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Attention Deficit Hyperactivity Disorder

Testing for ADD



How is it determined if an individual has ADD?


The answer varies somewhat on who does the evaluation. Where I work, at a private center for adults and children (The Affinity Center in Kenwood, Ohio) we have an evaluation process which usually takes several hours that includes a long questionaire, several mini-tests that help determine if there are other medical problems (physical or mental), as well as ADD-specific questionaires and two face-to-face interviews (one with the physician and one with the case-manager/counselor). We do that much because we have found there are some individuals who do not completely follow the DSM IV Criteria (the official Psychiatric criteria) but have ADD. In addition, we feel it is very important to carefully assess for other causes of attention deficit that may be present. We get teacher feedback, when appropriate. We also want to know about our clients to understand when to educate about the importance of things like good nutrition, appropriate exercise, having an identified primary care physician, stopping inappropriate stimulants (e.g., caffeine and nicotine), dealing appropriately with stress, when and where to get help from education specialists, etc. Regarding shorter evaluations, there are several "scales" in the form of questionaires that clinicians use. There is no specific "only" or "most appropriate" form although some have been verified more than others using scientific method. Forms by Drs. Barkley (ADHD: A Clinical Workbook, 1991), Conners (Conners Adult ADHD History Form, 1995), Brown (Brown`s ADD Scale), and Nadeau (Adult ADD Questionnaire, 1995) are often used. In addition, those of us with a lot of experience with persons with ADD use our clinical instincts. I am a primary care physician and, as such, my training in ADD evaluation was limited. It was not until I spent a lot of time working with persons with ADD that this "intuition" developed-- perhaps not until I had seen over several hundred clients at The Affinity Center. That is not to say I would begin medication for ADD with someone without extensive questioning, but I now have a sense of when to evaluate my patients further. This is true for most clinicians who do a lot of work with ADD and, when it takes place, less workup may be needed. A long answer to a short question! I hope this helps.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati