Attention deficit hyperactivity disorder (ADHD) Assessment

Attention deficit hyperactivity disorder (ADHD) is a mental health condition and one of the neurodevelopmental disorders. Its’ symptoms usually start in childhood. Sometimes ADHD is missed in childhood and only gets noticed later in life.

There is no single medical, physical, blood or genetic test for ADHD. Its assessment requires a diagnostic evaluation provided by a qualified mental health care professional, including psychiatrists, psychologists, or paediatrician who gathers information from multiple sources. They do a comprehensive and detailed history of current and past functioning, exploring the possibility of any other condition that could manifest similar symptoms like ADHD. They also ask for the completion of different questionnaires, checklists, and standardised behaviour rating scales by parents, primary care providers, teachers, or significant others who know the person well.

There are times when additional cognitive ability and academic achievement assessment is necessary to rule out a possible learning disability. ADHD cannot be diagnosed accurately from brief, one-session office observations or simply by talking to the person. A diagnosis of ADHD must include consideration of the possible presence of co-occurring conditions.

The DSM-5 lists three presentations of ADHD—Predominantly Inattentive, Hyperactive-Impulsive and Combined. In people with ADHD, there are differences in the parts of the brain that control our ability to plan, organise and focus—having ADHD can make family life, study, work and friendships difficult. It can lead to a decline in academic functioning, school refusal, and sometimes presenting with anxiety and depressive symptoms resulting from these challenges.

These are the list of some rating scales and testing that we use in ADHD assessment, besides clinical reviews and observations.

Conners Comprehensive Behaviour Rating Scales (Conners CBRS)

The CBRS is based on parent and teacher ratings of the child’s behaviour and yields measures of ADHD symptoms, concordance with DSM-5 diagnostic criteria for ADHD, learning problems and common childhood emotional and behaviour problems.

Behaviour Rating Inventory of Executive Function – 2nd Edition (BRIEF-2)

The BRIEF2 is a questionnaire completed by parents and teachers of school-aged children and adolescents ages 11 to 18 years. Parent and teacher ratings of executive functions are good predictors of an adolescent’s functioning in many domains, including the academic, social, behavioural, and emotional domains.

Test of Variables of Attention (TOVA.)

The Test of Variables of Attention (TOVA) provides objective attention and inhibitory control measurements for healthcare professionals. The visual TOVA aids in assessing and evaluating treatment for attention deficits, including attention-deficit/hyperactivity disorder (ADHD). The auditory TOVA aids in the assessment of attention deficits, including ADHD. The Test of Variables of Attention, or TOVA for short, is a neuropsychological assessment. It measures the individual’s ability to remain focused during a repetitive, boring task and their ability to control their impulses during a more stimulating task. From this assessment, a series of variables are measured and eventually analysed to determine whether or not the person truly had problems with paying attention and controlling impulses. The theory behind the assessment is essentially this: measuring the patient’s response time and the consistency of the patient’s response time during a boring, repetitive task can screen for ADHD.

TOVA results should only be interpreted by qualified professionals. The TOVA calculates response time variability (consistency), the response time (speed), commissions (impulsivity), and omissions (focus and vigilance). These calculations are then compared to a large age- and gender-matched normative sample. TOVA testing can be used for ages four and up. TOVA comprises auditory and visual components. Each component is administered individually., and each last for 23 minutes. It looks like a video game. Patients will respond to stimuli using a button.

TOVA test cannot be used alone to make a diagnosis of ADHD. TOVA test fee is not covered by Medicare. It includes a flat fee for its administration.