four (4) hours from start to finish. This does not include time spent completing various forms and questionnaires prior to the assessment.

After the assessment meeting is completed, a 45-minute feedback session is scheduled for a subsequent date (generally within 2 weeks) during which the test results are presented and explained in user-friendly terms and all questions are answered. Treatment options are described and discussed. Even when it is concluded that the presenting problems are not the result of ADHD, treatment options and appropriate referrals are offered in order to assist individuals in getting the help that they need.  

A written report summarizing the results and recommendations from the comprehensive evaluation will be mailed to you about 4 to 6 weeks following the feedback session. (The finished report is not made available at the feedback session because, at times, new information or clarifications arise during this meeting that are then integrated into the report.)

For adults with ADHD who can benefit from our services, we view the assessment as the first step in the treatment process. For most, the assessment results will provide concrete explanations for past and present difficulties at school, work, and home. Very often this leads to a renewed sense of self-esteem and self-confidence. In cases in which it is determined that an individual does not have ADHD, the assessment can be helpful to clarify the difficulties a person has been facing and to determine what sort of referrals to pursue.

Once diagnosed, ADHD is usually very treatable. As discussed elsewhere on this site, treatment may include medications, Cognitive Behavioral Therapy, individual coaching, and the group executive skills training program that, individually and/or collectively, help individuals develop effective strategies to minimize the negative impact of their ADHD symptoms while learning ways to better implement these strategies and apply their core strengths to attain more comfortable and satisfying life experiences.

The diagnostic assessments are conducted by senior clinical staff of the Adult ADHD Treatment and Research Program or by advanced clinicians-in-training who are closely supervised by senior clinical staff.

If pharmacotherapy through the Penn Adult ADHD Treatment and Research Program is recommended, the initial evaluation report is used to inform a much briefer initial meeting with one of our treating physicians to further sort through the need for medications, any potential contraindications, and working with each person to determine the correct approach for them. 

In some cases, individuals have had past evaluations and/or testing for ADHD. We will review past reports and other relevant information on a case-by-case basis to determine if a modified version of our full evaluation will be sufficient and will avoid unnecessary redundancy.

Click here for a brief assessment questionnaire developed by the World Health Organization (WHO)


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