The Clinical Interview: Building Your Complete Picture
Duration: 1-2 hours
Your ADHD evaluation begins with an in-depth clinical interview—the foundation of accurate diagnosis. During this conversation, our licensed psychologists gather essential information about your unique situation, developmental history, and current challenges.
What We’ll Discuss in Your Clinical Interview:
- Current Symptoms and Concerns: We’ll explore the specific difficulties you’re experiencing with attention, organization, impulsivity, or hyperactivity. You’ll describe how these challenges show up in different settings—at home, work, school, or in relationships. We want to understand not just what’s happening, but how it’s impacting your daily life.
- Developmental and Medical History: ADHD symptoms typically begin in childhood, so we’ll review your early development, academic history, and any childhood behavioral concerns. For children, we’ll discuss pregnancy, birth, developmental milestones, and early behaviors. This historical context helps distinguish ADHD from other conditions and confirms the long-standing nature of symptoms.
- Family History: Since ADHD has a strong genetic component, we’ll ask about attention difficulties, learning challenges, or ADHD diagnoses among family members. This information provides valuable insight into potential hereditary factors.
- Academic and Occupational Functioning: We’ll explore your school or work performance history, including grades, job changes, completion of tasks, and any accommodations you’ve received. Understanding patterns in these areas helps clarify how attention challenges have affected your achievements and progress.
- Social and Emotional Well-being: ADHD often impacts relationships, self-esteem, and emotional regulation. We’ll discuss your friendships, family dynamics, frustration tolerance, and mood patterns to understand the full scope of how symptoms affect your life.
Comprehensive Cognitive Testing: Measuring Brain Function
Duration: 2-4 hours (can be split across multiple sessions)
Following the clinical interview, you’ll complete a series of standardized psychological tests designed to objectively measure cognitive abilities that are often affected by ADHD. These aren’t pass/fail tests—they’re tools that help us understand how your brain processes information.
Key Cognitive Areas We Assess:
- Attention and Concentration Testing: We use specialized computerized tests, such as Continuous Performance Tests (CPTs), that measure your ability to sustain attention over time, resist distraction, and maintain focus during repetitive tasks. These tests are sensitive to the attention fluctuations characteristic of ADHD.
- Working Memory Assessment: Working memory—your ability to hold and manipulate information in your mind—is often impaired in ADHD. We’ll assess this through tasks that require you to remember sequences, follow multi-step directions, or mentally manipulate numbers and letters. Poor working memory often explains difficulties with math, following instructions, and organization.
- Processing Speed Evaluation: Processing speed measures how quickly you can take in and respond to information. Individuals with ADHD often process information more slowly, which can affect academic performance and daily efficiency. We use timed tasks that assess your speed of mental processing and visual-motor coordination.
- Executive Function Testing: Executive functions are the brain’s management system—planning, organizing, initiating tasks, shifting between activities, and inhibiting impulses. We assess these critical skills through various measures including planning and problem-solving tasks, cognitive flexibility tests, and more.
- Intelligence Assessment (When Appropriate): In some cases, we may include IQ testing to understand your overall cognitive strengths and identify any learning disabilities that might co-occur with ADHD. This helps us differentiate between attention problems and other cognitive factors that might be affecting your performance.
Behavior Rating Scales: Multiple Perspectives Matter
Duration: 30-45 minutes (completed by multiple people)
ADHD symptoms manifest across different settings, so gathering observations from multiple sources provides a more complete and accurate picture. We use standardized behavior rating scales—questionnaires that have been validated through research comparing people with and without ADHD.
Who Completes Rating Scales:
Self-Report Questionnaires
You (or your child if age-appropriate) will complete forms about your own attention, behavior, emotions, and daily functioning. These provide insight into your subjective experience of symptoms.
Parent Ratings (for children and teens)
Parents complete detailed questionnaires about their child’s behavior at home, including attention span, activity level, impulsivity, emotional control, and social functioning. Parent observations are especially valuable for understanding early developmental patterns.
Teacher Ratings (for school-age individuals)
Teachers observe students in academically demanding environments where attention problems become most apparent. Their ratings help us understand how symptoms affect learning, classroom behavior, and peer interactions. We typically request input from multiple teachers if possible.
Partner or Family Member Ratings (for adults)
For adult evaluations, we often ask a spouse, partner, or close family member to complete ratings about your behavior in daily life. These collateral observations help verify symptoms and provide perspective on how attention difficulties impact your relationships and home functioning.
Common Rating Scales We Use:
- Conners Rating Scales (comprehensive ADHD symptom assessment)
- Vanderbilt ADHD Diagnostic Rating Scale (DSM-5 criteria-based)
- Brown Executive Function/Attention Scales
- Adult ADHD Self-Report Scale (ASRS)
- Behavior Assessment System for Children (BASC)
Collateral Interviews: Gathering Additional Perspectives
Duration: 30-60 minutes (as needed)
In addition to written rating scales, we may conduct collateral interviews with important people in your life who can provide valuable observations about your symptoms and functioning.
Who We Might Interview:
For Children:
- Parents or guardians (always)
- Teachers or school counselors
- Previous therapists or healthcare providers
- Daycare providers or coaches
For Adults:
- Spouse or romantic partner
- Parents (for developmental history)
- Close friends or roommates
- Supervisors or colleagues (with permission)
- Previous treating professionals
These conversations help us understand symptom patterns across different contexts, verify the pervasiveness of symptoms, and gather historical information that might not be available through written records alone.
Timeline: From First Appointment to Final Results
Understanding the testing timeline helps you plan accordingly and sets realistic expectations for when you’ll receive answers.
Week 1: Initial Consultation and Clinical Interview
- Schedule your intake appointment
- Complete initial paperwork and history forms
- Clinical interview (1-2 hours)
- Distribute rating scales to relevant people
Week 2-3: Testing Sessions
- Complete cognitive and psychological testing (2-4 hours total)
- May be scheduled as one longer session or split into 2-3 shorter appointments
- Breaks provided as needed
- Collateral interviews conducted if necessary
Week 3-4: Scoring, Analysis, and Report Writing
- Our psychologists score all test measures
- Compare results to normative data
- Analyze patterns across multiple sources
- Integrate all information into diagnostic impressions
- Write comprehensive evaluation report (typically 10-15 pages)
- Develop individualized recommendations
Week 4-5: Feedback Session
This is where everything comes together. During your feedback session, we’ll:
- Review all test results in understandable terms
- Explain diagnostic impressions and what they mean
- Discuss how findings relate to your specific concerns
- Provide detailed, practical recommendations
- Answer all your questions
- Discuss next steps for treatment or accommodations
You’ll receive a complete written report that you can share with physicians, schools, employers, or other providers as needed.
What to Bring to Your ADHD Evaluation
Coming prepared helps us maximize the value of your evaluation:
Required Documents:
- Completed intake paperwork
- Insurance information and photo ID
- Previous psychological or educational testing reports
- School report cards or IEP/504 plan documents
- Medical records relevant to attention concerns
- List of current medications
Helpful to Bring:
- Examples of work or schoolwork showing difficulties
- Notes about specific symptoms or concerns
- Questions you want answered
- A snack and water for longer testing sessions
After the Evaluation: Turning Results into Action
The evaluation doesn’t end with your diagnosis. Our comprehensive report includes specific, actionable recommendations tailored to your situation:
Treatment Recommendations may include:
- Individual therapy approaches (CBT, behavioral interventions)
- Medication evaluation referrals
- Coaching or organizational skills training
- Family therapy or parent training
Academic Accommodations might include:
- Extended time on tests
- Reduced distractions in the classroom
- Assignment modifications
- IEP or 504 plan recommendations
Workplace Accommodations could involve:
- Flexible work schedules
- Written instructions and deadlines
- Quiet workspace arrangements
- Task management support
Lifestyle Modifications often include:
- Sleep hygiene improvements
- Exercise recommendations
- Time management strategies
- Environmental modifications
