Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Ask about the family properly: parents, brothers and sisters, children, then aunts, uncles and grandparents. Include drinking and drug use, in them as well as in the person sitting with you.
This tends to be the highest yield few minutes of an assessment, because the condition runs strongly in families. Relatives who were never assessed turn up in the history as the uncle who could not keep a job or the grandmother nobody could get to sit down. A family history of substance problems counts twice over: as a hint of undiagnosed difficulty in the family, and as something that bears on prescribing decisions later.
Qur’an and Sunnah
Go and seek news of Joseph and his brother (Quran 12:87). Ya'qub sends his sons out to gather what the family knows, which is roughly the task here.
يَٰبَنِيَّ ٱذۡهَبُواْ فَتَحَسَّسُواْ مِن يُوسُفَ وَأَخِيهِ وَلَا تَاْيۡـَٔسُواْ مِن رَّوۡحِ ٱللَّهِۖ إِنَّهُۥ لَا يَاْيۡـَٔسُ مِن رَّوۡحِ ٱللَّهِ إِلَّا ٱلۡقَوۡمُ ٱلۡكَٰفِرُونَ
My sons, go and seek news of Joseph and his brother and do not despair of God’s mercy- only disbelievers despair of God’s mercy.’
Qur’an 12:87read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A study of health system records found adult ADHD diagnoses rising sharply, with rates differing between racial and ethnic groups, so who holds a diagnosis reflects access and referral as much as who has the condition. No diagnosis in the family is therefore weak evidence that nothing was there. The study counts what services recorded, which is precisely the limitation that makes the point.
Chung W, Jiang SF, Paksarian D, Nikolaidis A, Castellanos FX, Merikangas KR, Milham MP. (2019). Trends in the Prevalence and Incidence of Attention-Deficit/Hyperactivity Disorder Among Adults and Children of Different Racial and Ethnic Groups.. JAMA network open doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Something that runs in families leaves traces in the family story even when nobody was ever diagnosed.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Strategies for ADHD are visible. A timer on the table, a list on the wall, an alarm going off in a meeting. If someone has not yet made peace with having ADHD, each of those is an announcement, and it will quietly get dropped.
Damage to the front of the brain can produce something that looks a great deal like ADHD: poor impulse control, blunted judgement, a person their family says has changed.
When a bright, talkative autistic child arrives looking mainly behavioural, look underneath for a coordination or reading difficulty. Once the first label is in place, whatever comes after tends to get filed under it and never assessed on its own.