Adult ADHD Testing, Part 2: When to Seek Psychological Testing for Adult ADHD & What to Expect

In the first post of this series, I shared some common symptoms of adult ADHD. Some symptoms (like restlessness) can look the same in adults and kids. However, some symptoms (like difficulty prioritizing tasks) can be difficult to spot in adults. Unfortunately, I’ve heard adults blame themselves, and call themselves “lazy,” “thoughtless” or other harsh labels, when they are really suffering from undiagnosed ADHD.

If you read the first part of this series and noticed some of those symptoms in yourself (or perhaps a partner), you may wonder whether you have ADHD. There are many people who have “self-diagnosed” ADHD and other mental health disorders, but there are benefits to being assessed and diagnosed by a psychological evaluator.

SIGNS YOU MAY WANT TO SEEK AN ADULT ADHD EVALUATION

If you suspect ADHD and have never been assessed or diagnosed, it is worth considering when:

• You notice lifelong “personal traits” that sound like adult ADHD symptoms. For example, being a daydreamer, being called “flaky,” and others. Check out part 1 for more examples.

• These symptoms interfere with your personal relationships--with your partner, family, friends, or colleagues

• ADHD-like symptoms interfere with your work, or lead to difficulty holding a job. This can look like being chronically behind on deadlines, always late to work, or taking on too much and not being able to follow through.

• The symptoms cause problems with your education. You might find yourself unable to focus during tests. Or you find it impossible to self-start for online classes that are mostly independent work.

• You find yourself often having to apologize to others for “dropping the ball” in some way – losing an important document, forgetting to pick up a child from practice, missing a deadline, or not hearing what someone says because you got distracted. Feeling like you are constantly letting others down unintentionally can be a sign of ADHD

• These problems have been part of your life for a long time, even dating back to childhood. For example, you might have always been in trouble for talking out of turn, getting out of your seat, distracting others, or daydreaming.

• You drink a lot of caffeine or use other substances to help manage your ADHD symptoms.

WHAT TO EXPECT FROM Adult ADHD Testing

If you have recognized some untreated symptoms in yourself, and want to move forward with psychological testing for ADHD in Los Angeles, there are a few things to know.

Getting Adult ADHD Testing is Important for accommodations

Adult ADHD testing can be done by a psychologist or neuropsychologist who is trained in evaluating ADHD. An ADHD diagnosis can be made by any psychologist or psychiatrist licensed to diagnose, but without an adult ADHD assessment, you won’t have insight into your brain strengths and vulnerabilities or learning style. A diagnosis without assessment also won’t help you get accommodations in school or the workplace. Disability and resource offices want to see a psychological report to support accommodations. These are the same reasons I recommend against “self-diagnosis,” in addition to the fact that it may not be accurate.

Looking at the big picture not just ADHD

Sometimes I get requests to “just test for ADHD,” but this is not good practice for a few reasons. Adult ADHD testing performed by a trained psychological evaluator will look at many areas of brain function, not just attention. This is because we need to rule out other explanations for your symptoms, and also, because ADHD often occurs along with other learning or mood problems. It’s important to get the full picture. This way, we don’t miss anything important, and you get the best treatment.

Be Prepared for the Day of Testing

Expect that you will have a long day of paper-and-pencil or computer/tablet adult ADHD testing. Come prepared with a good night’s rest, breakfast beforehand, snacks, water, glasses, hearing aids, and anything else you need to focus and do your best on testing.

Waiting for results from the adult ADHD testing

After testing, it can take a few weeks for your psychologist to write a report. In a feedback session, your doctor will explain the results, as well as explain a diagnosis (if you have one), and any recommendations. These recommendations can improve your quality of life, and might include anything from strategies for managing forgetfulness, to support in college, like extra time for tests. These recommendations are personal and should be taken seriously as they can truly make a difference.

Keep Ahold of the Report

You should keep that report; you may need it in the future. For example, if you ask for disability accommodations at work or school, or if you have neuropsychological testing in the future and want a baseline to look back at. Keep it safe, make copies, or save it digitally, and don’t give your only copy to HR or the disability office at school!

Get Adult ADHD Testing in Los Angeles, CA

Psychological testing for ADHD is a great way to test your cognitive functioning and identify any potential issues with attention, impulsivity, and hyperactivity. With proper diagnosis and treatment, individuals with ADHD can improve their quality of life and better manage their symptoms. If you're located in Los Angeles, CA, don't wait any longer to schedule an appointment with a qualified neuropsychologist. Take the first step towards getting the support and resources you need to thrive.

1. Reach out for a free consultation.

2. Schedule your adult ADHD testing with Dr. Reger.

3. Start your journey towards improved mental health, accommodations, and resources.

Other Testing & Mental Health Services Offered in Los Angeles, CA

Dr. Reger offers several types of neuropsychological assessments at her Redondo Beach practice and in many locations around Southern California. That is in addition to psychological evaluations for workers’ comp and preoperative assessments. Additionally, as a Psychologist in Los Angeles, she offers counseling for older adults.

Adult ADHD Assessments, Part 1: What is Adult ADHD?

Because it is neurodevelopmental (meaning it usually begins at a young age), Attention Deficit/Hyperactivity Disorder (ADHD) is a diagnosis often associated with children. We tend to think of a child with difficulty quietly paying attention in class. But ADHD is a lifelong neurodevelopmental disorder that can affect people of any age, and across the lifespan. In fact, there are many adults and older adults struggling with symptoms that have impacted them since childhood and have no idea that what they’re dealing with may be ADHD. It is only recently that it has become common for children to be assessed for ADHD if they show symptoms, so there are still many adults unknowingly dealing with the confusing and frustrating symptoms of ADHD.

In this three part blog series, I will share insights about adult ADHD. We’ll start with understanding ADHD in adults, then talk about what to expect from adult ADHD assessments, and then what to do after a diagnosis of ADHD in adulthood.

WHAT ADULT ADHD LOOKS LIKE

It’s estimated that 4.4% of adults in the US have ADHD. When ADHD is not treated, it can lead to other problems, like depression and anxiety. Here are some adult ADHD symptoms to look out for:

• Lack of attention to detail

• Difficulty following through on tasks

• Difficulty prioritizing

• Frequently losing things

• Difficulty organizing

• Forgetfulness

• Restlessness

• Frequent lateness/problems with time management

• Problems listening

• Procrastination

• Interrupting/Impulsive talking

• Difficulty engaging in rest or quiet activities

• Being high energy/always on the go

If you struggle with several of these symptoms, you might be facing adult ADHD. Often, adults with ADHD find ways to compensate for their symptoms, or even use these attributes to their advantage. For example, if you are always on the go and restless, this can mean you multitask and get a lot done. But, it can also mean you miss details, leave things partially finished, or forget to close the loop on the things you do. If you suspect you may have undiagnosed ADHD, it is never too late to seek out adult ADHD assessments.

FACTORS THAT WORSEN ADHD SYMPTOMS IN ADULTS

ADHD symptoms may be better or worse depending on a lot of life factors. For example, many women who have ADHD notice that their ADHD symptoms get much worse when they go through menopause. This is because hormones impact the function of brain areas important in attention and self-regulation. Here are a few other risk factors for adults with ADHD:

• Stress

• Malnutrition/poor diet

• Overstimulation

• Environmental distractions (sounds, temperature, visual distractions)

• Fatigue or sleep deprivation

• Lack of interest

You might have noticed from this list that ADHD symptoms tend to worsen when people are not practicing good self-care (e.g., sleep hygiene, balanced eating, creating a calm environment). ADHD is also worse when you have to work on tasks that you don’t enjoy, or don’t naturally interest you. Ironically, people with ADHD can often hyperfocus on tasks or activities they really enjoy. This can be very effective at times, but a lot of life tasks involve both fun and not-so-fun parts, so ADHD can interfere with getting the whole task done. For example, you may love to cook a new recipe, but hate to clean up and do dishes. So you can enthusiastically focus and make a great dish, but end up with a messy kitchen that stresses you out for days.

FACTORS THAT CAN HELP WITH ADHD SYMPTOMS

There are also things that help folks with ADHD manage their symptoms. Here are a few things that can improve symptoms:

• Using external organization tools (calendars, reminder alerts on the phone, timers, planners, partners or friends who help you stay on track)

• Seeking adult ADHD assessments with a neuropsychologist to understand your diagnosis as well as cognitive strengths and vulnerabilities.

• Saying no to unwanted/unnecessary activities

• Speaking to your doctor about your symptoms

• Getting enough sleep by practicing good sleep hygiene

• Avoiding caffeine and other substances

• Discussing your symptoms and diagnosis with your partner, family, friends, and possibly even at work, so people can understand some of the more frustrating symptoms that may impact your relationships and work

• If you have already had neuropsychological testing, you might seek cognitive rehabilitation or psychotherapy for ADHD

In the next blog, I talk about finding a psychological evaluator if you want to seek neuropsychological testing to confirm or rule out adult ADHD. I also discuss what to expect from the process of adult ADHD assessments.

Through Adult ADHD Assessments in Los Angeles you can find out if you have ADHD

Do you recognize some, or all, of the symptoms listed above? If you do Dr. Reger provides neuropsychological testing that can help determine if you have ADHD. If you are ready to speak with a neuropsychologist in Los Angeles then follow these steps:

1. Reach out with any questions that you have.

2. Schedule your appointment for Adult ADHD assessments

3. Get answers so you can learn what will help make life easier.

Other Assessment & Counseling Services Offered by dr. reger in Los Angeles, CA

Dr. Reger offers several types of neuropsychological assessments at her Redondo Beach practice and in many locations around Southern California. She also offers psychological evaluations for workers’ comp and preoperative assessments. Additionally, as a Psychologist in Los Angeles, she offers counseling for older adults.

What is the difference between neuropsychological testing & psychological testing

Perhaps you or a loved one need neuropsychological testing or psychological assessment. If you have been referred for testing to be completed by a psychologist, but aren’t totally sure what a “neuropsych eval” or “psych testing” means, this information may give you a clearer idea of the differences between these two types of testing. Along with what to expect either way. Or, if you want to pursue testing for your own interest and self-understanding, you may not have a referral, but could use some guidance about the type of testing you should look for.

Neuropsychological Assessment: An Overview

If you are seeking a neuropsych evaluation, odds are you’re experiencing some cognitive symptoms. This means some area of your brain function is not working the way you’re used to or is causing problems for you. A neuropsychological assessment can help you understand these symptoms, possibly get a diagnosis, or learn how to manage them.

cognitive symptoms assessed in A Neuro psych eval:

• Changes in memory

• New difficulty focusing or concentrating

• More impulsive speech or behaviors

• Difficulty finding words or slower tracking in conversations

• New problems with getting lost

• Difficulty doing complex mental tasks that you used to do without a problem (like managing medications or finances)

If you have symptoms like this or other problems that suggest your brain has changed or isn’t doing what it should, your physician, psychologist, occupational therapist, social worker, or other health professionals might refer you for a neuropsychological assessment.

What is Measured in a neuropsychological assessment

Neuropsychological testing involves using several tests (or “testing battery”) to measure the functions of your brain in different areas. A neuropsych test battery will most likely include measures of:

• Attention. The ability to focus your attention on a task for as long as needed.

• Working memory. The ability to hold information in your mind and work with it. For example, looking up the number for the pizza place, then repeating it out loud to remember it while you dial.

• Executive function. Your brain’s capacity for organization and impulse control. As well as how quickly you move from one mental task to another and communicate across brain areas.

• Memory. This is the measure of your ability to learn, retain, and recall information. It includes different tasks to look at different types of memory.

• Processing speed. How quickly you take in and respond to information.

• Visual/spatial function. The ease with which you understand and use the information presented visually, like abstract shapes and pictures. Think of the skill you might need for a game of tetris…this brain function is crucial!

• Intellectual function. This is a way to estimate your overall IQ (sometimes called “intelligence,” though this is an often-misunderstood term). This can be important because it gives your doctor a basis for comparison. For example, if your IQ is average and your scores on attention measures are much lower than that, this gives a clue about what’s going on with your symptoms, and more importantly, how to help.

• Questionnaires about mood or symptoms. These are usually a small part of neuropsych testing. Even though mood and symptoms aren’t the primary targets of testing, things like depression and anxiety CAN impact cognition. We measure them in case they contribute to the problem because they are often treatable.

A LOOK AT hISTORY & oVERALL hEALTH

In some cases, neuropsych testing might also involve measures of academic abilities, or interviews with teachers, parents, or caregivers. This depends on the question at the heart of testing, and your neuropsychologist will tailor a testing battery to meet your specific needs. In all cases, your doctor will do a clinical interview with you to gather information about your history, symptoms, and overall health.

what happens after a neuropsychological assessment?

Once the testing is done (this can be anywhere from 4 hours to 10 hours or more, depending on the reason for testing), your doctor will score your tests and consider all of the information together. This helps to understand patterns and the big picture, so we can offer insight into what is causing the symptoms, and make recommendations about how to manage them.

Psychological Evaluation: An Overview

If you are considering a psychological evaluation, also called “psychodiagnostic assessment,” you are most likely experiencing emotional or other psychiatric symptoms that are causing you distress or problems in relationships, at work, or in other areas. Psych testing can help you understand your symptoms, often by providing a diagnosis that can make sense of your experience.

symptoms assessed in A psychodiagnostic assessment

Here are some examples of psychiatric symptoms that might prompt someone to seek a psychological evaluation:

• Low mood that persists and doesn’t seem related to an obvious cause

• Frequent worry

• Panic attacks

• Difficulty in interpersonal relationships

• Difficulty maintaining jobs

• A history of abuse or trauma

• Problems with anger

• Low motivation

• Difficulty making decisions or lack of confidence

• Mood highs and lows

• Hypervigilance

• Social anxiety or fear

• Specific fears that cause problems in your life

• Nightmares

• Low self-esteem

• Feelings of loneliness or emptiness

• Wishing for better self-understanding*

*not really a symptom, but often a reason folks want testing

There are many types of emotional symptoms that might cause you concern enough to seek a psychological evaluation. Sometimes, people are referred for a psychodiagnostic evaluation by a therapist or physician. But just as often, people are seeking better insight and awareness for themselves.

What is Measured in a Psychological Evaluation

Similar to neuropsych testing, a psychological evaluation will involve a test battery using several different tests to answer your specific question. This allows your doctor to collect enough data for a broad understanding of you and your symptoms. Unlike a neuropsychological assessment, there are not specific functions we’re measuring in a psychodiagnostic assessment, rather, a broad understanding of your overall psychological function. A thorough psych testing battery will likely include:

• Personality measures. Long tests that ask many questions about how you see yourself and what characteristics define your personality

• Mood measures. Tests that ask you about your mood and symptoms related to mood in the recent past

• Specific symptom measures. These are likely to differ depending on your reasons for coming in for testing and can include questionnaires about specific symptoms you’re having. For example, if you suspect you may have posttraumatic stress disorder (PTSD) after a traumatic experience, your doctor might give you a questionnaire specifically measuring PTSD symptoms.

Similar to neuropsychological testing, when you undergo a psychological evaluation, your psychologist will do a thorough clinical interview to gather information about your background and what you’re experiencing. This interview provides important data, just like test results. Also similarly, your doctor will consider all of the data together, make a diagnosis (or not, if there is no diagnosis), and offer recommendations based on the results.

A Brief Comparison of a Psychological Evaluation & a neuropsychological assessment

You may have noticed that there are some shared themes across both types of assessment, which is part of what creates confusion when you are referred for testing, or think you might want to seek testing on your own. Here are a few things psychological assessment and neuropsychological assessment have in common:

Conducted by a specially trained psychologist

Psychologists are the only professionals who are trained, qualified, and licensed to conduct either psychological or neuropsychological assessments. These are highly complex evaluations that require significant knowledge of statistics, research methods, tests and measures, psychological assessment, diagnosis, and psychological interventions in order to be done properly. There is no other profession or licensure that involves training in all the elements of comprehensive psychological or neuropsychological testing, and even within the field of psychology, only a subset of clinical psychologists receive training in neuropsychological testing, or specialize in psych assessment. This is why it’s so important to find a well-qualified clinical psychologist for your testing.

Involve several different tests

There is no single test that can offer comprehensive information about something as complex as cognition or mental health. Psychologists put together test batteries that cover a broad range to get the full picture. This is good because it means we don’t miss important information. For example, if someone requests an “ADHD test” and I only do that one test, I may miss other symptoms that could also play a role in attention problems, like anxiety, grief, or a learning disorder. Like any good investigator, psychologists gather as much data as is necessary not only to confirm a suspected diagnosis, but also to rule out other possibilities and catch anything else that may be going on.

Begin with a question

Any psych or neuropsych eval starts with a question. This can come from another doctor, a therapist, a family member, or the patient themselves, but it is always our starting point. The question guides the testing battery, the interview, and the recommendations I might make after considering all of the data together. For example, let’s say you come in already knowing you have a traumatic brain injury from an accident and wanting to know your strengths and vulnerabilities as well as recommendations for how to manage them. If all I offer is a diagnosis of traumatic brain injury, I’ve wasted everyone’s time and money. It’s crucial to find a psychologist who will listen and address your specific question!

Include an interview

The clinical interview is a crucial part of testing, because although I may have expertise in clinical psychology and neuropsychology, YOU are the expert in your own experience. These types of assessments are not done to the patient, they are done with the patient. Your input and observations are the most important piece of the puzzle (and in cases of dementia or other situations where a patient may not have insight, caregiver input is invaluable).

You may have noticed that neuropsych assessment and psychological assessment also have some differences. Here are a few ways these types of testing differ:

Different focus

Neuropsych testing is about brain function, in terms of cognition, and is easiest to understand when we think about the specific tasks we measure, like memory and attention. In contrast, psych assessment is about psychological symptoms. Obviously, the brain is also involved in emotional and mental health functions, but a psychological assessment is less focused on the nuts and bolts of cognition, and more focused on overall emotional wellbeing, and specific psychiatric symptoms.

Different tests

These two types of testing may have some overlap in the tests involved (for example, a short measure of depressive symptoms is likely included in both), but generally speaking, neuropsych testing involves a totally different test battery than psychological evaluation, because we’re measuring different things.

Different types of diagnoses

When someone goes in for neuropsych testing, if they receive a diagnosis, it is likely to be a diagnosis related to neurocognitive function, like cognitive disorders due to dementia, traumatic brain injury, ADHD, stroke, or multiple sclerosis. These diagnoses are often used in medical settings. Psychological testing is more likely to result in a psychiatric diagnosis, related to mood or other mental health factors. These might include things like PTSD, depression, or anxiety disorders.

Different recommendations

Although both types of testing will result in a list of recommendations from your doctor about how to cope with or treat symptoms, the lists often look different. For example, neuropsych recommendations may include strategies to compensate for brain changes, like using a notebook to write things down, being allowed extra time for tests in school, or using a pill organizer to track medications. In contrast, psych recommendations are more likely to be aimed at treatment and ways to manage symptoms; things like specific types of psychotherapy that could be helpful, or a recommendation to see a psychiatrist for a medication eval.

This is an overview of what is involved in neuropsychological assessment and psychological evaluation. If you need either type of evaluation, hopefully, you now have a better understanding of the purpose of the testing you’re seeking, as well as what to expect from testing.

Do you need a psychological evaluation or a neuropsychological assessment in Los Angeles?

Whether you are interested in, or need, a psychological evaluation or a neuropsychological assessment Dr. Reger can help. As a Psychologist in Los Angeles, she offers these evaluations at several locations throughout Southern California. Follow these steps to set up your assessment.

1. Contact Dr. Reger with any questions

2. Schedule your appointment, remember it might take most of the day

3. Take the steps to be prepared for the day of your test

Other Services Available with Dr. Reger in Los Angeles

Dr. Reger specializes in assessments for med-legal capacity, workers’ compensation, and before surgery or operations. Additionally she provides individual therapy for older adults, trainings, and public speeking.

A Note to Physicians & Other Professionals in Los Angeles About Neuropsych Testing

As a clinical psychologist, I get referrals from physicians, social workers, occupational and physical therapists, and other psychologists for psychological and neuropsychological assessments. Neuropsychology can be mysterious to those outside the field. So I’ve found that many providers are unsure how best to refer someone for neuropsych testing, and how to get the most out of it when they have a question about cognition. Here are a few tips.

Understanding The Value of Neuropsych Testing

Testing is expensive, time consuming, and requires a lot of effort from patients. So it’s easy to understand why it might seem like more trouble than it’s worth. Often, neuropsych testing can offer answers and insight that clinical interviews and physical labs simply cannot. Neuropsychological Testing can provide:

• A differential diagnosis. Such as vascular dementia versus Alzheimer’s type dementia. This gives insight into the expected progression of the disease as well as areas of vulnerability and opportunities for additional support.

• Rule-outs. For example, it can determine if cognitive deficits are the result of psychiatric or substance problems rather than mild traumatic brain injury as originally suspected.

• Information on learning style and barriers. This is useful for academic accommodations or for recommendations on how to best support retention in physical rehabilitation programs.

• Monitoring of cognitive change over time. In neurodegenerative diseases like MS, testing every few years can help us understand function and inform treatment planning.

• Individualized recommendations. This is the greatest value of neuropsych testing. We can recommend strategies for managing problems with memory, organization, or functional decline. We can recommend evidence-based treatment for psychiatric needs. A Psychologist can comment on practical strategies to support carryover in rehabilitation, or strategies to support independent living for as long as possible. With appropriate testing, an experienced evaluator can offer tailored recommendations that can have a substantial impact on function and quality of life.

A Clear Referral Question for Neuropsych Testing

Neuropsych evaluation starts with a referral question. When the referral comes from another professional, I’ve often seen something like “Please test for dementia.” This doesn’t give much information. Instead, I recommend including as many of these elements as you can:

• Brief summary of symptoms. “Patient has noticed problems with focus, attention, and slower thinking.”

• Timeframe and/or precipitating event. “Patient began having these problems after infection with COVID in September of 2020.”

• Any observations you or others have made related to the referral. “I’ve seen this patient for the past five years, and I’ve also noticed a change in ability to remember what we’ve talked about at appointments. Patient’s partner now comes to every appointment with them to help communicate and remember what is discussed.”

• The desired outcome from testing. “Please offer a diagnosis.” Or “Please comment on the patient’s learning style and ways to improve carryover during rehab stay.” Or “Please provide an updated assessment of the patient’s cognitive function to inform treatment planning.” It could also be “Please recommend appropriate academic accommodations.”

Find a Neuropsychologist You Trust and Build That Relationship

Develop a relationship with a psychologist you trust to do thorough and competent neuropsych testing. This allows you to have a solid referral when you encounter patients who could benefit. If you work with older adults, this is crucial, but even if you work with kids or adults of any age, having a go-to neuropsych referral is helpful.

You never know when someone will report symptoms that sound a lot like undiagnosed ADHD, even in their 40s. Or when a patient will be in an accident and sustain a blow to the head with lingering symptoms. Having a relationship in place with a trusted psychologist ensures timely and quality neuropsych testing. This also fosters communication, as you become familiar with the release of information procedures for a given practice. As well as the type of information your psychologist wants about the patient. Good communication results in a thorough assessment and useful recommendations, both for patients and their providers.

Prepare Your Patients for neuropych testing

My final tip is that it’s helpful for referring professionals to prep their patients a bit for why they’re being referred for testing and what to expect. Even sending patients to my website testing pages or a blog post here to learn a little about neuropsych testing can help. People usually feel anxious about testing; but the more you prepare them by letting them know why they need testing and what to expect, the easier it will be for them to give their best effort. This results in the most accurate and useful results. You might say something like this:

“I’m referring you to Dr. Reger for neuropsychological testing. I’m concerned about your difficulty remembering things, episodes of getting lost lately, and new problems managing your medications on your own. Testing will give us some answers, and help us plan for the future. It is usually a long appointment, so be prepared for that. Dr. Reger will tell you more specifically what to expect on the day of testing. She will ask you questions and have you do some paper-and-pencil testing. Once you have the report, we can discuss Dr. Reger’s recommendations and where to go from there.”

Steps for Referring Someone for Neuropsych Testing in Los Angeles, CA

If you are looking for a Neuropsychologist you can refer someone to for neuropsych testing Dr. Reger can help. In order to start the process of a neuropsychological assessment follow these steps:

1. Send a referral and reach out with any questions

2. Have them schedule their appointment at one of our testing locations in Southern California

3. Get individualized recommendations and treatment suggestions for your client

Other Mental Health Services Available in Los Angeles, CA

Dr. Reger offers psychological and neuropsychological assessments for a variety of reasons. This includes cases of med-legal capacity, before operations or surgery, and for workers’ compensation psych claims. Beyond evaluations, she offers therapy for older adults.