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How ADHD is diagnosed after high school

By Kate Kelly

At a Glance

  • Many people aren’t diagnosed with ADHD until adulthood.

  • To be diagnosed with ADHD, symptoms must have been present in childhood.

  • An evaluation is the only way to find out if an adult has ADHD.

A young adult who struggling to stay organized and focused may wonder, “Do I have ADHD ?” The same is true for parents who struggle with focus and who  have a child who has been diagnosed with ADHD (also known as ADD). You may ask yourself, “Do I have ADHD, too?”

It’s common for ADHD not to be diagnosed until after high school. (Journalist Lisa Ling is a famous example.) That’s especially true for kids who did well in school and who are not hyperactive. Kids often find ways to work around challenges, allowing them to do well or “get by” in high school. But later in life, the demands of living independently, having a job, or dealing with family responsibilities can make it harder to stay organized and remain focused.

Signs of ADHD in adults include:

  • Being generally forgetful or “absent-minded”; may frequently miss meetings or lose items like keys

  • “Tuning out” during conversations; may be called a “bad listener” by others

  • Frequently interrupting others or blurting things out

  • Having trouble sitting still for long periods of time

  • Struggling to finish tasks at home, school, or work

  • Having a family member with ADHD

ADHD tends to run in families. If a child is diagnosed, there’s a good chance a sibling or parent could have it as well. But the only way to know for sure if you or your young adult child has ADHD is to get evaluated.

Learn more about how adults can find out if they have ADHD.

Specialists who test adults for ADHD

Only certain types of professionals are likely to be qualified to diagnose ADHD. They include:

  • Psychologists

  • Psychiatrists

  • Neuropsychologists

  • Physicians or APRNs (advanced practice registered nurses) who have had extra training on ADHD

It’s possible that some of the professionals listed above haven’t had adequate training in ADHD assessment and treatment. It’s important to ask whether your provider has had the proper training.

If you live in a rural area where there aren’t a lot of specialists, your primary care doctor may be able to diagnose you or your young adult child. This depends on the practice, though. Keep in mind that in most cases, psychologists and neuropsychologists can’t prescribe medication.

How specialists test for ADHD in adults

An ADHD evaluation needs to have certain components, no matter who does it. These are:

  • An initial meeting to identify how you or your young adult child is struggling. The doctor or specialist will want to know how your or your child’s symptoms are affecting daily life and why you’re seeking an evaluation. They’ll also ask about education and health history to figure out if these are lifelong symptoms or if they cropped up recently. That’s because an ADHD diagnosis requires a history of having at least some ADHD symptoms before age 12.

  • Checklists and questionnaires. You or your child may also complete one or more questionnaires or checklists designed to look at the frequency of ADHD-like behaviors. The clinician may send these in advance to complete before the meeting. Or you may fill them out during the meeting.

  • A follow-up meeting to discuss results and develop a plan. The goal of this meeting is to figure out a treatment plan and how you’ll monitor progress.

These are the three basic components of an ADHD evaluation. The doctor or specialist typically focuses on different things, however, depending on the age of the person being evaluated.

Evaluating young adults for ADHD: At the initial meeting, the evaluator may spend more time asking about past (and present, if appropriate) performance in school. They may also want your child to have a full evaluation for learning differences like dyslexia , which often co-occur with ADHD.

In that case, they should refer your child to a specialist to do this assessment if they can’t do it. If you have insurance, you’ll need to find out if it will cover the cost of that evaluation. If it doesn’t, explore resources for finding free or low-cost private evaluations .

Young adults should complete what’s called “normed ADHD rating scales.” Some rating scales help to assess whether a person has specific symptoms. Others compare the frequency and intensity of symptoms to people who are the same age and don’t have ADHD. There’s also a version for parents to complete so the evaluator can get your input, too.

Young adults often seek an ADHD evaluation because they’re struggling in school or having trouble deciding on a major or choosing a career path. They may also want to ask their specialist for a referral for career aptitude testing.

Evaluating older adults for ADHD: The older you get, the more likely it is that a medical condition (like anxiety, depression, or hypertension) could be mimicking the symptoms of ADHD. A good clinician will always be thinking “What else could be going on besides ADHD?”

That’s why they may spend more time doing a medical and psychological history with older adults than with younger adults. (Read more about the connection between ADHD and anxiety , and ADHD and depression .)

Older adults tend to seek an ADHD evaluation because of how ADHD symptoms affect their career or home life. The doctor may also focus more on relationship and work history, rather than school history.

Clinicians don’t always use the “normed ADHD rating scales” when evaluating older adults. Instead, older adults may complete a structured questionnaire to figure out how many symptoms are present.

Treating adults with ADHD

If the doctor or specialist diagnoses you or your young adult child with ADHD, the next step is to come up with a treatment plan.

ADHD medication is often helpful for both young and older adults. Young adults with ADHD need to learn the skills that will allow them to live and work independently. The clinician may recommend coaching or therapy to help them develop success strategies.

For older adults, medication is often enough. It can help them follow through on strategies they’ve known about but have been unable to execute. Many older adults benefit from counseling or coaching in addition to or instead of medication. This can be especially helpful for coping with anxiety, depression, substance abuse problems, and other issues that may be complicating the ADHD.

At this meeting, the clinician should address the plan to monitor progress. If you or your young adult is on medication, you should be seen regularly and fine-tune medication as needed. You need to make sure the dosage is effective and has minimal side effects. You also need to check in regarding whether counseling or coaching is working.

If you think you or your young adult child might have ADHD, an evaluation can give you a fuller picture of what’s going on and how to help.

You may also want to learn about the connection between ADHD and emotions . See a graphic that shows how ADHD medication works . And explore a collection of ADHD success stories .

Key Takeaways

  • ADHD evaluations for young adults versus older adults may be different.

  • There are other conditions that can mimic the symptoms of ADHD.

  • Treatment for ADHD may involve medication and therapy.

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