ADHD Assessment

ADHD Assessment – Attention Deficit Hyperactivity Disorder

ADHD assessment is based on a systematic elimination procedure. That is, the neuropsychologist must eliminate any other possible cause that may explain inattention, hyperactivity or impulsivity. An ADHD assessment therefore involves an examination of cognitive functions, but also a synthesis of developmental, social, academic, behavioural and medical history to ensure that the neuropsychologist or the professional involved does not miss any other cause or explanation of the person’s difficulties.

Process & Methods of Assessment

ADHD Assessment Process

The ADHD evaluation process in neuropsychology will therefore target several spheres of functioning in the individual. Once the personal and medical information is gathered during the initial interview, the ADHD assessment begins and the neuropsychologist will then examine several cognitive functions:

  • Intellectual potential including overall verbal and non-verbal skills
  • Expressive and receptive language skills
  • Fine and gross motor skills
  • Short-term Working memory
  • Long-term verbal and visual memory
  • Auditory and visual attention, short-term selective attention, long-term sustained attention, vulnerability to distractions, divided attention and multitasking
  • Executive functioning such as behavioural self-control, mental flexibility, abstract thinking, organizing, planning, time management, problem solving
  • Reading skills such as accuracy / speed & fluency / comprehension
  • Writing skills related to organization / accuracy / respect of grammatical rules
  • Calculations and mathematical manipulation
  • Summary screening for other elements such as anxiety, depression, self-esteem, social skills
  • Parents’ and teachers’ involvement regarding observations and functional impairments perceived in everyday life
evaluation du tdah

A comprehensive cognitive assessment provides a broad cognitive picture, which allows the neuropsychologist to see whether the complaints and difficulties experienced by the person are actually related to ADHD, or whether they stem from other problems. For example, might there actually be problems with memory, or do disorganized methods of memorization and inattention explain forgetfulness? Is a driver experiencing real visuospatial or perceptual problems, or are his difficulties more closely related to inattention and loss of alertness? Should we be concerned about dyslexia and learning disability in a student who does not understand what he/she reads, or does inattention lead him/her to skip lines, fall victim to contextual traps and have to reread texts all over again? Could a student’s difficulties in solving problems be due to errors of inattention, disorganization of information and skipped steps, or to something else altogether?

These are some of many other questions that the neuropsychologist will try to address during the ADHD assessment. A list of common ADHD symptoms can be found here, while information regarding ADHD treatments can be found by clicking here.

Eliminating All Other Causes

Eliminating All Other Causes

Because ADHD is diagnosed through a process of elimination, a typical ADHD assessment therefore involves the evaluation of most cognitive functions, as well as the individual’s own personal history from a medical, family, academic and/or professional standpoint. It is indeed important in neuropsychology to ensure that inattention, hyperactivity or impulsivity are not related to other known conditions or problems other than attention deficit disorder itself. Some individuals may in fact struggle with behavioural symptoms similar to those seen in ADHD. For instance :

  • Giftedness and individuals with high intellectual potential who can easily get bored or who tend to seek various other stimulations
  • Hearing problem where an individual may not seem to listen
  • Visual or perceptual problem that could diminish attention to visual details and increase the propension for mistakes
  • Anxiety disorders that often lead to decreased concentration and increased agitation
  • Major depression which often brings about sluggishness, fatigue, demotivation and lack of concentration
  • Social difficulties in which participation, initiative and involvement are reduced and where anxiety can also present itself
  • Learning Disorders (Dyslexia, Dysorthography, Dyscalculia) that result in academic difficulties, lack of comprehension, sluggishness or frustration, and which can mistakenly be perceived as a lack of concentration
  • Language Disorders (dysphasia) which limit expression/comprehension and resemble inattention, leading to forgetfulness and confusion with verbal instructions, or to disorganized ideas during oral expression
  • Movement or Motor Disorders (dyspraxia) that affect mobility, visuospatial and visual memory functions, which may also include involuntary line breaks, bad handwriting, difficulty with visual memory and inattention to visual details
  • Autism Spectrum Disorder, which also manifests as behavioral agitation, irritability, inattention and passivity/withdrawal
  • Intellectual Disability in which we also perceive attentional and learning deficiencies
  • Tourette Syndrome which includes elements of impulsivity or outbursts
  • Head traumas that often lead to sluggishness, slowed execution, diminished concentration and difficulty organizing ideas
  • Nutritional deficiencies (iron, etc.) or sleep problems (apnea, etc.) that can result in significant fatigue or decreased concentration
  • edical conditions such as Epilepsy or hormonal imbalances
  • Psychiatric conditions such as Schizophrenia, Bipolar Bisorder
  • Other possible causes

Finally, it should be said that the thorough process in neuropsychology in the context of an ADHD assessment does not only allow for an accurate ADHD diagnosis. On the contrary, the neuropsychological assessment process also provides a picture of personal strengths and weaknesses which will be useful in determining how to compensate said weaknesses, in choosing the most appropriate course of intervention, and in guiding professionals and physicians in their choice of treatment or medication.