Evidence-Based Assessment for Attention-Deficit/Hyperactivity Disorder

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals from all life stages, genders, and races/ethnicities. Accurate assessment of ADHD across different populations is essential as undiagnosed ADHD is associated with numerous costly negative public health outcomes and is complicated by high comorbidity and developmental change in symptoms over time. Predictive analysis suggests that best-practice evidence-based assessment of ADHD should include both ADHD-specific and broadband rating scales from multiple informants with consideration of IQ, academic achievement, and executive function when there are concerns about learning. For children under age 12, parent and teacher ratings should be averaged. For adolescents and adults, informant reports should be prioritized when self- and other-report are inconsistent. Future research should provide more stringent evaluation of the sensitivity of measures to treatment response and developmental change over time as well as further validate measures on historically understudied populations (i.e., adults, women, and racial/ethnic minorities).

A new paradigm for adult ADHD: A focused strategy to monitor treatment

“…ADHD diagnosis requires the presence of dysfunctional symptoms of inattention, hyperactive/impulsive behavior, or both, as noted in Table 1, 4,5 with clinicians examining the presence of reported symptoms in context. A person's highly reactive, impulsive behavior may be effective on the college football fi eld but dysfunctional in a classroom lecture.…”

“…5 The clinician must confi rm the presence and intrusiveness of at least 5 behaviors for inattention, hyperactivity/impulsivity, or both, as outlined in Table 1. 4,5 It is not enough that the patient engages in the behaviors associated with ADHD sometimes, as everyone exhibits them from time to time. It is critical to determine that the behaviors present a problem in daily functioning.…”

Evidence-Based Assessment of Developmental Disorders

“…This review presents thorough guidelines for the evaluation and diagnosis of common developmental disorders that often onset in the early developmental period and that are commonly encountered in clinical practice. Although all communication, sleep/wake disorders, feeding, motor, and elimination disorders are addressed, it should be noted that guidelines for the evaluation of some important neurodevelopmental conditions—autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), intellectual disability, and specific learning disorders—are independently provided in other articles and will not be discussed here (Eng et al, 2023; Fletcher et al, 2005; Kishore et al, 2019; Ozonoff et al, 2005). In addition, as the scope of this article is limited to disorders that typically onset in the early developmental/early childhood period, assessment guidelines are generally provided only for pediatric populations, although many of the conditions can and do present in or persist into adulthood.…”