Does My Child Need an ADHD Evaluation?
ADHD Evaluation: A Comprehensive Guide for Parents in Austin, Texas
According to the Centers for Disease Control (CDC), the number of attention-deficit/hyperactivity disorder (ADHD) diagnoses in children have increased. Specifically, for children ages 3 to 17 in the United States, there were an additional 1 million diagnoses in 2022 compared to 2016. Some of these increases may be due to better awareness about ADHD and lower stigma. For example, ADHD has historically been underdiagnosed in females, and broader awareness can help reduce these disparities. Some aspects of modern life may also be influencing these trends. Research suggests that some screen use can be beneficial for children, especially exposure in conjunction with parents. However, research also suggests that early exposure to excessive screen use can lead to decreased executive functioning. Executive functioning includes skills used to self-regulate, and children with ADHD tend to struggle with executive functioning. Overall, ADHD can sometimes be complex to diagnose, which is where an evaluation can help. Below are some considerations for when to seek an ADHD evaluation and challenges with using other methods for diagnosis.
What is a ADHD?
There are three types of ADHD: the predominantly inattentive presentation (ADHD-PI), the predominantly hyperactive-impulsive presentation (ADHD-PHI), and the combined presentation (ADHD-C).
ADHD-PI involves symptoms such as having difficulty sustaining attention for nonpreferred tasks, making careless mistakes, not listening when someone is speaking to the person, struggling to follow through on instructions or complete tasks, difficulty with organization, losing belongings, and being forgetful.
ADHD-PHI involves symptoms such as frequent fidgeting, struggling to stay in the seat when expected to do so, running or climbing in inappropriate situations (or restlessness in adolescents), difficulty playing quietly, acting as if “driven by a motor,” excessive talking, blurting out answers before the question has been finished, difficulty waiting for their turn, and interrupting or intruding on others.
ADHD-C is diagnosed when someone meets criteria for both ADHD-PI and ADHD-PHI. In all three cases, a certain number of symptoms must be present, the symptoms must be occurring in more than one setting, the symptoms must have started before the age of 12, and there must be some form of impairment from the symptoms.
What can look like ADHD?
Complicating the picture further is that symptoms that could indicate that someone has ADHD could have other causes or more than one cause. For example, people experiencing anxiety can also get distracted by their worries or experience restlessness. They can also struggle to keep track of belongings, be forgetful, or not follow through on instructions because of distractions from worries or worries leading to their focus being too narrow. For example, if someone worries about making a mistake, they may spend too much time checking a response and run out of time to finish an assignment or miss an instruction. They may also engage in avoidance that appears similar to avoiding a task that requires sustained attention, but in this case, it is due to feeling overwhelmed at the thought of mistakes and avoiding the task as a result. Similarly, some depressive symptoms can mimic symptoms of ADHD. This includes psychomotor agitation that can appear similar to hyperactivity, difficulty concentrating, difficulty making decisions, and avoidance of various activities. Furthermore, someone can experience ADHD as well as anxiety and/or depression. In addition to mental health explanations, research has linked digital media use and short-form videos to difficulties with attention. Many children and adolescents use social media and watch short-form videos (e.g., TikTok videos, Instagram reels, and YouTube shorts), making it challenging to separate the impacts of these activities from possible ADHD symptoms.
Why diagnose ADHD through an evaluation?
Some providers diagnose ADHD based on a rating scale and/or a short interview about symptoms. Many of the rating scales used in these settings are highly face valid, which means that it is obvious what the question is asking. Face valid rating scales are easier to manipulate, both intentionally and unintentionally, so they can sometimes reflect what a person expects to be occurring as opposed to the actual symptoms that a person is experiencing. These rating scales my also not include validity scales to check for possible manipulation of the data, Additionally, short, informal evaluations like this often do not account for observations or check whether the symptoms are occurring in more than one setting. All in all, this makes it easier for an ADHD diagnosis to be applied incorrectly and less likely that other possible explanations for the symptoms will be examined. Additionally, populations that are most likely to be overlooked, such as females, are more at risk for their symptoms being missed than they would be in a thorough evaluation. Evaluations, on the other hand, collect rating scales from multiple reports, use more complex rating scales that are more difficult to manipulate (e.g., they contain validity scales and are less face valid), often use more than one rating scale to assess various facets of the concern, and are able to incorporate observations. Furthermore, when assessing for ADHD due to impact on learning, it is important to rule out a learning disorder, and this can only be done through the assessment process.
When is it time to seek an ADHD evaluation?
Given the cost and time commitment for an ADHD assessment, it can be difficult to know when it is time to move forward. Some families may simply want to know so that they can appropriately support their child, which is always a sufficient reason to seek more information. But for other families, the barriers may be too high for this to be enough of a motivator. Below are several other indicators that may suggest the necessity of an evaluation. Of note, a common misconception is that receiving a diagnosis means a child must be given medication for ADHD. This is not the case, as there are other options to support children with ADHD, and whether to medicate a child is always a decision to be made between the child’s parents and physician.
Functional impairment or not meeting full potential
When the possible ADHD symptoms are affecting a child’s functioning, this is sign that more information may be needed to support the child. For example, if children appear to be falling behind their peers, or when their performance in school does not reflect their apparent potential, ADHD could be the explanation. Functional impairment could also involve social impairment or impairment in the home. For example, as children with ADHD may struggle to attend to social signals or interrupt their peers, this can lead to difficulty learning social skills or reduce opportunities to build friendships. In the home, parents may become frustrated with their children not following through on tasks or with children who seem to not listen when a parent is speaking, all of which can harm the parent-child relationship. Getting children to complete a task, such as a chore or homework assignment, may lead to arguments. In these situations, it is important to understand the source of the impairment so that this can be addressed and children can thrive across settings.
Effects on self-esteem, becoming discouraged, or high levels of distress
Children with undiagnosed ADHD experience frequent behavioral corrections or attention for unwanted behavior, which can lead to lower self-esteem and even other mental health conditions, such as anxiety and depression. While diagnosing ADHD does not solve a child’s problems, it can be used as a framework to shape the child’s environment around their needs. Parents and teachers can work on catching children being good and making sure their positive feedback outweighs constructive criticism. A differential diagnosis is also particularly important for these types of challenges, as anxiety or depression alone can have a similar impact.
About the Author
Dr. Rebecca Suffness is a licensed psychologist who specializes in the assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) across the lifespan. Her work focuses on comprehensive, evidence-based evaluations that clarify diagnosis, differentiate ADHD from overlapping conditions, and translate findings into practical, individualized recommendations. Dr. Suffness has extensive experience conducting diagnostic interviews, comprehensive testing, and collateral-informed assessments to support accurate diagnosis and effective treatment planning. She is committed to providing clear, thorough evaluations that help clients, families, and providers make informed decisions about care, accommodations, and next steps.
Scheduling an ADHD Evaluation at Austin Anxiety and OCD Specialists
If you are considering ADHD testing for yourself or your child, scheduling an evaluation at Austin Anxiety and OCD Specialists is a structured first step toward clarity. Our ADHD assessments are comprehensive and developmentally informed, designed to distinguish ADHD from anxiety, depression, learning differences, and other factors that can affect attention, behavior, and executive functioning. The process typically includes a detailed clinical interview, standardized rating scales from multiple informants (such as parents and teachers), and, when appropriate, cognitive and academic measures. Families receive a clear diagnostic explanation and practical, individualized recommendations to guide next steps, which may include school accommodations, behavioral supports, therapy, or coordination with a psychiatrist. Appointments for ADHD assessment can be scheduled by contacting our office to discuss your concerns and determine whether a full evaluation is the right fit for your child at this time.