ADHD Assessment
A Complete ADHD Assessment can include:
Self Rating Reports
Biopsychosocial Assessment
ADHD Clinical Interview
Objective Testing*
Collateral Reports*
(*Not required and depends on each individual)
Book an Appointment for ADHD Assessment
Also available online/virtually
1. Self Rating Reports (ASRS-v1.1)
The Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist is a widely used screening tool designed to help identify symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. It was developed in conjunction with the World Health Organization (WHO) and is based on the diagnostic criteria for ADHD outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
What is the ASRS-v1.1 Symptom Checklist?
The ASRS-v1.1 consists of 18 questions that assess the frequency of ADHD symptoms over the past six months. These questions are divided into two parts:
Part A: Contains 6 questions that focus on the most predictive symptoms of ADHD. These are used as the primary screening tool.
Part B: Contains 12 additional questions that provide a broader assessment of ADHD symptoms.
Why is the ASRS-v1.1 Important as a start?
Screening Tool:
The ASRS-v1.1 is a quick and effective way to screen for ADHD symptoms in adults. It helps identify individuals who may need further evaluation by a mental health professional.
Evidence-Based:
The ASRS-v1.1 is based on DSM criteria and has been validated in multiple studies, ensuring its reliability and accuracy in identifying ADHD symptoms.
Raises Awareness:
Many adults with ADHD go undiagnosed because their symptoms (e.g., difficulty focusing, disorganization, impulsivity) are often mistaken for stress, anxiety, or personality traits. The ASRS-v1.1 helps raise awareness and encourages individuals to seek help.
Time Frame: before the first session
2. Biopsychosocial Assessment
What is a Biopsychosocial Assessment?
A biopsychosocial assessment is a comprehensive evaluation approach that examines an individual’s condition through three interconnected lenses:
Biological Factors
Genetic Predisposition: Family history of ADHD or other mental health conditions.
Medical History: Birth complications, head injuries, or other medical conditions that may impact attention and behavior.
Physical Health: Sleep patterns, nutrition, and overall physical well-being.
Psychological Factors
Cognitive Functioning: Attention, memory, executive functioning (e.g., planning, organization).
Emotional Regulation: Ability to manage emotions, frustration tolerance, and impulsivity.
Behavioral Patterns: Hyperactivity, inattention, and impulsivity in various settings.
Co-occurring Conditions: Anxiety, depression, learning disabilities, or other mental health issues.
Social Factors
Family Dynamics: Parenting styles, family stress, and support systems.
School/Work Environment: Academic or occupational challenges, accommodations, and relationships with peers or colleagues.
Cultural Influences: Cultural norms, stigma, and access to resources.
Social Relationships: Friendships, social skills, and community involvement.
Why is a Biopsychosocial Assessment Important in ADHD?
Provides a Holistic Understanding
ADHD is a complex condition that cannot be fully understood by looking at symptoms alone. A biopsychosocial assessment helps clinicians identify the root causes and contributing factors of ADHD, ensuring a more accurate and comprehensive diagnosis.
Tailors Treatment to the Individual
By considering biological, psychological, and social factors, clinicians can develop personalized treatment plans that address the unique needs of each client. For example:
Biological: Medication, dietary changes, or sleep interventions.
Psychological: Cognitive-behavioral therapy (CBT), mindfulness, or skills training.
Social: Family therapy, school accommodations, or social skills groups.
Identifies Co-occurring Conditions
Many individuals with ADHD also experience other mental health conditions (e.g., anxiety, depression) or learning disabilities. A biopsychosocial assessment helps identify these overlapping issues, ensuring that all aspects of the individual’s well-being are addressed.
Addresses Environmental and Social Barriers
Social factors, such as family stress or lack of school support, can exacerbate ADHD symptoms. By identifying these barriers, clinicians can recommend interventions to improve the individual’s environment and relationships.
Empowers Clients and Families
A biopsychosocial assessment helps clients and their families understand ADHD in the context of their lives. This knowledge can reduce stigma, foster empathy, and empower individuals to take an active role in their treatment.
Tracks Progress Over Time
Because ADHD is a lifelong condition, ongoing assessment is essential. A biopsychosocial framework allows clinicians to monitor changes in biological, psychological, and social factors over time, ensuring that treatment remains effective and relevant.
Time Frame: one session
3. ADHD Clinical Interview
What is the ADHD Clinical Interview Based on DIVA 5?
The DIVA 5 (Diagnostic Interview for ADHD in Adults) is a structured, evidence-based clinical interview tool designed to assess ADHD symptoms in adults. It is an updated version of the DIVA 2.0 and is widely recognized for its thoroughness and accuracy in diagnosing ADHD. The DIVA 5 is based on the diagnostic criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), the standard classification of mental health conditions used by clinicians.
The interview is divided into three key areas:
Childhood Symptoms: Assesses the presence of ADHD symptoms before the age of 12.
Current Symptoms: Evaluates ADHD symptoms in adulthood.
Functional Impairment: Examines how ADHD symptoms impact daily life, including work, relationships, and self-care.
Key Features of the DIVA 5 Interview
Structured Format: The interview follows a clear, standardized structure, ensuring consistency and reliability.
Comprehensive Coverage: It assesses all 18 DSM-5 criteria for ADHD, including inattention, hyperactivity, and impulsivity.
Lifespan Perspective: It evaluates symptoms across the lifespan, from childhood to adulthood, which is critical for accurate diagnosis.
Functional Impairment Focus: It emphasizes how symptoms affect daily functioning, providing a clearer picture of the individual’s challenges.
Why is the DIVA 5 Important in ADHD Assessment?
Ensures Accurate Diagnosis
ADHD is a complex condition that can be easily misdiagnosed or overlooked, especially in adults. The DIVA 5’s structured approach ensures that all diagnostic criteria are thoroughly evaluated, reducing the risk of errors.
Captures Lifespan Symptoms
ADHD is a neurodevelopmental disorder that begins in childhood but often persists into adulthood. The DIVA 5 assesses symptoms both in childhood and adulthood, ensuring that the diagnosis is based on a complete history.
Highlights Functional Impairment
ADHD is not just about having symptoms—it’s about how those symptoms impact daily life. The DIVA 5 places a strong emphasis on functional impairment, helping clinicians understand the real-world challenges faced by individuals with ADHD.
Supports Differential Diagnosis
ADHD symptoms can overlap with other conditions, such as anxiety, depression, or bipolar disorder. The DIVA 5’s thoroughness helps clinicians differentiate ADHD from other mental health conditions, ensuring that clients receive the most appropriate treatment.
Time Frame: two to three sessions
4. Objective Testing (Qb Check-FDA Approved)
What is Objective Testing in ADHD?
Objective testing in ADHD refers to the use of standardized, data-driven tools to measure and evaluate the core symptoms of ADHD: inattention, hyperactivity, and impulsivity. Unlike traditional methods that rely on subjective observations, questionnaires, or self-reports, objective testing provides quantifiable, unbiased data to support the diagnostic process and treatment planning.
How Does Objective Testing Work?
Objective testing typically involves computer-based tasks or performance-based assessments that measure specific cognitive and behavioral functions. These tests are designed to:
Assess Attention: Evaluate the ability to focus, sustain attention, and resist distractions.
Measure Hyperactivity: Track physical movements or restlessness during tasks.
Evaluate Impulsivity: Measure the tendency to act without thinking or to make quick, unplanned decisions.
The results are compared to normative data (data from individuals without ADHD) to determine whether the individual’s performance falls outside the typical range.
Examples of Objective Testing Tools
One of the most widely used and scientifically validated tools for objective ADHD testing is QbCheck. Other examples include:
Continuous Performance Tests (CPTs): Measure sustained attention and impulse control.
Neuropsychological Tests: Assess executive functioning, working memory, and other cognitive skills.
Motion Tracking Systems: Use sensors or cameras to measure physical activity levels.
Key Features of Objective Testing
Standardized: The tests are administered and scored consistently, ensuring reliability and validity.
Data-Driven: Results are based on measurable performance metrics, not subjective opinions.
Time-Efficient: Most tests can be completed in 15-30 minutes, making them convenient for clients.
Age-Appropriate: Many tools, like QbCheck, are designed for specific age groups (e.g., children, adolescents, adults).
Why is Objective Testing Important in ADHD?
Improves Diagnostic Accuracy: ADHD symptoms can overlap with other conditions (e.g., anxiety, depression, learning disabilities). Objective testing helps clinicians differentiate ADHD from other disorders.
Reduces Bias: Subjective reports from parents, teachers, or individuals can be influenced by personal perceptions or situational factors. Objective testing provides an unbiased assessment.
Supports Treatment Planning: The data from objective tests helps clinicians tailor interventions to the individual’s specific needs.
Tracks Progress: Objective testing can be repeated over time to monitor the effectiveness of treatment and make adjustments as needed.
Validates Experiences: For individuals with ADHD, objective testing provides concrete evidence of their challenges, which can be validating and empowering.
QbCheck-FDA Approved
Supported by
What is QbCheck?
QbCheck is an FDA-approved digital ADHD assessment tool that combines objective data with clinical expertise to provide a comprehensive evaluation of attention, hyperactivity, and impulsivity—the core symptoms of ADHD. It is a computer-based test that takes just 15-20 minutes to complete and is suitable for both children (ages 6-12) and adults (ages 12-60).
How Does QbCheck Work?
The QbCheck setup is designed to be an At-home Telehealth test that you can access online. It is simple, user-friendly, and efficient test. Here’s a step-by-step overview of what the QbCheck setup looks like and how it works:
1. Equipment Needed
To administer QbCheck, you’ll need the following:
A Computer or Tablet: QbCheck is compatible with most devices running Windows, macOS, or iOS.
Webcam or Infrared Camera: Used to track head movements and measure hyperactivity.
Internet Connection: Required to access the QbCheck software and submit results.
Quiet, Well-Lit Space: Ensures the client can focus without distractions.
2. Setting Up the Test Environment
Seating: The client sits comfortably in front of the computer or tablet, with the camera positioned to capture their head and upper body.
Lighting: The room should be evenly lit to ensure accurate motion tracking.
Distraction-Free: The testing environment should be quiet and free from interruptions to ensure reliable results.
3. Administering the Test
The QbCheck test is straightforward and typically takes 15-20 minutes to complete. Here’s how it works:
Client Instructions: The client receives clear, on-screen instructions about the test. No prior experience or technical skills are needed.
Test Tasks:
Visual Tasks: Clients respond to specific stimuli on the screen, testing their ability to focus and sustain attention.
Motion Tracking: A webcam or infrared sensor tracks subtle movements, providing objective data on hyperactivity and impulsivity.
Data Analysis: The results are compared to a normative database of individuals without ADHD (with the same age and sex), offering clear, quantifiable insights into the client's symptoms.
Completion: Once the test is finished, the results are automatically uploaded to the QbCheck portal for analysis and immediately available.
4. Tips before taking the test
Understand the Test:
The QbCheck is a computer-based task designed to measure attention, impulse control, and activity levels.
It is intentionally designed to be repetitive and uninteresting to accurately assess your focus and behavior.
Prepare Mentally and Physically:
Aim for a full night’s sleep before the test to ensure you are well-rested and alert. Fatigue can impact your performance and results.
Avoid consuming excessive caffeine or stimulants on the day of the test, as they may affect your ability to concentrate.
Dress Comfortably:
Wear comfortable clothing that allows for easy movement, as the test may measure physical activity.
Medication Guidelines:
If you are currently taking ADHD medication, take it as prescribed by your healthcare provider.
Our office will schedule your test at a specific time after your medication, depending on the type and duration of its effects. Please inform us of any changes to your medication routine.
For Children:
Explain to your child that they will be taking a computer test that might feel boring, but it is an important part of understanding how they focus and behave.
Let them know they will wear a soft headband during the test, but reassure them that it is comfortable and does not hurt.
While the child will be alone in the room during the test, a family member can wait nearby outside for reassurance if needed.
Ask Questions:
If you have any concerns or questions about the test, reach out to our office before your appointment. We are here to help you feel prepared and confident.
Follow Instructions Carefully:
Listen to and follow all instructions provided by your clinician or the testing administrator to ensure accurate results.
Time frame
One to two sessions. (The whole process will be guided by a trained clinician)
Cost
We are not able to take insurance for QbCheck. This cost includes the QbCheck test, report fee, follow up appointment to explain results, and sending of reports to any medical providers upon completion of a release.
How does the testing results look like?
Figure 1: example of testing Result of a person without ADHD
Figure 2: example of testing result of a person with ADHD
Who Can Benefit from QbCheck?
Children and Adolescents: Early detection of ADHD can lead to timely interventions, improving academic performance and social relationships.
Adults: Many adults with undiagnosed ADHD struggle with focus, organization, and time management. QbCheck helps identify these challenges and provides a path forward.
Families and Educators: QbCheck results can help parents and teachers better understand a child's behavior and implement supportive strategies.
5. Collateral Reports
Collateral Reports in ADHD diagnosis refers to additional information gathered from sources other than the individual being evaluated, such as family members, partners, teachers, or coworkers. This information is crucial because it provides a more comprehensive and objective understanding of the individual’s behavior, symptoms, and functioning across different settings (e.g., home, work, school). ADHD symptoms often manifest differently depending on the context, and self-reports alone may not capture the full picture, especially if the individual lacks self-awareness or has difficulty recalling specific behaviors.
Why is Collateral Information Important in ADHD Diagnosis?
Provides a Broader Perspective:
ADHD symptoms can vary across environments. For example, an individual may struggle with focus at work but not at home, or vice versa. Collateral information helps identify these patterns.
Reduces Bias:
Self-reports can be influenced by factors like stigma, denial, or lack of insight. Collateral information from others who know the individual well can provide a more balanced view.
Confirms Consistency of Symptoms:
ADHD is a neurodevelopmental disorder, and its symptoms must be present in multiple settings (e.g., home, school, work) for a diagnosis. Collateral information helps confirm this consistency.
Identifies Functional Impairments:
Collateral informants can describe how ADHD symptoms impact the individual’s daily life, relationships, and responsibilities, which is critical for diagnosis and treatment planning.
Supports Differential Diagnosis:
ADHD symptoms can overlap with other conditions (e.g., anxiety, depression, bipolar disorder). Collateral information helps rule out other potential causes of the symptoms.
Common Tools for Gathering Collateral Information
Two widely used tools for collecting collateral information in ADHD assessments are the Vanderbilt Rating Scale-Parent and the ADHD Partner Rating Scale:
1. Vanderbilt Rating Scale - Parent
Purpose: This scale is designed to assess ADHD symptoms and related impairments in children and adolescents, as reported by parents or caregivers.
Structure:
Includes questions about the core symptoms of ADHD (inattention, hyperactivity, impulsivity).
Also assesses comorbid conditions, such as oppositional defiant disorder (ODD), anxiety, and depression.
Evaluates the child’s academic and social functioning.
Why It’s Important:
Provides a detailed account of the child’s behavior at home and school.
Helps identify whether the child meets the diagnostic criteria for ADHD and whether additional evaluations are needed for comorbid conditions.
2. ADHD Partner Rating Scale
Purpose: This scale is designed to assess ADHD symptoms in adults, as reported by their partners or close family members.
Structure:
Includes questions about inattention, hyperactivity, impulsivity, and emotional dysregulation.
Focuses on how ADHD symptoms impact the individual’s relationships, daily functioning, and household responsibilities.
Why It’s Important:
Provides insight into how ADHD symptoms affect the individual’s personal and family life.
Helps identify patterns of behavior that the individual may not recognize or report themselves.
How Collateral Information is Used in ADHD Diagnosis
Complements Self-Reports:
Collateral information is used alongside self-reports and clinical interviews to create a more complete picture of the individual’s symptoms and functioning.
Guides Treatment Planning:
By understanding how ADHD symptoms impact different areas of life, clinicians can tailor interventions to address specific challenges (e.g., improving focus at work, managing relationship conflicts).
Monitors Progress:
Collateral information can be used to track changes in symptoms and functioning over time, helping to evaluate the effectiveness of treatment.
Time Frame: before or after first session
References:
QbTech. (n.d.). QbCheck: ADHD testing made simple. Retrieved from https://www.qbtech.com/qbcheck
U.S. Food and Drug Administration (FDA). (2018). FDA clearance for QbTest and QbCheck. Retrieved from https://www.fda.gov
Riccio, C. A., Reynolds, C. R., & Lowe, P. A. (2001). Continuous Performance Tests: A review of the literature. Journal of Clinical Psychology, 57(3), 253-268.
DIVA Foundation. (n.d.). DIVA 5: Diagnostic Interview for ADHD in Adults. Retrieved from https://www.divacenter.eu
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Kooij, J. J. S., & Francken, M. H. (2010). DIVA 2.0: Diagnostic Interview for ADHD in Adults. DIVA Foundation.
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Barkley, R. A. (2015). Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (4th ed.). New York: Guilford Press.
National Institute for Health and Care Excellence (NICE). (2018). Attention deficit hyperactivity disorder: Diagnosis and management. NICE Guideline NG87. Retrieved from https://www.nice.org.uk
Adler, L. A., & Cohen, J. (2004). Diagnosis and evaluation of adults with attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America, 27(2), 187-201.
Biederman, J., & Faraone, S. V. (2005). Attention-deficit hyperactivity disorder. The Lancet, 366(9481), 237-248.
CDC. (n.d.). Attention-Deficit/Hyperactivity Disorder (ADHD). Retrieved from https://www.cdc.gov/ncbddd/adhd
CHADD. (n.d.). About ADHD. Retrieved from https://chadd.org