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Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
The nineteenth century railway worker who survived an iron rod through the frontal lobes is the standard illustration, and what altered in him was inhibition and social judgement rather than intelligence. Clinically it is the timeline that sorts it out. An acquired injury has a before and an after, and it fails the requirement that difficulties were present in childhood. That requirement gets criticised often, and this is one of the jobs it genuinely does.
God will raise up, by many degrees, those of you who believe and those who have been given knowledge (Quran 58:11). Knowing enough to tell two pictures apart is no small service to the person in front of you.
المجادلة
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا قِيلَ لَكُمۡ تَفَسَّحُواْ فِي ٱلۡمَجَٰلِسِ فَٱفۡسَحُواْ يَفۡسَحِ ٱللَّهُ لَكُمۡۖ وَإِذَا قِيلَ ٱنشُزُواْ فَٱنشُزُواْ يَرۡفَعِ ٱللَّهُ ٱلَّذِينَ ءَامَنُواْ مِنكُمۡ وَٱلَّذِينَ أُوتُواْ ٱلۡعِلۡمَ دَرَجَٰتࣲۚ وَٱللَّهُ بِمَا تَعۡمَلُونَ خَبِيرࣱ
You who believe, if you are told to make room for one another in your assemblies, then do so, and God will make room for you, and if you are told to rise up, do so: God will raise up, by many degrees, those of you who believe and those who have been given knowledge: He is fully aware of what you do
Qur’an 58:11read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A European consensus statement on adult ADHD sets out that the condition often persists into adulthood and old age while remaining underdiagnosed in many countries. The picture it describes is a long running difficulty rather than a new one, which is why a clear before and after in an adult should send you down a different line of questions. It is expert consensus about the evidence rather than a study of misdiagnosis rates.
Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J, Thome J, Dom G, Kasper S, Nunes Filipe C, Stes S, Mohr P, Leppämäki S, Casas M, Bobes J, Mccarthy JM, Richarte V, Kjems Philipsen A, Pehlivanidis A, Niemela A, Styr B, Semerci B, Bolea-Alamanac B, Edvinsson D, Baeyens D, Wynchank D, Sobanski E, Philipsen A, McNicholas F, Caci H, Mihailescu I, Manor I, Dobrescu I, Saito T, Krause J, Fayyad J, Ramos-Quiroga JA, Foeken K, Rad F, Adamou M, Ohlmeier M, Fitzgerald M, Gill M, Lensing M, Motavalli Mukaddes N, Brudkiewicz P, Gustafsson P, Tani P, Oswald P, Carpentier PJ, De Rossi P, Delorme R, Markovska Simoska S, Pallanti S, Young S, Bejerot S, Lehtonen T, Kustow J, Müller-Sedgwick U, Hirvikoski T, Pironti V, Ginsberg Y, Félegyházy Z, Garcia-Portilla MP, Asherson P. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD.. European psychiatry : the journal of the Association of European Psychiatrists doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A difficulty that began on a particular day has a different cause from one that was always there.
There is no box you type 'always late' into and get the answer out of. When a sensible strategy is not landing, the work is finding out what is blocking it rather than producing another strategy.
Run the assessment yourself and watch while they work. Under real effort you will see the small movements, the tics and the overflow that never appear in ordinary conversation, and none of it reaches you if a technician or an app does the testing.
Run a short anxiety and depression screener alongside the ADHD measure at every intake, not only when someone mentions their mood.