Who Can Diagnose ADHD? A Comprehensive Guide
If you or a loved one is struggling with focus, impulsivity, or hyperactivity, you may be wondering who can diagnose ADHD and what the evaluation process entails. Understanding who is qualified to diagnose attention-deficit/hyperactivity disorder (ADHD) is an essential first step toward getting the answers and treatment you need.
At KMN Psych, we specialize in comprehensive ADHD testing in San Diego for children, teens, and adults. Our experienced clinical psychologist, Dr. Max Doshay, and his assessment team provide accurate, thorough evaluations that can confirm or rule out an ADHD diagnosis and guide effective treatment planning.
What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects how the brain regulates attention, impulse control, and activity levels.
Many adults struggle with undiagnosed ADHD, often dismissing their symptoms as personal failings or character flaws rather than a treatable neurological condition.
1. Types of ADHD
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects how the brain regulates attention, impulse control, and activity levels. According to the Centers for Disease Control and Prevention (CDC), approximately 6 million children aged 3-17 years have been diagnosed with ADHD in the United States, making it one of the most common neurodevelopmental disorders of childhood.
ADHD presents in three primary types:
- Predominantly Inattentive Presentation: Characterized by difficulty sustaining attention, following instructions, and organizing tasks
- Predominantly Hyperactive-Impulsive Presentation: Marked by excessive fidgeting, restlessness, and difficulty waiting one’s turn
- Combined Presentation: Features symptoms of both inattention and hyperactivity-impulsivity
While ADHD is often identified in childhood, many adults live with undiagnosed ADHD. Research published by the National Institute of Mental Health indicates that ADHD often continues into adulthood, affecting approximately 4.4% of U.S. adults.
2. When to Talk With a Doctor About Adult ADHD
You should consider seeking an ADHD evaluation if you or your loved one experiences:
- Persistent difficulty focusing on tasks or conversations
- Frequent forgetfulness or losing important items
- Chronic disorganization and trouble meeting deadlines
- Excessive restlessness or inability to sit still
- Impulsive decision-making or frequent interrupting
- Academic struggles despite adequate intelligence
- Difficulty maintaining relationships or employment
- Emotional dysregulation or frequent mood swings
These symptoms should be present in multiple settings (such as home, school, or work), persist for at least six months, and significantly interfere with daily functioning to warrant professional evaluation.
Why an ADHD Diagnosis is Important
Obtaining an accurate ADHD diagnosis is crucial for several reasons:
- Access to Appropriate Treatment: A formal diagnosis opens the door to evidence-based treatments, including behavioral therapy, medication management, and targeted interventions that can significantly improve symptoms and quality of life.
- Educational Accommodations: Students with diagnosed ADHD may qualify for Individualized Education Programs (IEPs) or 504 plans that provide necessary classroom accommodations, such as extended test time, preferential seating, or modified assignments.
- Workplace Support: Adults with ADHD diagnoses may be eligible for reasonable accommodations under the Americans with Disabilities Act (ADA), such as flexible scheduling, written instructions, or modified work environments.
- Understanding Co-Occurring Conditions: Comprehensive ADHD evaluations can identify co-occurring disorders such as anxiety, depression, or learning disabilities that may require additional treatment.
- Improved Self-Understanding: A diagnosis helps individuals and families understand that symptoms are neurobiologically based, reducing self-blame and providing a framework for developing effective coping strategies.
- Prevention of Secondary Issues: Untreated ADHD is associated with increased risks of substance abuse, academic failure, unemployment, relationship difficulties, and mental health challenges. Early diagnosis and intervention can prevent these adverse outcomes.
- Treatment Planning and Progress Monitoring: A thorough evaluation establishes a baseline of cognitive and behavioral functioning, allowing healthcare providers to develop personalized treatment plans and measure progress over time.
Who Performs an ADHD Evaluation?
Several types of qualified healthcare professionals can diagnose ADHD, though the comprehensiveness of their evaluations may vary:
Clinical Psychologists
Clinical Psychologists like Dr. Doshay at KMN Psych are highly qualified to diagnose ADHD through comprehensive neuropsychological testing. Clinical psychologists hold doctoral degrees (PhD or PsyD) and complete specialized training in psychological assessment and diagnosis. They conduct thorough evaluations using standardized tests, behavioral observations, and clinical interviews to provide detailed diagnostic reports.
Psychiatrists
Psychiatrists are medical doctors (MDs or DOs) specializing in mental health who can diagnose ADHD and prescribe medication. They typically use clinical interviews, symptom checklists, and medical histories to make diagnoses.
Neuropsychologists
Neuropsychologists have specialized training in brain-behavior relationships and often conduct the most comprehensive evaluations, particularly when learning disabilities or other cognitive concerns are present.
LCSWs and LPCs
Licensed Clinical Social Workers (LCSWs) and Licensed Professional Counselors (LPCs) may conduct initial screenings and assessments but often work collaboratively with psychologists or psychiatrists for formal diagnosis.
Primary Care Physicians and Pediatricians
Primary Care Physicians and Pediatricians can diagnose ADHD, particularly in children, though they may refer patients to specialists for comprehensive evaluations when presentations are complex or co-occurring conditions are suspected.
Nurse Practitioners and Physician Assistants
Nurse Practitioners and Physician Assistants with mental health specializations may also diagnose ADHD, particularly in primary care or psychiatric settings.
At KMN Psych, our clinical psychologist and assessment team have extensive expertise in conducting and analyzing neuropsychological test results, ensuring you receive the most accurate and comprehensive evaluation possible.
The ADHD Diagnosis Process: How is ADHD Diagnosed?
ADHD diagnosis requires a comprehensive evaluation that goes beyond simple checklists or brief office visits. The diagnostic process typically includes:
- Clinical Interview: A detailed discussion of symptoms, developmental history, family history, and how symptoms impact daily functioning across multiple settings.
- Standardized Rating Scales: Questionnaires completed by the individual, parents, teachers, or other observers that measure symptom severity and frequency.
- Neuropsychological Testing: Objective assessments that measure attention, memory, executive functioning, processing speed, and other cognitive abilities. At KMN Psych, we use validated instruments such as:
- The Wechsler Adult Intelligence Scale – 5th Edition (WAIS-V)
- The Wechsler Intelligence Scale for Children – 5th Edition (WISC-V)
- Behavior Rating Inventory of Executive Function (BRIEF)
- Wisconsin Card Sorting Test (WCST)
- Behavioral Observations: Direct observation of behavior during testing sessions to assess attention, impulsivity, and activity level.
- Review of Records: Examination of academic transcripts, previous evaluations, medical records, and other documentation.
- Differential Diagnosis: Ruling out other conditions that may cause similar symptoms, such as anxiety disorders, depression, sleep disorders, or thyroid problems.
When is an ADHD Evaluation Performed?
ADHD evaluations can be performed at any age when symptoms become concerning or begin to significantly interfere with functioning. Common triggering events include:
- Academic difficulties or declining school performance
- Behavioral challenges at home or school
- Difficulty maintaining employment or meeting workplace expectations
- Relationship struggles or social difficulties
- Preparation for college or graduate school accommodations
- Medication management needs
- Co-occurring mental health concerns requiring clarification
Diagnosing ADHD in Adults
Adult ADHD testing requires careful evaluation, as symptoms may present differently than in childhood. The diagnostic process includes:
- Retrospective Analysis: Documenting childhood symptoms and their persistence into adulthood
- Functional Impairment Assessment: Evaluating how symptoms affect work, relationships, and daily responsibilities
- Comprehensive Testing: Using adult-normed assessments that measure attention, executive functioning, and processing speed
- Differential Diagnosis: Ruling out conditions like anxiety, depression, or borderline personality disorder that may mimic ADHD symptoms
- Co-Occurring Conditions: Identifying dual diagnoses that require integrated treatment
Many adults discover they have ADHD when seeking help for other concerns or when their children are diagnosed and they recognize similar patterns in themselves.
DSM-5 Criteria for ADHD
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, establishes the standard diagnostic criteria for ADHD. These criteria ensure consistency and accuracy across clinical settings.
Criterion A: Symptoms
The DSM-5 identifies 18 symptoms divided into two categories:
Inattention Symptoms (9 total):
- Often fails to give close attention to details or makes careless mistakes
- Often has difficulty sustaining attention in tasks or play
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish work
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks requiring sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
Hyperactivity-Impulsivity Symptoms (9 total):
- Often fidgets with or taps hands or feet or squirms in seat
- Often leaves seat in situations when remaining seated is expected
- Often runs about or climbs in inappropriate situations
- Often unable to play or engage in leisure activities quietly
- Is often “on the go” or acts as if “driven by a motor”
- Often talks excessively
- Often blurts out answers before questions are completed
- Often has difficulty waiting their turn
- Often interrupts or intrudes on others
Criterion B: Age of Onset
Several inattentive or hyperactive-impulsive symptoms must have been present before age 12 years.
Criterion C: Multiple Settings
Symptoms must be present in two or more settings (e.g., at home, school, work, or with friends or relatives).
Criterion D: Functional Impairment
There must be clear evidence that symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
Criterion E: Alternative Explanations
Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder.
Additional Conditions That Must Be Met for Diagnosis
Beyond symptom counts, clinicians must verify:
- Persistence: Symptoms must have persisted for at least 6 months
- Developmental Inappropriateness: Symptoms must be inconsistent with developmental level
- Childhood Onset: Several symptoms must have been present before age 12
- Pervasiveness: Symptoms must occur across multiple contexts, not just one specific setting
- Impairment: Symptoms must cause clinically significant impairment in functioning
- Rule-Outs: Other mental health conditions, medical issues, or substance use must be ruled out as primary causes
The Number of Symptoms Required for an ADHD Diagnosis (By Age Group)
The DSM-5 specifies different symptom thresholds based on age:
| Age Group | ADHD Presentation Type | Minimum Symptoms Required |
|---|---|---|
| Children (16 and younger) | Predominantly Inattentive | 6 of 9 inattention symptoms |
| Children (16 and younger) | Predominantly Hyperactive-Impulsive | 6 of 9 hyperactivity-impulsivity symptoms |
| Children (16 and younger) | Combined Presentation | 6 of 9 symptoms in both categories |
| Adolescents & Adults (17 and older) | Predominantly Inattentive | 5 of 9 inattention symptoms |
| Adolescents & Adults (17 and older) | Predominantly Hyperactive-Impulsive | 5 of 9 hyperactivity-impulsivity symptoms |
| Adolescents & Adults (17 and older) | Combined Presentation | 5 of 9 symptoms in both categories |
Adult ADHD Testing at KMN Psych
Understanding how to get tested for ADHD as an adult is an essential first step toward finding relief and support. The diagnostic process typically involves multiple steps to gather comprehensive information about your symptoms, history, and current functioning. At KMN Psych, we’ve streamlined this process while maintaining the thorough approach necessary for an accurate diagnosis. Here’s what you can expect when seeking an adult ADHD assessment with our team:
Step 1: Initial Screening and Intake Assessment
The diagnostic journey typically begins with a comprehensive clinical interview, where a qualified mental health professional gathers information about:
- Current symptoms and their impact on daily functioning
- Developmental and medical history
- Family history (as ADHD has a strong genetic component)
- Educational and work history
- Previous mental health concerns or diagnoses
- Substance use patterns
This initial assessment helps establish whether a complete neuropsychological evaluation is warranted.
Step 2: Comprehensive Neuropsychological Testing
At KMN Psych, we utilize a comprehensive approach to ADHD diagnosis, employing multiple evidence-based assessment tools.
Additionally, we may use standardized ADHD-specific assessments such as:
- Self-report symptom questionnaires
- Observer-report forms (completed by partners, family members, or close friends)
- Continuous performance tests that objectively measure attention and impulsivity
KMN Testing Measures Used:
- The Wechsler Adult Intelligence Scale – 5th Edition (WAIS-V)
- Wechsler Intelligence Scale for Children – 5th Edition (WISC-V)
- Minnesota Multiphasic Personality Inventory (MMPI-3)
- Bender Visual-Motor Gestalt Test (BVMGT)
- Wisconsin Card Sorting Test (WCST)
- Thematic Apperception Test (TAT)
- Vineland Adaptive Behavior Scales (VABS)
- Behavior Rating Inventory of Executive Function (BRIEF) Assessment Tools
Step 3: Differential Diagnosis
One crucial aspect of professional ADHD testing is ruling out other conditions that may cause similar symptoms. The epidemiology and proposed causes of ADHD are multifactorial, and symptoms can overlap with various other conditions, including:
- Anxiety disorders
- Depression
- Bipolar disorder
- Learning disabilities
- Sleep disorders
- Thyroid problems
- Substance use disorders
At KMN Psych, our experts, led by Dr. Doshay, are specially trained to differentiate ADHD from these other conditions, ensuring an accurate diagnosis that will inform effective treatment.
Step 4: Comprehensive Report and Feedback Session
Following the evaluation, our team analyzes the results. It translates them into a robust 15-20 page report to share findings, confirm or clarify the presence of ADHD, and provide a baseline for proper treatment planning.
Our reports include:
- A detailed summary of test results
- A clear diagnosis (or diagnoses)
- Specific recommendations for treatment
- Suggestions for accommodations at work or school
- Strategies for managing symptoms
- Resources for further support and education
Unlike many testing services, at KMN Psych, we offer clients the option to schedule a meeting following testing to discuss the report findings in detail with Dr. Doshay or a member of his assessment team.
Examples of ADHD Screening Questions
ADHD screening questionnaires typically include questions like:
For Inattention:
- How often do you have difficulty sustaining attention during tasks?
- How often do you have trouble organizing tasks or activities?
- How often do you lose items necessary for tasks?
- How often are you easily distracted by external stimuli?
For Hyperactivity-Impulsivity:
- How often do you fidget or squirm when seated?
- How often do you feel restless or “driven by a motor”?
- How often do you interrupt others or blurt out answers?
- How often do you have difficulty waiting your turn?
Functional Impact:
- How much do these symptoms interfere with your work or school?
- How have these symptoms affected your relationships?
- When did you first notice these difficulties?
- Are symptoms worse in certain situations or settings?
Questions are rated on frequency scales (e.g., “never,” “rarely,” “sometimes,” “often,” “very often”) and are typically completed by the individual being assessed as well as by observers such as parents, partners, or teachers.
How Long Does an ADHD Evaluation Take?
The duration of an ADHD evaluation varies based on the complexity of the case and the comprehensiveness of testing:
Initial Screening and Intake: 60-90 minutes for the phone screening and comprehensive clinical interview
Testing Session: 3-5 hours for the full battery of neuropsychological assessments, typically completed in one or two sessions with breaks
Total Timeline: From initial contact to final report, the complete process typically takes 2-3 weeks, including:
- Scheduling and preparation
- Testing sessions
- Data analysis
- Report writing
- Feedback session
At KMN Psych, we aim to minimize turnaround time while ensuring thoroughness and accuracy. We understand that waiting for answers can be difficult, which is why we strive to provide comprehensive results as efficiently as possible.
Other Conditions That Can Cause ADHD Symptoms
Many conditions can produce symptoms similar to ADHD, which is why differential diagnosis is crucial. Conditions that may mimic ADHD include:
Mental Health Conditions:
- Anxiety disorders: Worry and nervousness can impair concentration
- Depression: Low mood affects motivation and mental clarity
- Bipolar disorder: Mood fluctuations can impact attention and impulsivity
- Post-traumatic stress disorder (PTSD): Hypervigilance and intrusive thoughts disrupt focus
- Obsessive-compulsive disorder (OCD): Intrusive thoughts and compulsions interfere with concentration
Learning and Developmental Disorders:
- Learning disabilities: Specific academic struggles may appear as inattention
- Autism spectrum disorder: Executive functioning differences can resemble ADHD
- Intellectual disabilities: Cognitive limitations may present as attention difficulties
Medical Conditions:
- Sleep disorders: Insufficient or poor-quality sleep significantly impairs attention and executive functioning
- Thyroid disorders: Both hyperthyroidism and hypothyroidism affect concentration and energy
- Hearing or vision problems: Sensory deficits can appear as inattention
- Seizure disorders: Absence seizures may be mistaken for “spacing out”
- Traumatic brain injury: Cognitive effects of head injuries can mimic ADHD
Substance-Related Factors:
- Medication side effects: Many medications can cause attention problems or restlessness
- Substance use: Stimulants, alcohol, or other drugs can create ADHD-like symptoms
- Caffeine overconsumption: Excessive caffeine can cause restlessness and concentration difficulties
Environmental and Situational Factors:
- Chronic stress: Ongoing stressors impair cognitive functioning
- Understimulation: Boredom in inappropriate educational or work settings
- Poor diet or nutrition: Deficiencies can affect attention and behavior
- Lack of physical activity: Insufficient movement can increase restlessness
A comprehensive neuropsychological evaluation examines these possibilities, ensuring an accurate diagnosis and appropriate treatment recommendations.
What to Look For in an ADHD Testing Provider
When seeking an ADHD diagnosis as an adult, it’s crucial to choose a qualified provider. Here’s what to look for when considering where to get tested for ADHD:
1. Specialized Credentials
To give neuropsych assessments, a psychiatrist or psychologist must complete masters-level education programs, specific training, and yearly certifications. At KMN Psych, our leading clinical psychologist and neuropsychology expert, Dr. Doshay, and his assessment team administer all assessments, ensuring the highest standard of care.
2. Comprehensive Approach
Avoid providers who offer “quick” ADHD diagnoses based solely on symptom checklists. A thorough evaluation should include:
- Detailed clinical interviews
- Standardized assessments
- Collection of collateral information (from partners, family members, etc.)
- Consideration of alternative explanations for symptoms
KMN Psych provides simple yet comprehensive testing for all ages, with an individualized approach for each client.
3. Turnaround Time
At KMN Psych, we aim to simplify the psychological testing process and minimize the turnaround time so you can immediately gain insights into many of the unanswered questions.
After ADHD Diagnosis: Next Steps
Receiving an ADHD diagnosis as an adult can be an emotional experience. Many people feel relief, validation, grief for past struggles, and hope for the future. Here’s what typically happens after diagnosis:
Based on your specific symptom profile, strengths, and challenges, your provider may recommend:
- Medication management - Stimulant and non-stimulant medications can significantly reduce ADHD symptoms in many adults
- Cognitive-behavioral therapy - To develop skills for organization, time management, and emotional regulation
- ADHD coaching - Practical support for implementing strategies in daily life
- Lifestyle modifications - Including sleep hygiene, exercise, nutrition, and stress management techniques
With a formal diagnosis, adults may qualify for:
- Workplace accommodations (extra time for projects, reduced distractions, written instructions)
- Academic accommodations in higher education
- Support groups and community resources
ADHD management typically involves regular follow-up to assess:
- Medication effectiveness and side effects
- Progress toward personal goals
- Need for adjustments to treatment approach
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FAQs
Get a good night’s sleep, eat beforehand, take medications as prescribed, and bring ID, insurance, and any relevant records. Avoid alcohol, excessive caffeine, or trying to “prepare” for the test—honest, typical functioning leads to the most accurate results.
Online ADHD screenings can suggest whether further evaluation may be helpful, but they cannot diagnose ADHD. A comprehensive, in-person assessment is required for accurate diagnosis, treatment planning, and official documentation.
You’ll receive a detailed written report explaining whether ADHD is diagnosed, which presentation applies, and any co-occurring conditions. The report includes clear, actionable recommendations for treatment, school or workplace accommodations, and next steps.
Most ADHD evaluation reports are completed within 7–10 business days after testing. From initial screening to final feedback, the full process typically takes 2–4 weeks, depending on scheduling.
After testing, you’ll review your results and recommendations and may schedule a feedback session to discuss next steps. If ADHD is diagnosed, the report can be used to guide treatment and request school or workplace accommodations; if not, alternative explanations and supports are outlined.
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