Why cannot we diagnose ADHD in one session?

ADHD (Attention-Deficit/Hyperactivity Disorder) is a complex neurodevelopmental disorder that typically requires careful and comprehensive evaluation to diagnose accurately. There are several reasons why a single session is usually insufficient for an ADHD diagnosis:

  • Complexity of Symptoms: ADHD symptoms can be subtle and overlapping with other conditions. Different individuals may present with varying combinations of symptoms, including inattention, hyperactivity, and impulsivity. Evaluating these symptoms thoroughly takes time.
  • Developmental Context: ADHD symptoms can change over time and can be influenced by developmental stages. What might seem like ADHD-like behaviour in a child could be considered typical behaviour for another child of a different age.
  • Multiple Perspectives: Gathering information from multiple sources, such as parents, teachers, and sometimes even the individual themselves, is important to gain a comprehensive understanding of the symptoms and their impact across different settings.
  • Rule Out Other Conditions: Many other conditions can mimic or coexist with ADHD, such as anxiety disorders, learning disabilities, and mood disorders. It’s essential to rule out these possibilities to ensure an accurate diagnosis.
  • Medical and Family History: Gathering a thorough medical and family history is crucial to identify any genetic or environmental factors that might contribute to the symptoms.
  • Observation and Longitudinal Assessment: Monitoring symptoms over time provides a better picture of their persistence and impact on daily functioning. This helps distinguish ADHD from transient issues.
  • Differential Diagnosis: Professionals need to differentiate ADHD from other conditions that might have similar symptoms but require different treatment approaches.
  • Coexisting Conditions: ADHD often coexists with other conditions. Identifying and addressing these conditions is important for effective treatment.
  • Comprehensive Assessment Tools: Clinicians use standardised assessment tools to diagnose ADHD. These tools require information from different sources and sometimes require multiple sessions. These are tools, and different clinicians use different tools. They need a careful interpretation as some other conditions might increase the ADHD-like symptoms on these tools. Sometimes, while the symptoms rating on these tools is high, your psychiatrist, who provides holistic care, might not agree with the diagnosis. They might disagree with the diagnosis in these circumstances, even if another clinician made that conclusion. They might also ask for further observation, information, or testing before making their final decision.
  • Clinical Judgment: ADHD diagnosis is not based on a single specific test but on the collective clinical judgment of professionals considering various factors. Unfortunately, sometimes performing one tool, such as Conners, regardless their score, will not lead to a diagnosis.

Overall, a comprehensive evaluation involving multiple sessions and various assessment methods helps ensure a thorough and accurate diagnosis of ADHD, leading to appropriate treatment planning and support.

If you or someone you know is seeking an ADHD diagnosis, it’s recommended to consult a psychiatrist to plan the assessment process to avoid unnecessary costs. While most psychologists are qualified professionals who can do these assessments well; unfortunately, not all psychological assessments will have the same quality, so the psychiatrists in Family Nurture might disagree with the conclusion as they lack the very comprehensive details and process in the assessment. Psychiatrists need to provide recommendations for treatment, including pharmacological and non-pharmacological treatment, so they will not agree with the diagnosis without being sure about it, as they do not want to suggest pharmacological intervention and place your child and you at unnecessary risk.