The minimum components of a real assessment
Defensible adult ADHD assessment is grounded in DSM-5-TR and clinical guidelines (APSARD 2024, NICE NG87, CADDRA). The components that separate a real evaluation from a sales call:
- A structured clinical interview covering current and childhood symptoms.
- Developmental history — school reports, report cards, family accounts where possible.
- Collateral information from someone who knows you, when available.
- At least one validated rating scale (e.g. ASRS, CAARS, DIVA).
- A screen for conditions that mimic ADHD — sleep disorders, thyroid, mood, anxiety, trauma, substance use.
- A written report you keep.
What to bring
- Symptoms written down in your own words, with concrete examples.
- Old report cards or school notes if you have them.
- Your medication list and any previous mental-health letters.
- One or two examples from work or life where attention, time, or initiation failed visibly.
What to expect on timing and cost
Expect 60–180 minutes of initial assessment, often split over two sessions, plus report time. Cost and insurance coverage vary enormously by country, state, and clinician — the variability is the defining feature of the market. Modality matters less than protocol: a rigorous video assessment is operationally similar to the in-person version, and a rushed in-person intake is not saved by the room.
The practitioner question
Ask directly before booking: “Will this include a structured interview, developmental history, collateral, a rating scale, and a written report?” A clear yes is a strong signal. A vague “we’ll see” is a reason to look further.
After the diagnosis
Diagnosis is a door, not the finish line. The useful next steps are education on the mechanism — start with executive dysfunction — and then scaffolding: coaching, accommodation, tools. Our ADHD coaching guide covers the support layer; the task initiation guide covers the first daily barrier most people hit.
FAQ
Can telehealth diagnosis be valid?
Yes, when the protocol is complete — structured interview, developmental history, screens, report. The issue is never the modality, it is whether the protocol was run.
Do I need a referral?
That depends on your country and insurance route. In some systems you can book a specialist directly; in others you need a GP or psychiatrist gateway.
What if the first clinician says no?
A negative result from a rushed intake is not a verdict. Ask what was and was not assessed, and seek a second opinion with a full-protocol clinician.