ADHD Assessment: Finding the Right Professional for You

We know that there are many affordable options nowadays for getting assessed for ADHD, and that psychologists charge more. None of us can afford to waste money, and you may be asking yourself whether paying more for a psychologist to assess you is really worth it. While an assessment by a psychologist may not be needed by everyone, here are some disadvantages to getting assessed by someone who isn’t a psychologist:  

1. It could cost you more in the end  

“...most universities require documentation of how your disorder functionally impairs you...[s]o you’re likely to end up needing an in-depth assessment later on anyway.” 

Nurse practitioners are qualified to diagnose ADHD, and they do so quickly and inexpensively. Good! We need more clinicians to help people get access to support! However, the tools that most NPs use to diagnose may not open all the doors you need, including access to accommodation. NPs use screening questionnaires and conduct abbreviated interviews (less than 1.5 hours) to go through a symptom checklist. They confirm that symptoms were present when you were young and discuss how symptoms affect daily life. This is enough to make a diagnosis. However, most universities require documentation of how your disorder functionally impairs your learning. Reports from NPs don’t include this (they need to be short and sweet. Otherwise, they’d cost more). So, you’re likely to end up needing an in-depth assessment later on anyway.  

Comprehensive psychoeducational and ADHD-specific assessments involve hours of in-depth interviewing and the use of standardized tests that reveal strengths and weaknesses in attention, information processing and learning. Recommendations include specific accommodations that will best serve you. Additional hours (not to mention the costs of testing materials) mean additional cost – it is true that an in-depth assessment is an investment.  

2. It’ll leave questions unanswered 

“Symptoms of ADHD, trauma, anxiety, hormonal imbalance, burnout, concussions, among other things have considerable overlap... If you don’t know the why, you won’t know the how: How do I best manage –or resolve! – the underlying issue so that move forward in creating a personally meaningful life?” 

Receiving a diagnosis might bring some tangible benefits like getting access to psychostimulants or being eligible to apply for tax benefits. Again, good! But you might be left asking yourself, why do I have these challenges? Do I truly have a neurodevelopmental disorder that I will live with for my whole life? Or is this anxiety, complex and/or relational trauma, or the side effects of a learning disorder that I have learned to live with or compensate for? Going through a symptom checklist won’t answer these questions. Symptoms of ADHD, trauma, anxiety, hormonal imbalance, burnout, concussions, among other things have considerable overlap. If you don’t know the why, you won’t know the how: How do I best manage –or resolve! – the underlying issue so that I can move forward in creating a personally meaningful life? 

A comprehensive assessment with a qualified psychologist will help differentiate among possible underlying causes of your challenges and create a tailor-made roadmap for moving forward.  

3. Risks of both over-diagnosing and missing ADHD 

“I identify as neurotypical, but don’t give me an ADHD symptom checklist the week before Christmas while I’m studying for an exam and my baby is having a sleep regression. In terms of symptom severity, I’d put everyone to shame.” 

ADHD is real. People with ADHD know what it’s like to go through their whole lives having to work harder than their peers, unwittingly adopting self-perceptions that they’re not smart or capable (for example) and battling a kind of brain fog and exhaustion than only the most sleep-deprived among us can relate to. (ADHD can also be a boon in some ways; see ADHD is Awesome by Penn and Kim Holderness, for example.) It is a life-long difference in the way information is processed in the brain. However, when stressed, taxed with too many tabs open in the brain, exhausted, burnt out, etc., we ALL experience executive dysfunction. I identify as neurotypical, but don’t give me an ADHD symptom checklist the week before Christmas while I’m studying for an exam and my baby is having a sleep regression. In terms of symptom severity, I’d put everyone to shame. If we’re diagnosing based on a checklist, we risk over diagnosing and contributing to the growing public perception that ADHD is not real. This invalidates neurodivergent peoples’ experiences. Their life is challenging enough.  

On the other hand, there is an equal risk that more “complex cases” (i.e. ones where an individual meets the diagnostic criteria for multiple things) are dismissed as having ‘just anxiety’, for example. Most of us are complex. We know that ADHD very rarely presents without anxiety, commonly co-occurs with other things such as autism, PTSD, depression, substance use and disordered eating, and is commonly mistaken for symptoms of personality disorders. Generally, NPs don’t take complex cases because it’s tricky to parse it all out. An in-depth assessment means catching ADHD when it might be present along with other challenges. Here’s a key double negative: meeting diagnostic criteria for something else doesn’t mean you don’t have ADHD.  

You can have more confidence in your diagnosis when you do an assessment with a qualified psychologist.  

You can have more confidence in your diagnosis when you do an assessment with a qualified psychologist.  

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