Written by Emily Anastasio, PhD, LP

The short answer is: no. You do not technically need psychological testing for a diagnosis of ADHD. Some doctors will give the diagnosis based on a single checklist. There are even internet-based “assessments” you can complete now that can lead to a diagnosis by a mental health professional who has never even met you.

But not all options are equally good. Here are some reasons why an in-person evaluation with data collection is still the best way to diagnose ADHD, and why more and more primary care providers are requiring documentation of testing before initiating treatment of ADHD:

  1. ADHD can be difficult to diagnose. ADHD, or Attention-Deficit/Hyperactivity Disorder, is one of the more challenging diagnoses to determine, for a number of reasons. It’s a disorder characterized by certain combinations of executive function deficits that cause real-world impairment. It has complex presentations, and different degrees of severity. There are also a number of other mental health and social/environmental problems that cause difficulties with attention and focus. Psychologists train for years at the graduate level to understand how to accurately diagnose ADHD and rule out other potential causes. Diagnosing ADHD is not as simple as running through a checklist of symptoms you come across on the internet.
  2. ADHD causes other problems. Untreated ADHD often leads to the development of additional issues, such as mood disorders (anxiety and depression) and substance abuse, which then further complicate the clinical picture. Adults with ADHD are at increased risk for these and other mental health issues that also cause executive function deficits and real-world impairment. It is best practice to have a professional who understands the relationships between these issues on board to recognize and parse these things out.
  3. Medications are misused. Stimulant medications can be abused and misused. It is well-known that the medications that are most often prescribed for the treatment of ADHD, stimulants like Ritalin and Adderall, can be obtained illegally or through others with the diagnosis (i.e., college students sharing their meds with friends). One way to minimize these dangerous practices is to do everything possible to prescribe stimulants only to those who truly have a diagnosis of ADHD.
  4. Testing is actually really cool. The evaluation itself can be a therapeutic experience for the person completing it. Based on patient feedback, the process of reviewing personal history in depth and completing tests of cognitive, behavioral, and emotional functioning often translates into feeling deeply heard and understood for the first time ever. There is value to psychological testing beyond the scores that it yields.

For the record, children suspected of having ADHD should always receive an evaluation by a psychologist with experience and expertise in evaluating and diagnosing children and adolescents. There are different tests and methods that need to be utilized with children versus adults, and specialized training and experience matters in terms of the quality of the evaluation your child receives.

To sum up: Although there may be other ways nowadays, a psychological evaluation remains the best way to diagnose ADHD in adults and create a customized plan that works best for that individual. This is what we strive to do at Cashman Center… contact us today for more information about ADHD evaluation for adults.