According to SonderMind, neuropsychological testing isn’t needed for every ADHD diagnosis, and the CDC’s ADHD diagnosis page says there is no single test to diagnose ADHD. A diagnosis is a process with several steps, and a psychologist, psychiatrist or primary care provider can run it. SonderMind says neuropsychological testing can be useful when the picture is complicated or when there are co-occurring learning differences to consider.
What does a standard ADHD assessment look like?
Ohio State Health’s ADHD assessment page describes the first step as a comprehensive clinical interview. The clinician asks about childhood, mental health history, and academic and occupational history. That interview can last a couple of hours.
Next, you and people who know you well, such as a spouse, roommate or parent, complete questionnaires about current and childhood behavior. When no one else is available to give input, the clinician can use documents such as old report cards or transcripts. After the interview, the clinician decides what else is needed. Ohio State says that, if necessary, the clinician may have you complete cognitive or executive functioning tests, which “typically require you to sit across from an evaluator and complete tasks that may seem like games.”
SonderMind, an online mental health provider, describes the same core steps: a clinical interview, rating scales and symptom checklists, and a review of your medical and psychiatric history to rule out other causes. For children, the CDC says the process includes a medical exam, including hearing and vision tests, to rule out other problems.
What are common symptoms of ADHD in adults?
Ohio State Health says adults need to show several symptoms of inattention and/or hyperactivity, and those symptoms need to cause some impairment in daily life. The symptoms it lists are:
- Distractibility
- Difficulty sustaining attention
- Hyperactivity
- Impulsivity
- Restlessness
- Talking too much or interrupting others
Southeast Psych Nashville, a private practice, adds forgetfulness or losing items, and struggling with time management or task completion.
Many of these overlap with other conditions. SonderMind notes that anxiety, depression, sleep disorders and burnout can look similar from the outside. The NIA memory problems page lists depression, anxiety, sleep problems and medication side effects among the things that can cause memory trouble. If focus is your main worry, is brain fog adhd or anxiety walks through those overlaps. You can also read Memory and Brain Fog for the memory side.
Does a neuropsychologist diagnose ADHD?
Some neuropsychologists do diagnose ADHD. Keck Medicine of USC says its neuropsychologists help objectively and accurately diagnose neurodevelopmental and neuropsychiatric conditions in both children and adults, and that in children and young adults they mostly evaluate ADHD and learning disorders.
The Thriving Wellness Center blog says neuropsychological evaluations are always conducted by clinical psychologists. The CDC names psychologists, psychiatrists and primary care providers such as pediatricians as clinicians who can make an ADHD diagnosis.
What is neuropsychological testing for adults and for kids?
Keck Medicine of USC, citing the American Psychological Association, describes neuropsychology as the study of how processes of the brain and nervous system relate to behavior and cognition. Testing and evaluation are a big part of a neuropsychologist’s job.
For children and young adults, Keck says neuropsychologists mostly evaluate ADHD, learning disorders such as dyslexia and dyscalculia, and autism spectrum disorders. For adults, the same work also looks at emerging memory issues and dementias such as mild cognitive impairment.
What does neuropsychological testing measure?
Here is what each source says these evaluations look at. Keck describes evaluations that may run over several hours and include feedback from friends, family or teachers.
| Area | What the source says it covers | Source |
|---|---|---|
| Memory | Short-term, long-term and visual memory | Keck Medicine of USC |
| Attention | Auditory attention and attention across various tasks | Keck Medicine of USC; Southeast Psych Nashville |
| Processing speed | How quickly you process information | Ohio State Health; Southeast Psych Nashville |
| Impulse control | Impulse control | Southeast Psych Nashville |
| Problem solving and organization | Problem solving and organization | Southeast Psych Nashville |
| Reading, reasoning and mood | Reading, intelligence, reasoning and mood disorders | Thriving Wellness Center |
On the “pass or fail” worry: Ohio State describes the tasks as things that “may seem like games,” with the goal of finding out whether you have problems with memory, how quickly you process information, and your overall intellectual ability. SonderMind says the rating scales “aren’t pass/fail tests.”
When can additional testing help?
Extra testing can help when a simpler assessment leaves questions open. Each situation below is credited to the source that describes it.
- Attention problems with an unclear cause. Keck says clinicians are often asked to help determine the underlying cause of attention and concentration problems, which can be due to ADHD, comorbid anxiety disorders and/or comorbid mood difficulties, such as depression.
- A complicated picture or learning differences. SonderMind says this testing “can be useful when the picture is complicated or when there are co-occurring learning differences to consider.”
- Brain injury or other serious conditions. Thriving Wellness Center lists brain injuries and other serious co-occurring mental health conditions as reasons for a neuropsychological assessment.
- School accommodations. Thriving Wellness Center also lists cases where a neuropsychological assessment is specifically asked for to obtain certain school accommodations.
- Treatment that is not working. Keck says patients are often referred after seeing several providers, when no one can work out why their treatment is not working.
Is neuropsychological testing needed for everyone with ADHD?
SonderMind says this level of testing “isn’t needed for every diagnosis.” The Thriving Wellness Center blog asks whether you need a 12-hour neuropsychological evaluation to learn if you have ADHD. It says you could benefit from a diagnostic evaluation if you want to know whether you have ADHD, autism, depression or anxiety, and it puts a diagnostic evaluation at two to four hours.
Ask each clinic why it recommends the approach it does. The CDC diagnosis page does not compare a full neuropsychological evaluation with a shorter diagnostic one, so bring that comparison to your clinician.
Why does ADHD testing take so long?
The time is spread across the interview, questionnaires from several people, and a separate feedback visit. Ohio State says the entire process can take from two to six hours, and that the feedback appointment often comes a couple of weeks after testing because questionnaires have to be gathered from multiple people. It also says you should only need to undergo testing for ADHD once.
Thriving Wellness Center puts a neuropsychological evaluation at ten to twelve hours, usually over two or three sessions, and a diagnostic evaluation at two to four hours. Those are that practice’s figures. Ask any clinic for its own schedule.
Can a brain scan show ADHD?
The CDC’s ADHD diagnosis page says there is no single test to diagnose ADHD. The same page does not address MRI or brain imaging for ADHD. Ask your clinician which tests are part of your assessment.
Who can start an ADHD assessment?
| Professional | What the sources say they can do |
|---|---|
| Primary care provider, such as a pediatrician for children | The CDC says a primary care provider can make the diagnosis. Ohio State Health says a referral is the best way to reach a specialist who can assess you. |
| Psychiatrist | SonderMind describes psychiatrists as medical doctors qualified to diagnose ADHD and prescribe medication. |
| Clinical psychologist | Can conduct psychological testing and provide diagnoses. Thriving Wellness Center says neuropsychological evaluations are always conducted by clinical psychologists. SonderMind says psychologists can’t prescribe medication in most states. |
| Licensed clinical social worker or therapist | SonderMind says they can screen for ADHD and refer you out for a full evaluation, but can’t diagnose on their own. |
Before you book an assessment
- Start with a primary care visit, or ask for a referral to a psychiatrist or psychologist. The CDC and Ohio State Health both point to this first step.
- Ask whether the clinic recommends a neuropsychological evaluation, a diagnostic evaluation, or both, and why. Thriving Wellness Center says a neuropsychological evaluation gives a long, detailed written report, while a diagnostic evaluation usually gives a signed diagnosis letter.
- Ask who else will give input, such as a partner, parent or teacher.
- Make a list of your current medications and any supplements you take. SonderMind notes that some substances affect attention and can be relevant to diagnosis.
- Ask the clinic what each step costs before you book. Our neuropsychological testing cost and purpose guide covers what to compare.
- If you are seeking an assessment for a child, the CDC says a local early intervention program can offer a free or low-cost evaluation for children under age 3, and a school system can offer a free evaluation for children 3 years or older.
Your next step is small: book one conversation with a primary care provider, psychiatrist or psychologist, and let that clinician decide whether neuropsychological testing belongs in your assessment. If you are also wondering how a diagnosis fits your daily life, what unmedicated ADHD feels like covers signs of ADHD in adults and how it is assessed.
By the Global MH Summit Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.