ADHD Testing

Attention-deficit/hyperactivity disorder (ADHD) is not made up and it’s not “just a kid thing”. Admittedly, ADHD can be overdiagnosed--we all wish that schools had smaller class sizes, more 1-on-1 support, and time for exercise. In teens and adults, anxiety or depressive disorders can mimic ADHD. Our lifestyles also drive distraction; our brains were not designed to be attached to screens all day long. Not only are we overscheduled, we’re frequently on the computer for 8-10 hours at work and go home to relax with activities on our phones or tablets.

As a specialist, I’ve certainly met with patients who were overtreated, receiving high dose stimulant medications in an attempt to control other disruptive behaviors. But I’ve met with more patients where symptoms were undertreated as poor performance was attributed to lack of motivation or laziness. The correct diagnosis of ADHD in an adult can be life-changing and many identify with books like Driven to Distraction and You Mean I’m Not Lazy, Stupid or Crazy?!

In the age of the opioid epidemic, many teens and adults are frustrated that their healthcare providers are now requiring objective testing for ADHD before prescribing stimulant medications. Time and cost are also barriers as most psychologists have lengthy waitlists and insurance coverage for testing is often spotty.

I started using computerized continuous performance testing (CPT) as a clinical tool to support my medical decision-making. I can administer the test in my office and have results 20 minutes later. CPT reports are not only helpful for diagnosis, but for ongoing monitoring of treatment response. I am humble to the fact that CPT is not a replacement for full psychological testing and more detailed measures of processing speed and working memory may be indicated.

Even board-certified child & adolescent psychiatrists can miss ADHD in teens who initially present with depression. Having CPT readily available in my office allows me to screen more patients; showing teens their symptoms improves compliance with treatment. We can reassess symptoms following growth spurts or when teens are preparing to drive. Adult patients appreciate CPT as an analysis of their strengths and weaknesses.

A comprehensive ADHD assessment includes a review of history, standardized ratings scales, screening for anxiety and mood disorders, CPT administration and result interpretation. As a psychiatrist, I can review both stimulant and non-stimulant treatment options. I frequently refer families to parentsmedguide.org or CHADD for additional information. Adults who are tested often benefit from working through Organize Your Mind Organize Your Life regardless of diagnosis.

I have recently upgraded my testing package to include not only CPT but an additional test of executive functioning, the abilities that are necessary for self-regulation of behavior and achievement of purposeful goals. 

Author
Candace Good, MD Dr. Good is the founder of Sig: Wellness, LLC, an integrative psychiatry practice in State College, PA. Her office includes a mind-body studio to encourage yoga, meditation, and other healing arts for stress management. The space serves as an incubator for other female wellness practitioners to grow their presence in the community. Dr. Good welcomes freelance writing and editing projects relevant to her specialty.

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