Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Some people simply cannot get a family history. Refugee journeys, destroyed records, closed adoptions, families that did not survive. That is a gap in the paperwork and not evidence against the diagnosis.
Say so out loud, and write it in the notes as a gap rather than as a negative finding, so the next person reading does not mistake silence for an answer. Then lean on what you do have: their own account, school records if any exist, anyone who knew them as a child. Where adoption records are sealed, courts will sometimes open them when there is a medical need.
Qur’an and Sunnah
'We have honoured the children of Adam and carried them by land and sea' (Quran 17:70). The honour is stated of people who are carried across land and sea, which is to say it never depended on any of it being written down.
۞وَلَقَدۡ كَرَّمۡنَا بَنِيٓ ءَادَمَ وَحَمَلۡنَٰهُمۡ فِي ٱلۡبَرِّ وَٱلۡبَحۡرِ وَرَزَقۡنَٰهُم مِّنَ ٱلطَّيِّبَٰتِ وَفَضَّلۡنَٰهُمۡ عَلَىٰ كَثِيرࣲ مِّمَّنۡ خَلَقۡنَا تَفۡضِيلࣰ ا
We have honoured the children of Adam and carried them by land and sea; We have provided good sustenance for them and favoured them specially above many of those We have created
Qur’an 17:70read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Who gets assessed depends on more than symptoms. A study of United States health system records found adult ADHD diagnoses rising sharply, with rates differing by racial and ethnic group, which points to differences in recognition and access rather than in people. It is record based, so it shows the pattern without explaining it, and it is a good reason to be careful about turning a thin history into a negative one.
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
An absent family history usually means absent access, and access has never been evenly shared.
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
Run a short anxiety and depression screener alongside the ADHD measure at every intake, not only when someone mentions their mood.
When you need a date, hand people events rather than months. Was that before or after the holiday? Same year as the move?
If someone was adopted, or simply does not know their family history, say early and plainly that this is not a problem. It helps to have and it is not needed.