While you are at your evaluation appointment, your clinician may ask you to complete testing, (assessments), to further aid in determining a diagnosis. These assessments are another way for your clinician to get information on your symptoms and experiences. They can also act as a tool to help your clinician eliminate (that is, rule out) other diagnoses such as bipolar disorder. While there is not one definitive test that can diagnose ADD, these tests can be a valuable part of the overall evaluation process, providing your clinician with more pieces to the puzzle.
There are two main types of assessments for ADD: rating scales and tests of working memory.
RATING SCALES
Rating scales measure your current ADD symptoms and childhood symptoms - the total number of symptoms and the frequency and severity of each. Some of the rating scales you fill out yourself, such as the Adult ADHD Self-Report Scale and the Current Symptoms Scale and Childhood Symptoms Scale.
The clinician will fill out some of the scales as she talks with you; these include the ADHD Rating Scale-IV, the Brown Attention-Deficit Disorder Scales, and the Wender Utah Rating Scale. Be as honest and open as possible.
As mentioned previously, the more information you give your clinician, the better able she is to help you.
As you read earlier, family members often have a more accurate view then you do of your behaviors and their impact on your quality of life. Therefore, your clinician may also give you rating scales for your family members to fill out regarding your childhood and current ADD symptoms. You return the scales at your next appointment. Add Testing For Adults
TESTS OF WORKING MEMORY
The frontal lobes of the brain perform the executive functions. These functions are impaired when you have ADD. One of the executive functions is called working memory. Working memory is the ability to hold information, process it, and put the information back out again. The more severe your ADD symptoms are, the more difficulty you may have on tasks where you have to use your working memory.
During your evaluation appointment, your clinician may want you to take a test of your working memory. Tests of working memory can be of different types. One type is the "continuous performance test" (CPT), where you are asked to pay attention for a long period of time while you perform a task that tests your working memory processes.
The Integrated Visual and Auditory CPT (IVA+Plus) is a CPT that you take on a computer. The test measures your verbal and auditory attention capabilities. During the test, you are asked to press the space bar every time you see a number 'T' or hear the word "one." The test measures how many times you hit the space bar accurately, how many times you hit it inaccurately, how long it took you to hit the space bar, and other variables.
Another task of working memory is called the Tower of London (or Tower of Hanoi). In this task, you have a board with three pegs of different sizes, in addition to beads of different colors. Your job is to match the bead patterns that the tester (or computer program) demonstrates for you. There are rules you must follow for this task, and you are timed by the tester or computer for each of the patterns.
While taking the IVA+Plus or the computerized Tower of London test, you are usually sitting in a room by yourself with limited distractions. This is because outside distractions might change the results of the test and make it a less accurate measure of your ADD symptoms.
You may also be asked to take other tests of working memory function: a Stroop test and a Trail-Making Test. The Stroop test consists of names of colors written in an ink that is different from the color name. You are asked to say the color of the word, not the word itself. For example, the word "yellow" may be written in blue. Therefore, the correct answer would be "blue." People with ADD tend to have difficulty with this task because the frontal lobe of your brain has difficulties inhibiting (or stopping) itself from saying the word, not the color of the word. Add Testing For Adults
The Trail-Making Test consists of two parts. In Part A, twenty-five circles are on a sheet of paper. Every circle has a number in it, from one to twenty-five. Your task is to connect the numbers in order. In Part B, there are twenty-five circles with numbers in them, and there are also circles with letters in them. Your task is to connect the circles in this way: 1-A.2-B and so on. You are not allowed to lift the pen or pencil from the paper, and you are timed by the tester.
Don't worry if you get bored or your brain gets tired during these tests, That is one of the purposes of the working memory tests - to see how your brain reacts to long and repetitive tasks. It is very normal for an ADD brain to feel tired during and/ or after one of these tests. However, give it your best shot and try to get through the whole thing, The more information your doctor receives from this testing, the more she can help you.
If you are prescribed medication for ADD, your clinician may ask you to take the same test(s) again at a later appointment while the medication is in your system. The results of the later test, when compared to your baseline (original) test, will give the clinician an indication of how well your medication is working.
Based in part on this information, your clinician may consider increasing or decreasing the dose of your medication or change your medication altogether, Let your doctor know if you have forgotten to take your medication that day or if you took your medication immediately before your appointment. Otherwise the results of your testing may not be entirely accurate.
MOTION TRACKING TESTS
Another type of ADD assessment is a computerized test that measures your amount of movement while you are sitting in a chair doing a working memory task. One of these motion tracking tests is called the Quotient ADHD System. This assessment measures both your physical movements (such as squirming in your chair and being restless) and your working memory ability. Two infrared scanners track your movements for twenty minutes while you take the computerized test. These types of assessments are less common due to their cost and the extra space in the clinician's office that they require.
BRAIN SCANS
You may have read about the use of brain scans, like single photon emission computed tomography (SPECT) to determine an ADD diagnosis. However, there is not enough research to recommend this as a definitive test of ADD. In addition, these scans can be expensive and you might have to travel quite a distance to obtain one. For the majority of people, the lack of scientific evidence outweighs the cost. To find out more, you can check out Add Testing For Adults.
