What happens in an ADHD assessment?

The short answer

An ADHD assessment is a structured conversation with a specialist, backed by questionnaires and, at many services, an objective test. The clinician looks at your history from childhood to now, how much your difficulties affect daily life, and whether anything else could explain them. You then get a written report and a chance to talk it through. If ADHD is diagnosed, the next step may be medication, other support, or both.

At ADH-Me the process has five steps:

1. Free screeningA short questionnaire to help you decide whether a full assessment is appropriate. It is not a diagnosis.
2. Get in touch and bookWe reply to every enquiry personally and explain which package is most suitable.
3. AssessmentAn in-depth clinical interview, rating scales and QbCheck, in person or by video.
4. Report and feedbackA detailed written report following NICE guideline NG87, and a session to talk it through.
5. Medication and your GPIf medication is right for you, titration with regular reviews, then a letter to your GP about shared care.

Before the assessment

Screening. Most people start with a screening questionnaire. It asks how often you notice common ADHD traits, and it helps you and the clinician decide whether a full assessment is worth doing. ADH-Me has a free adult screening and a free child screening. Screening cannot diagnose or rule out ADHD on its own.

Forms and background. Services usually gather some information before the appointment, such as your health history and any medicines you take. When you book, ask what you will be asked to complete or send.

Someone who knew you as a child. ADHD symptoms begin in childhood, and the diagnostic criteria require several symptoms to be present before the age of 12. Many people are not diagnosed until adulthood. NICE guideline NG87 says an assessment should include a full developmental history and reports from people who see you in everyday life. So it can help to talk to a parent, older relative or sibling beforehand about what you were like at school and at home. Old school reports are useful if you still have them. For a child, the parent's account and how they manage at school are central.

During the assessment

The clinical interview. This is the central part of the assessment. With ADH-Me it is an in-depth interview with one of our ADHD nurse specialists and independent prescribers (RMN, INP), either by video or, subject to availability, in person. You can expect questions about:

• Your early years and school: concentration, behaviour, friendships and reports from teachers
• Life now: work or study, home, relationships, money and the day to day admin people with ADHD often find hard
• How long the difficulties have been there, and whether they show up in more than one part of life
• Your physical and mental health, sleep, and any family history of ADHD
• Your strengths, not only your difficulties

A good clinician also considers whether something else, or something alongside ADHD, better explains what you are experiencing. Read about adult ADHD symptoms or ADHD in children if you would like to know what the clinician looks for.

Rating scales. These are structured questionnaires that score ADHD traits in a consistent way. ADH-Me uses the ASRS for adults and Conners' Rating Scales for children and young people.

QbCheck. An online test you do at home on a computer with a webcam, in a quiet room, for about 20 minutes. It measures attention, impulsivity and activity, and compares your results with people of the same age and sex who do not have ADHD. It supports the diagnosis but never decides it alone. More in our guide to QbCheck.

For children. Parents are closely involved throughout. In South and West Wales, an ADHD specialist from our team can also visit your child's school and observe them in class, to see how they manage day to day, not only in an appointment. A school observation is £100.

After the assessment

The report. You receive a detailed written report following NICE guideline NG87. It sets out the outcome, the reasons for it and recommendations. A thorough report matters later, because it is what a GP or another prescriber will read.

The feedback session. A session to talk through the report, ask questions and understand what the outcome means for you.

A letter to your GP. ADH-Me reports and letters are written to support GP shared care, in case you go on to medication. Shared care is voluntary for GP practices, so read our guide to shared care in Wales before you book anywhere.

Medication and other support. If ADHD is diagnosed and medication is right for you, it is started at a low dose after health checks and adjusted at regular reviews. That is titration. Medication is not right for everyone, and we will discuss all your options with you, including support that does not involve medication. Our guide to ADHD medication in the UK explains the types and how prescribing works.

How to prepare

• Note real examples from work, study and home, especially ones that keep happening
• Talk to someone who knew you as a child, and find old school reports if you can
• List your current medicines and any health conditions
• For a video appointment and QbCheck, have a quiet room and a computer with a working webcam
• Write down your questions, including what happens with your GP afterwards

What it costs

A Comprehensive ADHD Assessment with ADH-Me is £895, including the interview, rating scales, QbCheck, the report and the feedback session. With medication titration it is £1,395. See what an assessment costs or every package and price. If you live in Wales, NHS Right to Choose is not an option for you; our guide to Right to Choose in Wales explains why and what your options are.