Can your primary care doctor diagnose ADHD? Or do you need to see a specialist? Here’s how to get started.

If you have concerns about yourself or your child having attention deficit hyperactivity disorder (ADHD), getting an official diagnosis is the first step toward accessing essential support, treatment, and accommodations that can help you manage your symptoms and significantly improve your quality of life.

If you’re wondering how to begin and who to contact for a potential ADHD diagnosis, here’s where to start.

If you suspect that either you or your child might have ADHD, the first step is to consult your primary care doctor or pediatrician. They can conduct initial screenings and assessments to diagnose ADHD. However, for a more thorough evaluation, they may refer you to specialists, including:

  • psychiatrists
  • psychologists
  • neuropsychologists
  • clinical social workers
  • licensed counselors

These specialists can provide comprehensive assessments and tailored treatment plans.

Professionals within the school system, such as school psychologists and special education professionals, can assist in preliminary assessments for ADHD in children, but only qualified healthcare professionals, such as pediatricians or child psychiatrists, can provide an official diagnosis.

ADHD is typically diagnosed through a comprehensive assessment that includes a thorough clinical evaluation, a review of the individual’s medical and developmental history, and input from parents, teachers, or caregivers.

The process is typically carried out by qualified healthcare professionals, such as pediatricians, child psychiatrists, or clinical psychologists who consider the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

Various tools are used to gather information and assess ADHD symptoms, including:

  • ADHD rating scales: Questionnaires completed by parents, teachers, or individuals.
  • Continuous performance tests (CPTs): Evidence suggests that the continuous performance test (CPT) is one of the most popular ways to objectively assess inattention and impulsivity in ADHD.
  • Behavioral observation: Directly observing behavior in different settings.
  • Neuropsychological testing: Assessing cognitive functions.
  • IQ tests: Administered to rule out other causes of attention issues.
  • Psychological interviews: In-depth discussions with healthcare professionals.
  • Questionnaires and checklists: Assessing daily functioning and comorbid conditions.

In the future, brain scans might have a role in ADHD diagnosis, thanks to research published in 2022 suggesting a connection between ADHD and alterations in brain white matter volume. However, at this time, these markers aren’t yet specific or reliable enough to replace standard clinical assessments and the DSM-5-TR criteria.

The cost of an ADHD assessment can vary widely depending on several factors, including the location, the healthcare professional or specialist conducting the assessment, and the specific tests and evaluations performed.

On average, a comprehensive ADHD assessment may range from a few hundred to a couple thousand dollars. Health insurance may cover a portion of the assessment, but the extent of coverage can vary widely.

The DSM-5-TR diagnostic criteria for ADHD are as follows:

Inattention Symptoms: There should be at least six (for children under 17) or five (for 17 and older) symptoms of inattention, lasting for at least 6 months.

  • Frequently makes careless errors and overlooks details in tasks or activities.
  • Struggles to maintain attention on tasks or play.
  • Appears to not listen when spoken to directly.
  • Frequently fails to follow through on instructions and complete school or work-related tasks.
  • Has difficulties organizing tasks and activities.
  • Often avoids or dislikes activities requiring prolonged mental effort.
  • Loses items necessary for tasks and activities.
  • Easily distracted by external stimuli.
  • Frequently forgets daily activities.

Hyperactivity and Impulsivity Symptoms: Similarly, there should be at least six (for children under 17) or five (for 17 and older) symptoms of hyperactivity-impulsivity, persisting for at least 6 months.

  • Often fidgets, taps hands or feet, or squirms in the seat.
  • Leaves the seat in situations where remaining seated is expected.
  • Runs or climbs in inappropriate situations (adolescents and adults may feel restless).
  • Unable to engage in leisure activities quietly.
  • Often seems to be in constant motion.
  • Talks excessively.
  • Blurts out answers before questions are completed.
  • Struggles to wait their turn.
  • Interrupts or intrudes on others (e.g., interrupts conversations or games).

Additionally, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms should have been present before age 12.
  • Symptoms should occur in two or more settings (e.g., home, school, work, with friends or family).
  • Clear evidence that symptoms interfere with social, school, or work functioning.
  • Symptoms should not be better explained by another mental disorder.
  • Symptoms should not occur exclusively during schizophrenia or another psychotic disorder.

Based on the types of symptoms, ADHD can manifest in three different presentations:

  • Combined presentation: When enough symptoms of both inattention and hyperactivity-impulsivity are present for the past 6 months.
  • Predominantly inattentive presentation: When enough symptoms of inattention, but not hyperactivity-impulsivity, are present for the past 6 months.
  • Predominantly hyperactive-impulsive presentation: When enough symptoms of hyperactivity-impulsivity, but not inattention, are present for the past 6 months.

Here are some tips for finding a professional to diagnose ADHD:

  • Start with your primary care physician (PCP) or pediatrician: Your child’s pediatrician can provide an initial assessment and refer you to a specialist if needed. You can also seek help from your PCP if you’re interested in adult ADHD testing for yourself.
  • Get recommendations: Ask for recommendations from a healthcare professional, friends, family, or support groups for ADHD. Word-of-mouth referrals can help you find a trusted professional.
  • Consider insurance coverage: Check if the professional accepts your health insurance to minimize out-of-pocket expenses.
  • Talk with someone at your child’s school: Request a meeting with your child’s teacher, school counselor, or psychologist to discuss your concerns and explore potential support within the educational setting.
  • Trust your instincts: Choose a healthcare professional you feel comfortable with and can establish a good rapport with. Effective communication is crucial in the diagnosis and treatment of ADHD.

Connecting with a healthcare professional to get an ADHD diagnosis, whether for yourself or your child, is an important first step in gaining access to the necessary support and treatments for effective symptom management.

If you suspect ADHD, don’t hesitate to reach out to your primary care doctor, pediatrician, or a mental health professional. It can make a significant difference in managing your ADHD symptoms and improving your quality of life.