Neuropsychological testing for ADHD in adults and children involves a comprehensive assessment approach we use to evaluate various cognitive functions and behaviors associated with the diagnosis. These test batteries add a layer to traditional psych testing, making the results more powerful and detailed. However, not everyone needs a neuropsychological evaluation for ADHD – it is more expensive and takes longer. If you are considering an assessment for yourself or your child, we wanted to provide this overview so you could be fully informed, including a neuropsychological testing for ADHD example at the end. Of course, you can contact us or schedule a consultation anytime if you have questions.
Neuropsychological Testing for ADHD Process
The process involved in neuropsychological testing for ADHD for adults and children follows our usual timeline and planning:
1. Clinical Interview and Background Information Gathering
Before conducting any neuropsychological testing for ADHD in adults or children, we conduct a thorough clinical interview with the client and their parents or guardians, if applicable. This interview helps us gather information about developmental history, academic performance, social behavior, family dynamics, and current attention, hyperactivity, and impulsivity symptoms. This way, at least initially, we can choose the best testing battery.
2. Behavioral Rating Scales
We will administer standardized rating scales to assess symptoms and related behaviors as an adjunct to the background information. These scales may be completed by the client, parents, teachers, or other relevant caregivers. Common rating scales include the Conners’ Rating Scale and the Vanderbilt Assessment Scale.
3. Actual Neuropsychological Testing for ADHD in Adults or Children
The next step is detailed further in the next section, but it involves choosing and administering the testing battery. Attention deficit hyperactivity disorder can be assessed remotely or in person. Your or your child’s testing battery will be uniquely chosen based on the first two steps.
4. Integration of Neuropsychological Testing for ADHD Findings
After administering and scoring the tests, we integrate the findings from the interview, rating scales, and test results to formulate a comprehensive understanding of the client’s strengths, weaknesses, and diagnostic status regarding the diagnosis. We look for opportunities for growth and ways to overcome barriers. We also might suggest certain accommodations for work or school.
5. Feedback Session
We always have a feedback session after you’ve been able to review our report. We provide feedback to the client and their family regarding the assessment results, diagnostic impressions, and recommendations for intervention and treatment. These recommendations may include behavioral strategies, educational accommodations, medication management, therapy, and other support services. For younger children, we may have two feedback sessions, one with the child present and one without.
Neuropsychological Tests For ADHD
The following are the types of tests and some examples we use in neuropsychological testing for ADHD.
Cognitive Neurological Tests for ADHD
Neuropsychological tests are administered to assess various cognitive functions that are often impaired in individuals with ADHD. These assessments 
may include:
- Continuous Performance Tests (CPT): CPTs assess sustained attention and impulsivity by presenting stimuli (e.g., letters, numbers) and requiring the individual to respond when specific criteria are met.
- Digit Span and Letter-Number Sequencing: These tests assess working memory, often impaired in individuals with ADHD.
- Trail Making Test: This test evaluates processing speed, visual-motor coordination, and cognitive flexibility.
- Stroop Test: The Stroop Test assesses response inhibition and cognitive flexibility by measuring the ability to suppress automatic responses.
- Wisconsin Card Sorting Test: This test assesses cognitive flexibility, problem-solving ability, and response inhibition.
- Executive Functioning Tasks: These tasks assess executive functions such as planning, organization, inhibition, and cognitive flexibility.
Academic Achievement Assessments
Assessments of academic skills (e.g., reading, writing, math) may be included to evaluate how symptoms impact academic performance. Here are some considerations regarding academic achievement assessments and ADHD:
- Behavioral Observations: We look beyond academic achievement that may be measured through a test score or a grade and ask for observations of the individual’s behavior during class. This can provide valuable insights into how symptoms may impact academic performance and may have affected their scores on academic achievement tests. Behaviors such as impulsivity, distractibility, difficulty sustaining attention, and hyperactivity may affect the individual’s ability to complete tasks effectively.
- Flexible Assessment Formats: We may look to see how academic achievement was affected by flexible assessment formats that accommodate different learning styles and preferences. For example, did you or your child do better when both written and verbal instructions were given or in classes allowing for oral and written responses?
- Attention to Motivation and Engagement: Individuals with ADHD may struggle with motivation and engagement, particularly in tasks that they find challenging or uninteresting. Assessments that incorporate elements of interest, relevance, and meaningfulness are more likely to capture the individual’s true abilities. We look at achievement scores with this in mind – how did you do in subjects that had really caught your attention vs. those that you were not as interested in?
As you can see, academic achievement testing as part of neurological testing for ADHD involves close collaboration with parents and teachers. This collaboration is essential in understanding the academic strengths and challenges of individuals with ADHD. Gathering information from multiple sources and considering the individual’s performance across different settings can provide a more holistic view of their academic achievement as part of neuropsychological testing for ADHD.
Behavioral Neuropsychological Tests for ADHD
When assessing ADHD (Attention-Deficit/Hyperactivity Disorder), it’s essential to consider emotional and behavioral aspects alongside the core symptoms of inattention, hyperactivity, and impulsivity. Emotional and behavioral assessments help paint a comprehensive picture of an individual’s functioning and can inform diagnosis, treatment planning, and intervention strategies. Here are some key components of emotional and behavioral assessments for ADHD:
- Behavioral Rating Scales: Standardized rating scales completed by parents, teachers, and/or the individual can assess emotional and behavioral symptoms associated with ADHD. These scales may include measures of emotional regulation, social skills, oppositional behavior, anxiety, depression, and other comorbid conditions commonly seen in individuals with ADHD.
- Self-Report Measures: For older children, adolescents, and adults with ADHD, self-report measures can capture their subjective experiences of emotional and behavioral symptoms. These measures can provide insights into areas such as emotional dysregulation, stress management, coping strategies, and self-perception.
- Direct Observation: Observing the individual’s behavior in various settings, such as home, school, or clinical settings, can offer valuable information about emotional and behavioral functioning. Observations may focus on aspects such as frustration tolerance, social interactions, impulse control, emotional outbursts, and task engagement.
Overall, conducting comprehensive and individualized assessments that take into account the unique characteristics of ADHD is crucial for accurately evaluating academic achievement and guiding intervention efforts to support the academic success of individuals with ADHD.
Other Aspects of Neuropsychological Testing for ADHD in Adults and Children
There are several other considerations when we provide neuropsychological testing for ADHD in adults or children, including:
Cultural Considerations in Neuropsychological Testing for ADHD
When conducting emotional and behavioral assessments, including neuropsychological testing for ADHD, it’s important to consider cultural factors that may influence the expression and perception of symptoms. Cultural competence and sensitivity ensure that assessments are conducted in a culturally appropriate manner, taking into account your cultural background, beliefs, and values.
“Rule Out” Assessments
In addition to ADHD symptoms, we also assess emotional and behavioral functioning, including mood disorders, anxiety, oppositional behavior, and overall social skills. Each of these challenges can occur along with ADHD, but they can also be misinterpreted as ADHD. It’s important to understand which of these possibilities may be at play.
Why Get a Neuropsychological Evaluation for ADHD
Getting a neuropsychological evaluation for ADHD is beneficial for several important reasons:
A Neuropsychological Evaluation for ADHD GIves an Accurate Diagnosis
Attention deficit hyperactivity disorder shares symptoms with other conditions such as anxiety, depression, learning disabilities, and autism spectrum disorders. A neuropsychological evaluation for ADHD helps in distinguishing these other conditions to ensure an accurate diagnosis.
A Neuropsychological Evaluation for ADHD Provides a Comprehensive Understanding
A neuropsychological evaluation for ADHD provides a detailed understanding of the individual’s cognitive, behavioral, and emotional profile, clearly showing whether attention deficit hyperactivity disorder is present. The evaluation identifies specific cognitive strengths and weaknesses, which can inform tailored interventions and support. It also assesses related areas such as executive functioning, memory, and processing speed, which are often affected in individuals with the diagnosis.
Individualized Treatment Planning
With a detailed profile, your healthcare providers can develop personalized intervention strategies, including behavioral therapy, educational support, and, if necessary, medication. The evaluation can provide evidence for accommodations in educational or work settings, such as extra time on tests or tasks, reduced homework load, or assistive technology.
Behavioral and Emotional Insights
A neuropsychological evaluation for ADHD offers insights into behavioral issues related to attention deficit hyperactivity disorder, such as impulsivity, hyperactivity, and difficulties with self-regulation. It helps you understand the emotional aspects of the diagnosis, such as frustration tolerance and self-esteem issues. It can also inform the development of coping strategies and skills training to help the individual manage symptoms more effectively. Individuals gain greater self-awareness and understanding of how attention deficit hyperactivity disorder affects their daily lives, which can be empowering and motivating.
Understanding the impact on personal relationships and daily functioning can help individuals develop strategies to improve their personal and professional lives.
Neuropsychological Testing for ADHD Provides Support for Families and Employers
Our psychological testing report provides families with guidance on how to support their loved one with attention deficit hyperactivity disorder, including strategies for managing behaviors at home and advocating for necessary resources. With children, parents and caregivers are better equipped to work with schools and other institutions to ensure the individual receives appropriate support and accommodations. For adults, the evaluation can support requests for accommodations in the workplace, such as flexible scheduling or a distraction-free environment.
Overall, a neuropsychological evaluation for ADHD is a comprehensive approach that provides detailed, individualized information, guiding effective treatment and support strategies. It ensures the individual’s unique needs are met, promoting better academic, professional, and personal outcomes.
Neuropsychological Testing for ADHD Example
Here is a fictitious neuropsychological testing for ADHD example to illustrate our process:
Neuropsychological Testing for ADHD Example: 28-Year-Old John
John is a 28-year-old graduate student referred for neuropsychological testing for ADHD in adults due to persistent difficulties with focus, time management, and completing tasks. He reports long-standing issues with attention and organization, which have become more noticeable during his demanding academic program. He also feels “mentally scattered” and struggles with deadlines, which impacts his academic performance and daily functioning.
1. Clinical Interview
Background Information:
- Developmental history: No significant delays; typical childhood milestones.
- School history: Described as “bright but distracted.” Teachers noted difficulty staying seated, frequent incomplete assignments, and daydreaming. John performed well in subjects he found interesting but struggled in those requiring sustained attention.
- Family history: John’s father has ADHD, diagnosed later in life.
- Work history: Consistent work record but struggles with task prioritization and meeting deadlines.
- Current symptoms: Procrastination, inability to focus during long lectures or work sessions, impulsive decision-making, and forgetfulness (e.g., misplacing items).
DSM-5 ADHD Symptoms Checklist:
John meets criteria for ADHD, predominantly inattentive presentation, including:
- Trouble organizing tasks and activities
- Easily distracted by unrelated thoughts or stimuli
- Frequent forgetfulness
- Difficulty sustaining attention in tasks or activities
2. Behavior Rating Scales
John and his partner completed standardized questionnaires:
- Adult ADHD Self-Report Scale (ASRS): High scores on inattention items, moderate scores for hyperactivity/impulsivity.
- Conners’ Adult ADHD Rating Scale (CAARS): Elevated T-scores on inattention, impulsivity, and executive functioning deficits.
- Partner report: Confirms difficulties with forgetfulness, organizing daily activities, and frequently “spacing out” during conversations.
3. Neuropsychological Testing for ADHD in Adults: Measures
a. Attention and Executive Functioning Tests:
- Continuous Performance Test (CPT):
- Results: John demonstrated slow response times and a high number of omissions (missed targets), consistent with sustained attention difficulties.
- Trail Making Test (TMT):
- Part A: Processing speed slightly below average.
- Part B: Deficits in cognitive flexibility and task-switching.
- Stroop Color-Word Test:
- Difficulty inhibiting automatic responses, indicating problems with impulse control.
b. Working Memory and Processing Speed:
- Wechsler Adult Intelligence Scale-IV (WAIS-IV):
- Working Memory Index (WMI): Low average range (scaled score: 88).
- Processing Speed Index (PSI): Average range (scaled score: 98).
- Verbal Comprehension and Perceptual Reasoning scores were in the high average range, indicating strong reasoning abilities but significant weaknesses in attention and speed.
c. Memory and Learning Tests:
- Digit Span Test: Difficulty with backward sequences, consistent with working memory challenges.
- California Verbal Learning Test (CVLT): Adequate verbal learning but poor attention to detail on recall tasks.
4. Emotional and Behavioral Screening
- Beck Depression Inventory-II (BDI-II): Mild depressive symptoms (score: 14).
- Beck Anxiety Inventory (BAI): Minimal anxiety (score: 7).
- Observations: John appeared distracted during tasks requiring sustained focus. He often needed instructions repeated and would lose track of test details.
5. Neuropsychological Testing for ADHD Example Summary
John’s neuropsychological testing revealed the following:
- Attention deficits: Significant difficulties with sustained attention, processing speed, and working memory.
- Executive functioning weaknesses: Trouble with task-switching, organization, and impulse control.
- Cognitive strengths: Excellent verbal and perceptual reasoning abilities (when he can focus and attend).
- Mood profile: Mild depressive symptoms, likely secondary to ADHD-related struggles.
Diagnosis:
- Attention-Deficit/Hyperactivity Disorder (ADHD), Predominantly Inattentive Presentation
6. Recommendations
Based on the results, the following accommodations and interventions were recommended:
Academic Accommodations:
- Extended time on exams and assignments
- Permission to record lectures to aid in note-taking
- Use of organizational tools (e.g., digital planners, reminders)
Therapeutic Recommendations:
- Referral for cognitive-behavioral therapy (CBT) to address executive functioning and time management skills
- Consideration for a medication evaluation with a psychiatrist
- Holistic approaches related to diet, self-help, and exercise
Workplace Support:
- Break tasks into smaller, manageable steps
- Use of timers or alarms for task-switching
- Regular check-ins with a supervisor for accountability
In this fictitious Neuropsychological testing for ADHD example, we also would have helped John see the advantages and benefits of having ADHD.
Neuropsychological Testing for ADHD Example Outcome
John reported significant improvement after receiving academic accommodations and starting medication. He also worked with a therapist to develop strategies for managing his time and attention, which led to better school performance and reduced stress.
Neuropsychological Testing for ADHD in Adults vs. Kids
Neuropsychological testing for ADHD in adults versus kids has similarities but also important differences in approach, emphasis, and interpretation. Here’s a breakdown of key distinctions:
1. Purpose of Testing
- Neuropsychological Testing for ADHD in Children:
The focus is on identifying ADHD symptoms that impact learning, behavior, and social functioning in school, home, and peer settings. Testing often helps rule out learning disabilities, developmental delays, or emotional challenges. - Neuropsychological Testing for ADHD in Adults:
The emphasis shifts to assessing how ADHD affects work performance, relationships, daily functioning, and executive skills (e.g., time management, organization, impulsivity). Adults often need formal diagnosis for workplace accommodations or treatment planning.
2. Tools and Tests Used
Neuropsychological testing for ADHD in adults and kids assesses cognitive domains like attention, memory, processing speed, and executive functioning.
- Common Tools for Both:
- Continuous Performance Tests (CPTs) like the TOVA or Conners CPT to measure attention and impulsivity.
- Rating scales: Parent/Teacher reports for kids; self-reports for adults (e.g., Barkley Adult ADHD Rating Scale).
- Cognitive testing: Parts of the WAIS or WISC for IQ and processing speed.
- Neuropsychological Testing for ADHD In Children :
- Emphasis on multi-informant reporting: Parents, teachers, and the child’s perspective are collected.
- Tests often include achievement tests to identify co-occurring learning disorders (e.g., dyslexia).
- Observations of behavior during testing are crucial.
- Neuropsychological Testing for ADHD in Adults:
- Self-reports carry more weight, and clinicians may look for retrospective evidence of ADHD symptoms in childhood.
- Adults undergo more extensive executive functioning assessments, such as planning, organization, and decision-making tasks.
- Co-existing mental health issues (e.g., anxiety, depression, substance use) are often screened because they can mimic or mask ADHD.
3. Presentation of Symptoms
- Children:
Symptoms often manifest in hyperactivity, impulsivity, and inattentiveness. Teachers and parents typically observe the child’s struggles in structured settings like classrooms. - Adults:
Hyperactivity may diminish or present as internal restlessness (e.g., feeling unable to relax). Adults often struggle more with time management, procrastination, emotional regulation, and organization.
4. Diagnosis Criteria
Both children and adults are diagnosed based on DSM-5 criteria, but:
- Children:
Symptoms must appear before age 12 and persist across at least two settings (e.g., home, school). Behavioral observations by adults are essential. - Adults:
Adults must show evidence of ADHD symptoms since childhood, though symptoms may evolve over time. Self-awareness and memory biases can affect reporting, so clinicians often gather collateral information from family members or school records.
5. Interpretation of Results
- Neuropsychological Testing for ADHD in Children
Results are compared to age-based norms. Any deficits can point to developmental lags or specific areas needing intervention (e.g., tutoring, behavioral therapy). - Neuropsychological Testing for ADHD in Adults:
Results are interpreted relative to adult norms, focusing on real-world implications like job performance, relationships, and independent living. Co-morbid conditions like anxiety or sleep disorders are more likely to cloud the diagnosis.
6. Accommodations and Recommendations
- Neuropsychological Testing for ADHD in Children:
Recommendations often include classroom ADHD accommodations (e.g., extended test time, preferential seating), behavioral interventions, and parent training. - Neuropsychological Testing for ADHD in Adults:
Recommendations may involve workplace accommodations (e.g., flexible deadlines, noise-canceling headphones), counseling, and strategies for managing executive dysfunction in daily life.
Summary and Our Services
Neuropsychological testing for ADHD in adults and children is an essential component of the diagnostic process for people who suspect they or their child has an attention deficit or have already been diagnosed but want to understand their diagnosis better. It provides valuable information for treatment planning and interventions tailored to your needs. It can also point out the benefits of ADHD and how to use them. We also provide related but more general neurodivergence testing and we have a specialty service for assessing ADHD symptoms in girls.
We would be happy to talk to you about what neuropsychological testing for ADHD might be like for you, including the answers it could bring and the limitations. Please get in touch with us or schedule a consultation anytime.
