ADHD in adults and children: How is it diagnosed

What is ADHD, how is it diagnosed, and who do I need to see to determine diagnosis?

At Sydney City Psychology, our psychologists often get asked about attention deficit hyperactivity disorder (ADHD) in both children and adults.  Over the next two blog posts, clinical psychologist Angel Lee-Aube addresses some frequently asked questions about getting an ADHD assessment and diagnosis.

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is defined by the American Psychiatric Association as a chronic and debilitating mental condition, characterised by inattention (difficulty keeping focus), hyperactivity (excess movement that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought) (APA, 2023). It is considered as a neurodevelopmental disorder, which means that it is related to brain development and that symptoms are present in childhood.

There are three presentations of ADHD: predominately inattentive presentation, predominately hyperactivity/ impulsivity presentation, and combined presentation.

Who can diagnose ADHD?

In Australia, people who can diagnose ADHD are psychologists (who include registered psychologists, clinical psychologists and clinical neuropsychologists), paediatricians (for children), and psychiatrists. They should be appropriately registered by a body such as the Australian Health Practitioner Regulation Agency (AHPRA).

What does an ADHD diagnosis involve?

The assessment process may look slightly different depending on which profession makes the diagnosis, but should involve the following components:

  • Clinical interviews (talking in depth with the client and perhaps their caregiver or teacher, if a child) including obtaining the person’s developmental, medical and mental health history
  • Discussion about the person’s symptoms and strengths, and how these present in different domains and settings of everyday life.
  • Administration and interpretation of standardised rating scales (i.e., questionnaires that you fill out and the clinician scores)
  • Observer reports of the person’s symptoms and mental state (done by the clinician or others)
  • Consultation with the person’s doctor or psychiatrist.

In addition to the above, the assessing clinician may also use other ways to collate relevant information for diagnosis, such as:

  • Neuropsychological assessments: for example, cognitive, learning or attention-based assessments. These are more in-depth assessments than the standardised rating scales described above, and can involve the clinician asking the client a series of questions and to complete a series of tasks in a particular way. This gives the clinician a more detailed understanding of the person’s neuropsychological profile, such as their areas of strength and weakness
  • Classroom observations: these can be useful for children to gain an understanding of the child’s behaviour in other contexts.

Who can prescribe medication and other treatment for ADHD?

In Australia, people who can prescribe medication for ADHD are psychiatrists and paediatricians (for children). Psychologists can provide psychological treatments such as talk therapy, ‘ADHD coaching’, skills and strategies, and can assist with reducing the impact that symptoms have on a person’s ability to live meaningfully. This can include focusing on emotional and social aspects of ADHD, as well as strategies related to attention, focus, planning, time management, and impacts on mood and anxiety.

Sources:
‘What is ADHD?’, American Psychiatric Association psychiatry.org/patients-families/adhd/what-is-adhd
Australian Evidence Based Clinical Practice Guidelines for Attention Deficit Hyperactivity Disorder (ADHD), AADPA adhdguideline.aadpa.com.au

For information about what an ADHD assessment looks like at Sydney City Psychology, click here.