Specialized Tests and Tools
Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.Specialized tests and tools that help to identify and diagnose adult ADHD
In the previous sections, we discussed the various diagnostic challenges that face a clinician when evaluating an adult for ADHD. Fortunately, there are several specialized tests and tools that aid the evaluation process.
To guide the interview and assessment process, the clinician may use a variety of written questionnaires, checklists, and interview protocols. As you may recall, although an adult may receive a diagnosis of ADHD, there must be evidence of childhood symptoms before the age of 12. Therefore, these tools provide a standardized set of questions that serve to structure the memory recall process about childhood symptoms.
Some of these tools are quick and efficient screening tools. Screening tools are brief tests used to rapidly identify someone who might have ADHD. This helps clinicians decide whether to proceed with a more costly and thorough evaluation. The results from these test and tools are alone insufficient for a definitive diagnosis. However, the information gathered from these tools can be extremely helpful in the evaluation process. Now we will review some of these tools:
Adult ADHD Self-Report Scale Symptom Checklist (ASRS)
The ASRS Symptom Checklist is a screening tool. It helps doctors and their patients decide if a more comprehensive ADHD evaluation is warranted. It evaluates 18 symptom criteria. Six of the questions have been identified as the most predictive symptoms of ADHD.
Barkley Adult ADHD Rating Scale - IV
This is another quick screening tool used by physicians and mental health professionals alike to identify adults who may need further evaluation for ADHD. The rating scale takes 5-7 minutes to complete and the Quick Screen tool takes 3-5 minutes. The scale consists of questions about both current and past symptoms. It uses a scoring system from Never (0) to Very Often (3). Research indicates that a high score suggests a strong likelihood of ADHD.
Brown ADD Scales (Adult)
This 40-item, self-report measure is a quick way to screen for adult ADD. This scale uses the term ADD to reflect the fact that it does not examine hyperactivity/impulsivity symptoms. Instead, it focuses more on evaluating inattention and executive skills. It also helps to identify which executive function skills might be impaired LINK TO EXECUTIVE FUNCTION. This evaluation tool focuses on six key skill areas: 1) sustained attention; 2) sustained effort for task completion; 3) activation of organizational skills needed to complete tasks; 4) recollection of learned material; 5) utilization of short-term memory; and, 6) mood regulation. These executive functioning skills are often poorly developed in people with ADD. This evaluation can be completed with paper and pencil, or with digital software. The digital software version includes comparison with age-based normative data. Significant deviation from what is average for a person's age would suggest a problematic skill area.
Connors' Adult ADHD Rating Scales (CARRS)
These scales can be used to assess inattention, hyperactive-impulsive behaviors, and overall ADHD symptoms in adults over 18 years of age. CAARS provides a self-assessment form for the patient. It also includes forms to be completed by people who might have useful information about the patient (e.g., family members). Thus, CARRS collects data from more than one source. Both versions contain 66 items, including nine subscales. The results can also help to determine which respondents might benefit from a more thorough evaluation.
Copeland Symptom Checklist for Attention Deficit Disorders - Adult Version
This checklist is designed for adults (18 and older). Like the children's version, the Copeland Symptom Checklist (adult version) assesses the severity of symptoms in eight areas. These are: 1) emotional difficulties; 2) peer relations; 3) family relationships; 4) attention skills; 5) impulsivity; 6) activity level; 7) organization or learning problems; and, 8) degree of compliance.
Wender Utah Rating Scale (WURS)
The Wender Utah Rating Scale assesses ADHD-relevant childhood behaviors and symptoms in adults. It was designed to aid in retrospective identification of childhood ADHD in adults. The most recent version consists of 25 items. The WURS does more than simply identify people with ADHD. It also helps to differentiate between persons with ADHD versus people with Major Depression. The symptoms of these two diagnoses overlap so this differentiation is very helpful. Moreover, it helps to identify people who may respond well to an ADHD treatment with a drug called Ritalin ® versus those who may not. LINK
Once an initial assessment of developmental history has been completed (via interviews, questionnaires, and checklists) additional tests may be needed. The initial assessment phase will often raise questions about alternative diagnoses that might better account for the symptoms. Before ADHD diagnosis can be made, these alternative diagnoses must first be considered and then ruled out:
- A medical exam may be needed to rule out physical or psychological causes that could better account for the symptoms. Examples include hyperthyroidism, hearing loss, bipolar disorder, substance abuse, depression, and anxiety.
- Brain scans or brain imaging techniques (e.g., EEG, CT, or MRI) may be ordered to rule out brain abnormalities (that are inconsistent with ADHD), or brain trauma.
- Psychological and education testing (e.g., IQ tests and/or achievement tests) may be necessary to identify additional problems such as learning disability, intellectual disability, or other mental limitations.
Intelligence and Memory Testing
Intelligence and Memory testing are important parts of an ADHD evaluation. Although a diagnosis of ADHD can be made simply based on checklists and history, a more thorough assessment is performed to more clearly identify individual cognitive strengths and weaknesses. This detailed assessment further aids the development of a customized treatment plan.
Wechsler Adult Intelligence Scale (WAIS)
Intelligence tests measure peoples' mental abilities across many different areas. The WAIS is the most commonly used intelligence test for adults. The WAIS evaluates two primary areas of mental abilities: 1) Verbal Skills and, 2) Performance Skills. The verbal and performance skills sections each have several subtests. When the subtests scores are combined in each area, they form a single verbal score and a single performance score. When the verbal score and the performance scores are added together, you get a single number referred to as Intelligence Quotient or IQ for short. The average IQ score is 100.
The subtests scores help the clinician to identify patterns of relative strengths and weaknesses. Everyone excels in some areas, and not-so-well in others. This is very normal. However, a person's subtest pattern can be compared to the typical subtest scoring pattern of individuals with ADHD. For instance, we would expect to find that people with ADHD would have relative strengths in subtests that do not require concentrated effort; e.g., general information and vocabulary. Likewise, we would expect to find weaknesses in subtests that require sustained focus and concentration; e.g., mathematical computation and pattern recognition. The research supports these common-sense expectations. In fact, there is enough consistency among people with ADHD that these subtest patterns can be very helpful in the diagnostic process.
You will also recall that ADHD is characterized by a lack of achievement. The intelligence test also offers the clinician the opportunity to compare someone's mental abilities with their actual school or work performance. This comparison enables clinicians to detect if someone is underachieving, relative to their abilities. Of course, there can be many reasons for underachievement but it adds another clue to the diagnostic puzzle.
Wechsler Memory Scale, Third Edition (WMS-III)
The WMS-III is a battery of adult memory tests for ages 16 to 89 years. The test consists of 11 subtests (6 primary and 5 optional subtests). The primary subtests assess logical memory (memory for stories), verbal paired associates (memory for word pairs), letter-number sequencing, and various tasks related to visual memory. The optional subtests assess information and orientation; memory for lists of words and numbers; and other related memory tasks.
Resources
-
Articles
-
Childhood ADHD Overview
- Introduction to Attention Deficit Hyperactivity Disorder (ADHD)
- Signs & Symptoms of ADHD
- ADHD Signs and Symptoms: Attention Difficulties
- ADHD Signs and Symptoms: Hyperactivity
- ADHD Signs and Symptoms: Impulsivity
- Are There Different Types of ADHD?
- The Social, Educational, Financial & Occupational Impact of ADHD
- What are the Legal Rights of Caregivers and Their Children with ADHD (USA)?
- A Positive Spin: Is There Anything Good about ADHD?
- Signs of ADHD in Children at Home
- Signs of ADHD in Children at School
- Signs of ADHD in Children in Peer Relationships
- How Do I know if My Child Needs an ADHD Evaluation?
- What Should I Do If I Think My Child Might Have ADHD?
-
ADHD Discoveries and Controversies
- ADHD: New and Exciting Brain Research
- ADHD: New and Exciting Brain Research - Part II
- Neurotransmitter Changes with ADHD
- Executive Functions
- Neurodiversity: Is ADHD a True Mental Disorder?
- ADHD Statistics
- Cultural and Gender Differences in Prevalence Rates
- Should Children with ADHD Be Medicated?
- New and Promising Areas of Research
- Causes of ADHD in Children
- ADHD or Another Condition?
-
Diagnosis of ADHD in Children
- Who Can Diagnose ADHD?
- How Does ADHD Multi-Source Assessment Work?
- Assessment Instruments: Behavioral Checklists
- Assessment Instruments: Intelligence Tests
- Assessment Instruments: Achievement Tests (or Academic Tests)
- Assessment Instruments: Tests of Attention
- Assessment Instruments: Memory and Other Common Tests
- Step 2: Clinical Interviews
- Step 3: Physical Exam and Medical History
-
ADHD Treatment in Children
- Multimodal ADHD Treatment Approach
- ADHD Medications
- Treating ADHD with Stimulant Drugs
- Commonly Prescribed ADHD Stimulant Medications
- Treating ADHD with Non-Stimulant Drugs
- Risks of ADHD Medication
- Risks of ADHD Medications - Part II
- Benefits of ADHD Medication
- Side Effects of ADHD Medications
- Medication Decisions and Medication Management
- How Long Should ADHD Medication Treatment Last
- Psycho-Education about ADHD and Its Management
- Family Therapy
- Individual and Cognitive Behavioral Psychotherapy for the Child with ADHD
- Skills Training
- Social Skills Training and Coaching
- Supports
- Alternative ADHD treatment: What Does NOT Work?
-
Family and Personal Supports
- Effective Disciplinary Techniques
- Learn about Resources and Be Proactive
- Manage Stress, Self-Regulation & Provide Order
- Develop Routines, Organization and Expectations
- Communicate and Collaborate with Schools
- Express Confidence in Your Child's Abilities
- Help Children Improve Social Skills and Peer Relationships
- Avoid Homework Battles and Monitor Medication
- I Think I have ADHD. What should I do?
- I Think I Have ADHD - Part II
- Famous People with ADHD
- Adult ADHD Overview
-
Diagnosis of Adult ADHD
- How is Adult ADHD Diagnosed?
- Diagnostic Challenge 1: Looking into the Past
- Diagnostic Challenge 2: ADHD versus Similar Disorders
- Diagnostic Challenge 2 - Part II
- Diagnostic Challenge 3: ADHD Symptoms
- Diagnostic Challenge 3 - Part II
- Diagnostic Challenge 4: A Concealed Disorder
- Specialized Tests and Tools
-
Adult ADHD Treatment
- ADHD Medication Treatment
- Stimulant and Non-Stimulant Drugs for Adult ADHD
- Medication Timing, Dosage, Monitoring, and Duration of Treatment
- Weighing the Risks and Benefits of Adult ADHD Medications
- Psychotherapy for ADHD
- Coaching/Supported Employment for Adult ADHD
- Social Skills Training for Adult ADHD
- Psycho-Education and Cognitive Behavioral Therapy (CBT)
- ADHD Resources and References
-
Childhood ADHD Overview
-
Questions and Answers
- Does This Sound Like Bipolar?
- Do I Have Adult ADD?
- Why do I See Words and Numbers in my Mind...
- ADD Maybe?
- How do I Get Medical Treatment for my Medicine Refill Without Insurance?
- Is There Something Wrong With Me?
- I Can't function Normally Anymore, Can More Diagnoses issues Risk Survival?
- Bipolar Teen Son, ........
- Is My Daughter ADD?
- ODD and Risperdal
-
34 more
- If There's Nothing New, There's Nothing Good.
- Mystery Symptoms
- Bipolar Disorder and ADHD
- How To Help My Son
- Anger
- Depression in College Seniors
- Odd Eating Behavior
- 5 Year Old Behavior-Is it ADHD or Bipolar or Both?
- odd (ADHD)
- Attention Deficit and Depression
- What Should I do? Noah
- 16 year old girl with Attention Deficit Disorder
- Thoughts
- Diagnosed ADHD at 13, now being told I have bipolar disorder
- ADHD in Twins
- Inherited ADHD
- How to get off Focalin
- new diagnosis
- am i off my head i feel i have no feelings and want to harm ppl
- 17 yr old refuses help with bi-polar disorder
- Is Depression a Factor in Children With ADD?
- IS ADHD CAUSING HIM TO FAIL?
- heightened sexual behavior in my 8 yr. old with adhd
- seperation anxiety disorder or environment?
- my 7 year old nephew
- my daughter
- Do I have adult ADD?
- Fantasy land for attention
- 13 Yearl Old
- ADD
- Misdiagnosed and Lied To
- Funding Treatment (Without Insurance)
- Can ADHD Turn Into Bipolar?
- How Long To Diagnose ADHD?
-
Tests
-
Book & Media Reviews
- 10 Simple Solutions to Adult ADD
- A Walk in the Rain With a Brain
- ADD-Friendly Ways to Organize Your Life
- ADHD & Me
- ADHD Grown Up
- ADHD in Adults
- ADHD Nation
- Attention Deficit Disorder
- Attention-Deficit/Hyperactivity Disorder
- Buzz
-
29 more
- Driven to Distraction
- Facts About ADHD Children
- Healing ADD
- Helping Hyperactive Kids
- I Am Not Joey Pigza
- Joey Pigza Loses Control
- Joey Pigza Swallowed the Key
- Learning Outside the Lines
- Making ADD Work
- Medicating Children
- Mind Fields
- New Look at ADHD: Inhibition, Time, and Self-Control
- Non-Drug Treatments for ADHD
- Overcoming ADHD
- Parenting Children With ADHD
- Reclaiming Our Children
- Rethinking ADHD
- Ritalin is Not the Answer Action Guide
- Ritalin Nation
- Running on Ritalin
- Should I Medicate My Child?
- Taking Charge of ADHD, Revised Edition
- The Explosive Child
- The Gift of Adult ADD
- The Little Monster
- The Science of ADHD
- Thumbsucker
- Treating ADHD and Comorbid Disorders
- What Would Joey Do?
-
Links
-
Videos
- How to Select the Best School Accommodations for Your Child with ADHD
- How to Manage ADHD and Anxiety
- What You Need to Know about Students with ADHD and Anxiety
- ADHD and Eating Right
- Tourette Syndrome and ADHD
- Homework, Organization, and Time Management Strategies to Help Kids with ADHD
- Nutrition in Support of ADHD Treatment
- Behavioral Therapy: What it is and finding a therapist
- Project-Based Learning and ADHD
- Conditions May Mimic ADHD
-
102 more
- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part I
- Treating ADHD in the African American Community
- How to Build Self-Motivation in Teens with ADHD
- Goal Setting and Keeping for the ADHD Brain
- Neurofeedback Treatment for ADHD
- ADHD in Preschoolers: What to Look For and How to Help
- FYI on ADHD Evaluations
- Teaching Grit, Perseverance and Frustration Tolerance to Students with ADHD
- Does my Child Have ADHD?
- How to Start Eating Well When You Have ADHD
- 5 Solutions for Common ADHD Social Struggles
- Is My High School Student Ready for College? (And Is My College Student Ready to Go Back?)
- Understanding and Applying the Science of Time Management
- ADHD Medication and College Students: Prevent Misuse, Abuse, and Diversion
- Improve Homework Time with Strategies That Work For ADHD
- Student Voices: What Really Matters to Young Adults With Learning and Attention Issues
- 5 Ways Nutrition can Impact ADHD Symptoms
- 3 Tips for Adjusting to a New Diagnosis of ADHD
- Creating the Best Learning Environment for Students with ADHD
- ADHD & Executive Functioning
- Department of Education Guidance Broadens Understanding of 504 Rights for Kids with ADHD Part II
- Ask The Expert: Neurofeedback Treatment for ADHD
- ADHD and Suicide Risk Factors
- The Choice is in the Details: Medication Options for ADHD
- Understanding and Supporting Young Adults with ADHD
- Helping Your Young Adult Become Independent
- Creating Structure and Routines for Children with ADHD
- When You and Your Child Have ADHD - Communication Skills to Resolve Conflict
- Guidance for Uncertain Times: Navigating Relationship Challenges
- Guidance for Uncertain Times: Mindful Parenting
- Couples with ADHD: Creating Caring Connection amid the Chaos
- Disclosure and Workplace Accommodations for Individuals With ADHD
- A Summer At Camp
- Self-Advocacy Tips For Teens With ADHD
- ADHD and Curbing Impulsive Spending to Help Your Relationship
- ADHD: Signs, Symptoms, Research
- ADHD & Risk of Adult Drug Use
- Health and Life Expectancy in ADHD
- Focus on ADHD
- Pediatrics: ADHD and Food Allergies
- ADHD: It's a Family Affair
- Does Your Child Have ADHD?
- ADHD in Children
- Living with ADHD
- Rise in ADHD Cases in Children
- Why is Dating Difficult When You Have ADHD
- Video Games, Screens, and ADHD A Potent Mix
- Ask the Expert Helping Children with ADHD LD Conquer Chronic Stress
- Ask the Expert: Mindfulness, Stress, & Emotion
- Attention Deficit Hyperactivity Disorder
- Ask the Expert Educator Edition: ADHD & Executive Functioning
- Ask the Expert - Academic Evaluations - What Parents Need to Know
- ADHD and Sibling Relationships
- Medication Treatment for ADHD
- Using Time Out
- Treating Childhood ADHD
- ADHD-friendly Summer Family FUNdamentals
- Preparing Older Teens for the Road Ahead
- Tips for Teachers: Tailoring homework to make a difference
- Your Active Preschooler: Could it be ADHD?
- Tips for Teachers: Creating a positive dialogue with parents of students with ADHD
- Helping Parents & Kids Understand the Social & Emotional Aspects of ADHD
- Social and Emotional Concerns of Children with ADHD: Strategies to Help
- Holiday Gifts for Children with ADHD
- Behavior Management and Combined Treatment for Children with ADHD
- Setting Realistic School Expectations for Students with ADHD
- On Their Own: Helping College Students with ADHD
- Children's Communication Challenges: Is it Attention, Language or Both?
- Out-of-School: Parenting During the Summer
- ADHD in the Workplace: Finding Success
- Emotions and Motivation in ADHD
- The Role of Medication in Managing Children's ADHD Symptoms
- Top Tips for Combating Stigma and Addressing Myths about ADHD
- Facts and Myths about ADHD
- What To Do If Your Child Has ADHD?
- How Common is ADHD?
- Children, Meds, and Heart Safety: A Tale of ADHD and Public Health
- ADHD & Your Child’s Transition to College
- Your Teen with ADHD: Challenges and Strategies for Success
- Ask the Expert - No more homework battles
- A Frontline to ADHD
- Understanding Girls with ADHD
- What is ADHD?
- What To Do When Your Child With ADHD is Bullied
- Stop the Chaos! Tips for Creating a Peaceful Household When Mom has ADHD
- Is It ADHD?
- Ask the Expert - What else can I do? Complementary approaches to ADHD treatment
- All in a row: Getting your kids with ADHD organized
- Your Student With ADHD Was Admitted to College, Now what?
- Evidence-based treatment for ADHD in young children
- Home life when Mom or Dad has ADHD: Succeeding with your family
- How does technology affect ADHD?
- Diagnosing ADHD
- Helping Your Child Successfully Handle Change
- Recognizing challenging behaviors in young children: Could it be ADHD?
- Classroom Managment Supports for ADHD Behaviors in Preschool Settings
- Getting through to your teenager with ADHD
- What Everyone Should Know about ADHD
- Make Learning Exciting: Apps for Executive Functioning
- Teenagers, ADHD, and Substance Abuse
- Past Procrastination -- Get Your Kids Organized, Focused and Motivated
- Ask the Expert: Late, Lost, and Unprepared: How to Help Your Child with Executive Functioning
-
More Information
Topics
-
Related Topic Centers
-
Addictions
-
Aging & Elder Care
-
Assessments & Interventions
-
Career & Workplace
-
Emotional Well-Being
-
Life Issues
-
Parenting & Child Care
-
Abuse
-
ADHD: Attention Deficit Hyperactivity Disorder
-
Adoption
-
Autism
-
Child & Adolescent Development: Overview
-
Child & Adolescent Development: Puberty
-
Child Development & Parenting: Early (3-7)
-
Child Development & Parenting: Infants (0-2)
-
Child Development & Parenting: Middle (8-11)
-
Child Development & Parenting:Adolescence (12-24)
-
Child Development Theory: Adolescence (12-24)
-
Child Development Theory: Middle Childhood (8-11)
-
Childhood Mental Disorders and Illnesses
-
Childhood Special Education
-
Divorce
-
Family & Relationship Issues
-
Intellectual Disabilities
-
Learning Disorders
-
Oppositional Defiant Disorder
-
Parenting
-
Self Esteem
-
-
Psychological Disorders
-
Anxiety Disorders
-
Bipolar Disorder
-
Conversion Disorders
-
Depression: Depression & Related Conditions
-
Dissociative Disorders
-
Domestic Violence and Rape
-
Eating Disorders
-
Impulse Control Disorders
-
Intellectual Disabilities
-
Mental Disorders
-
Obsessive-Compulsive Spectrum Disorders
-
Personality Disorders
-
Post-Traumatic Stress Disorder
-
Schizophrenia
-
Sexual Disorders
-
Somatic Symptom and Related Disorders
-
Suicide
-
Tourettes and other Tic Disorders
-