Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Run the assessment yourself and watch while they work. Under real effort you will see the small movements, the tics and the overflow that never appear in ordinary conversation, and none of it reaches you if a technician or an app does the testing.
Sit where you can see hands and face. Note what happens as the task gets harder: the tongue that comes out, the leg that starts going, the free hand copying whatever the writing hand is doing. Those observations often matter more than the score, and they are the part that no report from elsewhere will ever contain.
Qur’an and Sunnah
'you were gentle in your dealings with them' (Quran 3:159). Being in the room and watching kindly is most of what gentleness means during an assessment.
فَبِمَا رَحۡمَةࣲ مِّنَ ٱللَّهِ لِنتَ لَهُمۡۖ وَلَوۡ كُنتَ فَظًّا غَلِيظَ ٱلۡقَلۡبِ لَٱنفَضُّواْ مِنۡ حَوۡلِكَۖ فَٱعۡفُ عَنۡهُمۡ وَٱسۡتَغۡفِرۡ لَهُمۡ وَشَاوِرۡهُمۡ فِي ٱلۡأَمۡرِۖ فَإِذَا عَزَمۡتَ فَتَوَكَّلۡ عَلَى ٱللَّهِۚ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُتَوَكِّلِينَ
By an act of mercy from God, you [Prophet] were gentle in your dealings with them- had you been harsh, or hard-hearted, they would have dispersed and left you- so pardon them and ask forgiveness for them. Consult with them about matters, then, when you have decided on a course of action, put your trust in God: God loves those who put their trust in Him
Qur’an 3:159read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Watching adds something that asking does not. The long follow up of the multimodal treatment study of ADHD found self report and informant report diverging as those children reached young adulthood, a reminder that any account of how someone is functioning depends on who is giving it. It was not a study of clinical observation, so it argues for gathering more than one kind of information rather than for this practice in particular.
Swanson JM, Arnold LE, Molina BSG, Sibley MH, Hechtman LT, Hinshaw SP, Abikoff HB, Stehli A, Owens EB, Mitchell JT, Nichols Q, Howard A, Greenhill LL, Hoza B, Newcorn JH, Jensen PS, Vitiello B, Wigal T, Epstein JN, Tamm L, Lakes KD, Waxmonsky J, Lerner M, Etcovitch J, Murray DW, Muenke M, Acosta MT, Arcos-Burgos M, Pelham WE, Kraemer HC, MTA Cooperative Group. (2017). Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.. Journal of child psychology and psychiatry, and allied disciplines doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Effort brings out what an easy conversation keeps hidden.
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
The family history is not the warm up before the real assessment. Give it proper time and it will often tell you more than any single rating scale in the folder.
When you read that some proportion of people with ADHD have a particular problem, the number tells you nothing until you know the figure for everybody else.
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.