ADHD and Psychological Assessments
You may have been told by your primary care doctor or psychiatrist that you need to complete an ADHD or psychological assessment before he or she will prescribe you meds. But why? What is in it for you to spend between $1000 and $3000 out of pocket for an assessment just to get relief from your symptoms?!
Here's the short-short version: Without a proper diagnosis, you or your kid could be taking the wrong medication that could increase your symptoms and make your life miserable. I've had many people come in and tell me that Adderall has made their kid zone out, become aggressive, or at the extreme, suicidally depressed. I've assessed adults who were previously diagnosed with ADHD and turn out actually have crippling anxiety. Stimulant medication can sky rocket anxiety and make life unbearable! This happens because the diagnosis is wrong, which dictates what meds to take and what coping strategies are best.
A good psychological assessment is essential for being accurately diagnosed. There are many causes for poor focus and concentration and without the correct diagnosis, individuals can be improperly medicated or use insufficient coping strategies.
The primary criteria for ADHD involves concerns with executive functioning. These include issues with:
· Completing tasks
· Time management skills
· Planning (from completing sequential tasks to prioritizing tasks)
· Avoidance of tasks that require mental effort
· Forgetfulness and losing items
Several other diagnoses include concerns with executive functioning such as learning disabilities, Bipolar Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, and Autism Spectrum Disorder. As such, these disorders should be ruled out as a cause for problems with executive functioning.
A good ADHD assessment will include assessments that focus on:
· A comprehensive clinical interview – This will include questions about the examinee’s symptoms, educational and employment concerns, history of physical and mental health, and family history of mental health.
· A continuous performance task – This is a computerized assessment that assesses one’s ability to remain focused on a boring activity for 20 to 30 minutes. Assessments include the CPT II and IVA-2.
· Freedom from distractibility – These measures target the ability to hold and manipulate information without distraction. Such measures may include an intelligence assessment, counting backwards from 100, and short-term memory evaluations. (An intelligence assessment can also rule out other disorders such as nonverbal or verbal processing disorders and test anxiety).
· Achievement testing – Though not always utilized, these assessments can rule out the presence of a learning disability, which may cause symptoms that look like executive functioning concerns (avoidance of tasks, distractibility). Such measures include the WIAT-II and the Woodcock-Johnson.
· Rating scales – These are measures provided to family, teachers, and the examinee to determine if concerns with executive functioning are similar to others who have been diagnosed and exist in multiple environments. These assessments include the BASC-3, Conners 3, and the Vanderbilt.
· Personality assessment – These are designed to rule out other diagnoses that could cause symptoms of executive functioning. They include assessments like the MMPI-A, MMPI-2, PAI-A, PAI, and BAI or BDI.
A comprehensive assessment should then include a list of recommendations that will guide you on what to do next, so you do not feel lost and overwhelmed by the diagnosis.
Adequate recommendations often include:
· Book recommendations and online resources
· Therapeutic techniques
· Information on Individualized Education Plans (IEP) or 504 Plans
· Basic behavioral modification techniques
· Medication recommendations
Without a comprehensive evaluation, you may be taking the wrong medication or using skills that are not completely effective. Please feel free to contact me for more information about my assessment process.