Adult ADHD and Modified Adult Evaluations

Adult ADHD

What Does it Look Like in Adults?

It is often not hard to spot what we have long thought of as “typical” ADHD in children and adolescents. But adults can have more subtle symptoms. This means many adults struggle with ADHD yet may not even know they have it. Many are diagnosed with other co-occurring disorders, such as depression or anxiety. Adults may not realize that many of the problems they face, including staying organized, difficulty starting a task, or being on time, relate back to ADHD.

Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten classes or meetings, or even social plans. The inability to control impulses (hyperactivity), often thought of as the “8 year old boy running around the classroom”, in adults can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger. Many of these adults have been forced most of their lives to “Mask” their ADHD, told to stop the pen clicking, foot tapping, chair rocking, and excessive chatter, because it was “impolite,” “annoying,” and “inconsiderate” of others. No one understood that their brain couldn’t focus unless their body was engaged in some type of movement.

Isn’t ADHD a Disorder in Childhood?

While ADHD is a disorder typically diagnosed in childhood, there are approximately 10 million adults who have ADHD, with around 20% treating it. More often than not, the other 80% of these adults may not even be aware they have ADHD. While these adults had ADHD in childhood, several factors may have prevented those around them from recognizing it.

As a child, they may have been missed because they were very bright, managing well throughout school, sometimes even through high school, college or even graduate school, until they experienced the demands of adulthood, especially at work. For others, teachers and parents may not have recognized the signs, especially as the work became more challenging, and their struggle increased.

I Was Told I Was “Too Smart” To Have ADHD
– a 53 year old client and CEO

They Did Not Want To “Label” Me As ADHD, So They Never Told Me About My Diagnosis In Early Childhood –
a 28 year old client in medical residency

Why Didn't Someone Realize I Had ADHD?

There are many reasons why parents and/or teachers do not recognize the signs of ADHD in childhood or adolescence. These are just a few of the common ones:

Intelligence

As a child you may have been missed because you were smart. You may have understood the material in class, or read voraciously, or had interests that clearly showed you were very bright. You may not have had to work very hard or at all, listen in class, or even study to get good grades for many years. Many people, even some professionals, believe that intelligence and ADHD are mutually exclusive.

Performance

Good grades have long been the benchmark of a child's well being. If you have good grades, you must be fine. However, we know that many children can be achieving academically yet still be struggling emotionally, socially, and even physically. The more challenging the work becomes, the later you may have waited to start it, often staying up into the early morning to complete it. But, as long as you got it done, you were "fine."

Anxiety/Depression

There is a strong relationship between undiagnosed ADHD, Anxiety, and Depression. Often teachers or parents do not recognize the emotional toll of undiagnosed ADHD, which presents as anxiety and/or depression. Some of these individuals enter therapy for anxiety and/or depression secondary to the ADHD. Not all clinicians consider the possibility of ADHD in adults and may not ask the right questions about early childhood school experiences. When ADHD is diagnosed and treated often these symptoms improve.

Medication

It is no secret that a well known treatment for ADHD is medication. Most parents are cautious about considering medication for their child, as well they should be. Some may make the decision to ignore symptoms or not have them evaluated to avoid feeling pressure to consider medication should there be a positive diagnosis. Sometimes parents themselves may have had similar struggles with focus and "done fine" without intervention. Many falsely assume one will "grow out of it."

We are not a “Quick Diagnosis” clinic. We have been established since 2009 and have helped hundreds of individuals and families understand and navigate the complexities of ADHD. Our reports

are comprehensive and assist providers in the treatment of the individual and their family.

Modified Adult Evaluations

Modified Adult ADHD Evaluations are an option for adults who have often thought or wondered if they have ADHD but have never been formally assessed or diagnosed. Many times they realize this during the process of their child receiving a diagnosis, or they encounter difficulties in their job or relationships after years of experiencing issues with focus, time management, procrastination, organizational issues or impulsivity. More recently, with the wealth of discussion about adult ADHD on platforms such as TikTok, more adults are recognizing their long term struggles as possible undiagnosed ADHD rather than “laziness” or another “character flaw.”

Some adults who seek our Modified Adult Evaluation have previously been diagnosed with ADHD, and maybe been on medication, but need a formalized evaluation and report now for a variety of reasons. Some have moved and need to establish care in a new state, no longer having access to an evaluation from childhood. Others have been informally told they have ADHD but want to understand more about how severe the impairment may be.

This evaluation is similar to our comprehensive evaluation, using the same tools, however the report is a detailed summary (4-5 pages vs 8-15) which can be used to share with a provider for treatment planning including medication for ADHD. This is intended for adults only (18+) and not for those looking for recommendations or accommodations for college. College/Graduate students looking for support for accommodations typically choose the comprehensive evaluation, with the longer report and follow up session included.

If you have questions please feel free to contact the center and speak with Dr. Rappaport. This evaluation does not include an assessment of Executive Functioning or a follow up session, however one may be scheduled at any time in the future for an additional fee.

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