Where to Start If You Are Wondering About ADHD
When you are wondering whether you meet diagnostic criteria for a diagnosis of Autism or ADHD you have a few choices. For ADHD, many Primary Care physicians are comfortable assessing and prescribing medication, so that may be your most direct access to getting your questions answered. If you don’t have a PCP or your doctor doesn’t address this diagnosis, you could investigate diagnosis and medication by a PMHNP, a Psychiatric Mental Health Nurse Practitioner. In addition to medication, a variety of other therapies and strategies have been developed for supporting people with ADHD. Even without medication, many people find they can improve symptoms like distractibility, organizational difficulties or impulsive behavior. Various psychotherapy approaches by Masters-level Therapists and Psychologists can make a difference. Some Occupational Therapists (OT) and Speech Therapists (SLPs) are informed on ADHD and can be effective as well.
How Autism and ADHD Are Classified
Autism and ADHD are both classified as Neurodevelopmental Disorders, so these are different from commonly recognized mental health diagnoses like anxiety or depression. People who identified diagnostic categories originally thought only children could have one of these diagnoses and that most adults would mature out of the symptoms. ADHD didn’t come to the public’s attention until about 1994. Autism wasn’t recognized as an adult diagnosis for those without intellectual disability until about 2011, so it’s not surprising that it is still poorly understood. Autism continues to carry more social stigma than ADHD because our society has so many myths and misunderstandings about it. Professionals have also only recently agreed that people can be diagnosed with both ADHD and Autism.
Why Autism Diagnosis Is More Complicated
Autism diagnosis is more complicated to identify than ADHD. One reason your PCP may not address it in their practice is that there are no medications to prescribe for autism. The recommended treatment might include psychotherapy, Occupational Therapy or Speech Therapy, so these issues are not directly addressed by a PCP.
Looking Into Self-Diagnosis First
One option is to spend some time looking into self-diagnosis. Perhaps you’ve already done that. There are many good resources to answer this question sufficiently for a lot of people’s needs. You shouldn’t have to purchase any expensive products to investigate this. A few resources you can consider include a brief book by Cynthia Kim, I Think I Might be Autistic. It costs about $10 and libraries often have it available. You can also take many screening tests online. You might want to think about privacy considerations, and whether you want to have your email address associated with receiving the answers to an online test. Some people prefer to save an email with a fake name for purposes like this. Some of the screening tests we use include RAADS-R, Ritvo Autism Asperger Diagnostic Scale-Revisited; CATI, Comprehensive Autistic Trait Inventory; CAT-Q, Camouflaging Autistic Traits Questionnaire; AQ, Autism Spectrum Quotient.
What a Screening Test Is
A screening test refers to a preliminary set of questions that you would self-report, so that someone working with you can decide whether it’s worth pursuing a more detailed diagnosis with professionally administered questionnaires. People who wonder about whether they are autistic frequently question their perceptions and become preoccupied with whether they might be claiming an identity or label that they have no right to. Seeking a diagnosis by a professional can help reduce this uncertainty.
Formal Diagnosis by a Licensed Psychologist
If you decide you want to pursue diagnosis by a professional, you have several other choices. The most detailed kind of formal diagnosis that you can obtain is through speaking with a licensed psychologist. Depending on your state, a variety of terms may be used but the most common credential is licensed psychologist with a PsyD or PHD degree.
This testing is extensive and might include IQ tests, personality testing, tests for learning disability or other cognitive difficulties.
If You Are Applying for SSI or Social Security Disability
It is essential that you locate someone who can provide this specific service if you are applying for SSI or Social Security Disability Payments. These programs are administered by the federal government and follow strict regulations about eligibility.
If You Are Seeking School or Workplace Accommodations
It is also advisable to meet with a licensed psychologist if you are looking for determination of accommodations based on your needs in your school or workplace. Some organizations will accept a Masters level assessment, but you may be told that you need to go back and get a full psychological evaluation to get the academic or vocational adjustments you are requesting.
Assessment by a Masters Level Professional
As long as you don’t require verification of a diagnosis for disability, benefits, or accommodations, you may be satisfied with an assessment by a Masters level professional. This could be someone with any of these degrees:
- LPC Licensed Professional Counselor, LMFT Licensed Marriage and Family Therapist.
- LCSW or LICSW Licensed (Independent) Clinical Social Worker
- M.Ed. Masters in Education These professionals can diagnose in an academic setting
Any of these credentials qualify clinicians to use a combination of tests and interview formats that will help them arrive at a conclusion about whether you meet the diagnostic criteria for ADHD, autism or a variety of other diagnoses that commonly accompany these groups such as Depression, Anxiety, PTSD, OCD, and others.
What to Expect During the Assessment
When you meet with the clinician for an assessment, they may send you questionnaires to complete in advance, or they may prefer to ask screening questions with you during the interview. The questions can be especially difficult for people who tend to experience confusion about exactly what a test question is trying to define. If you are specific and careful about use of language, be aware you may experience frustration when trying to accurately respond to test questions.
The therapist will typically ask numerous questions about your life, history, sensations, social activities, your health, medical history, and your interests and aptitudes. Depending on the format that the clinician is using, this could take anywhere from 3 to 8 sessions.
Tests Used to Identify Autism
Along with the free screening tests described above, clinical tests that are typically used to identify autism include the ADOS and MIGDAS. Therapists go through a training period of several days in order to qualify to administer these tests and they pay for each individual test every time they use it with a client. Another standardized test was developed in. England called the ACIA, Autism Clinical Interview for Adults. Any of these test formats are considered sufficient for allowing a series of thoughtful conversations that will produce the information we need to address the diagnostic criteria.
Tests Used to Identify ADHD
ADHD can be explored through screening tools, such as ASRS-v1.1., Adult ADHD Self-Report Scale. Tests that clinicians rely on include CAARS, Conners Adult ADHD Rating Scales, and tests for variable attention or executive function. Along with the screening tools, another popular test used internationally is Diva 5, Diagnostic interview for ADHD in Adults. While tests can provide important information, the heart of your assessment will involve the interviewer getting to know you and hearing your story and lifelong patterns.
How Many Adults Are Autistic or Have ADHD
We don’t yet know how many people are autistic or have ADHD, especially in the adult population, where numerous people are only recently recognizing that they have neurodivergent traits. Studies in England have shown most adults who are autistic, an estimated 89-97%, have still not been identified. We are seeing substantial overlap of ADHD and Autism diagnoses, possibly up to 70 percent.
Collateral Sources and Co-Occurring Conditions
The clinician can discuss your wishes to involve collateral sources, i.e. other people who know you and spend time with you and who can report knowledgeably on your day-to-day behaviors. This could be a parent, Spouse/partner or housemate.
Part of the diagnosing process is identifying whether the person has any other diagnosis that would better explain what they are experiencing. So as we are interviewing you, we are deciding whether to look into co-occurring conditions that may provide a more precise explanation for whatever difficulties you are experiencing.
Receiving Your Results
Once you’ve gone through the process of filling out the questionnaires and participating in the interview, the clinician may need some time to assemble the data they have gathered and arrive at a conclusion. Usually, you would be scheduled for a session where they review their findings with you and discuss your reaction and their recommendations. You may receive a written report, depending on what you initially agreed to.
Adjusting to a Confirmed Diagnosis
If the clinician confirms the diagnosis that you were inquiring about, that may conclude your time together. Where do you have ADHD or autism or both, people have a mix of reactions. Many people are relieved to have an expert opinion on something that you have been curious or concerned about. It can take some time to get used to having a new diagnosis. This is a shift in your identity and the way you understand yourself and interact with others. It can be a lot to adjust to, both for you and the other people in your life. You will be faced with some decisions about who to disclose your diagnosis to, if at all, and how to do that, so we have another article on that question.
When the Diagnosis Is Not Confirmed
Occasionally people come seeking a diagnosis, and the clinician is unable to match their report of their experience to the diagnostic criteria. Typically the evaluator will explain their conclusion and they may refer you to another therapist for follow up. Even though the outcome is unknown until you go through the steps, many people find diagnosis a worthwhile process so they can set their questions and doubts to rest.
Talk With a Therapist About Your Questions
The therapists on this site are happy to confidentially answer questions about diagnosis decisions. You can search the directory by the state you live in and look for therapists who can meet with you online or in-office. You can also look for someone in your state who can bill your insurance. Please contact us if we can be of assistance.
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