Helping my husband get a diagnosis

Hey everyone,

Heart here!

First of all can I just say that the process of getting evaluated and diagnosed for ADHD, especially during Covid is the least ADHD friendly experience. And total props to all of you have gone through it with or without help from a loved one, Covid or not. I’m a neurotipical trying to help my husband navigate the system and I can’t imagine how someone struggling with executive function would get through this alone.

All that being said, I’d love to get some help and guidance on the diagnosis process. We’ve found two different routes we can go that seem to have VERY different diagnostic processes. We’re still working out insurance coverage. But talked with both about what the process would be like.

One is an ADHD center that lists EEG readings, a Cambridge Brain Sciences Evaluation, Neuropsychological testing and psychological testing and scoring. From their website reviews, it sounds like they treat using biofeedback and neurofeedback sessions. Which is something I’ve never heard of for ADHD.

The other is a psychologist who offers evaluation, therapy and coaching. He explained the evaluation process as playing a video game, followed by a test, and then a second day of a face to face evaluation/interview.

We’ve also have another nearby center centers that is out of network that does a whole set of tests including The Wechsler IQ tests (WAIS-IV for adults and WISC-V for children), The Wechsler Individual Achievement Test (WIAT-III), A Millon objective personality test (MCMI, MACI, or M-PACI) and Behavior Assessment System. Along with evaluation by a psychologist or psychiatrist. While we’d prefer everything to be covered, if these are important we are able to handle it financially. I just want him to get the care he needs.

Why in the world would these processes be so different? Any opinions on which would be most helpful or accurate?

I’ve been helping him deal with the mess that is insurance and also gather his old school records, IEPs etc. in preparation as I know a history of symptoms is important and self evaluation (especially of past self) can be a struggle. Is there anything else that would have been helpful to you during the process of getting evaluated?

Thank you all!

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I highly recommend you take a look here: https://drhallowell.com/

:sunglasses:

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My employer provides an Employee Assistance Program (EAP) as part of the benefits package. I was able to get diagnosed through a licensed counselor that the EAP referred me to, at no cost to me. (Not all employers contract with an EAP service. In fact, this is the first employer I’ve had that I know had this benefit.)

My doctor confirmed the diagnosis via a questionnaire in the software that his practice uses. However, he referred me to a psychologist’s office for a more thorough evaluation. I’ve been on the wait list since December.


I’m intrigued by the idea of biofeedback (neurofeedback) for ADHD, but from what I’ve read about it, there seems to be a lot of variation in method and mixed results.


A university near me (not the one that I currently work at) has a service available to the community. They charge a sliding scale cost for their thorough ADHD testing (at my income, it would cost over $400, but I’m going to change to a lower-paying job soon, so I think I’ll wait to see how much it’ll drop).

There may be a service like that available in your area. However, there are also providers who are available via telemedicine (now more than ever, thanks to the response to COVID).

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I agree!!

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To start, I’d recommend the place that has evaluation, therapy, and coaching.

Biofeedback, neuroimaging, scans, and neuropsychological testing have all not been shown to be effective in diagnosing ADHD, and they have nothing to do with the treatment of ADHD. There’s a lot of research available from Dr. Russell Barkley that talks about this, and he’s been on several podcasts through Additude Magazine or ADHD reWired where he talks about that. Testing like that is not effective.

The second clinic sounds better. If they do a good evaluation and determine a diagnosis, they could also be able to do ongoing care. Coaching is highly effective for ADHD, especially when it comes to executive functioning.

Clinics offer different services for different reasons. Some clinics are “for profit” so they offer services that enhance their bottom line. Some clinics do services that are new and flashy but don’t have a lot of evidence based, such as genetic testing or neurofeedback. Some clinics just want your money. They don’t actually specialize in diagnosis or care, but they specialize in preying on people in need of answers and support.

I would say some other advice for evaluation:

  • Take time to go through the criteria for ADHD and have your husband list out examples of how he experiences each one. The criteria can be found here: Neurodevelopmental Disorders (DSM-5)
  • Come prepared with any historical information such as school reports, letters from professors, supervisor performance reviews, or anything that can show a past pattern of struggles.
  • Make sure he signs a release of information at the center so that you can give and receive information. Make sure you have the opportunity as a spouse to share your concerns and what you noticed.
  • Be prepared to describe what real world challenges he faces with his symptoms. Does he struggle to get things done? Are there lots of unfinished projects at home? Does he frequently get into accidents? Does he have mood instability? Does he struggle with things like finances or work? Etc. The three main areas you want to expore are work, school, and personal life.
  • You can also have him complete and bring in various self-report measures that are available, including the SSRS. You can find a couple of standardized rating forms here: ADHD Self-Report Rating Forms

All in all, be patient with the process. Most providers are slow to give official diagnoses until they’ve met with someone for at least a couple of times. In my experience providers are more hesitant with ADHD diagnoses as well. I do like the center that offers evaluation and coaching, though, and they seem like they would be better equipped.

Good luck to you both!

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It is really intriguing. But after doing some research it doesn’t seem to be a place we want to start. The neurofeedback sessions are 3x a week from home with a whole like… Setup. The more we learned the more daunting and less supported it sounded.

The main feeling we got after talking to them now is that it’s more about the doctors own scientific curiosity and project of peddling this treatment than about my husband’s well-being. She kind of wrote off therapy and medication before even making an appointment. The more we talked to her the more uncomfortable we were.

Thank you so much for all of these. We just got his IEPs from school. It was heartbreaking to read. They kept mentioning all of his ADHD symptoms, but then just saying he needed to try harder. I’m so glad we have that information to give to the doctor. Thank you for suggesting it.

As for writing down symptoms, he’s so afraid of like… Rigging the test. I’m going to show him your post later and hope it helps to encourage him to just write down symptoms. We’ve done some self evaluations and He’ll be unsure what “counts” or unable to remember the things that apply to the question. Which from what I understand is probably part of his ADHD. Just for an example, the question might be “Do you skip meals or forget to eat?” And he will say “I don’t skip meals, I just eat when I’m hungry” When the reality is just that day before he looked up from his computer at 8pm cranky and hungry. And I ask him when he last ate and he says he hadn’t yet today. And that happens most days that he isn’t specifically reminded to eat or meals aren’t built into the day. I’m hoping writing down examples will help.

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They would certainly make me uncomfortable, too. I think you made a good call on that.

According to longtime ADHD researcher Dr. Russell Barkley, up to 90% of people with ADHD respond to one or more of the ADHD medications, and 50% of those who respond can be “normalized” by the medication. He and other ADHD medical & psychology professionals also advocate coaching (ADHD coach, life coach, career coach).

Since 80% of people with ADHD also have at least one co-morbidity, treatment for the co-morbidity/ies may be needed as well.

I’m convinced that a good treatment plan should be a combination of medication (if it works for the person), coaching, and therapy (when needed).
Of course, it can only help to do of learning (books, videos, podcasts, forums).


I’m disappointed that adult ADHD coaching is so hard to find in my area (if you’re not a student at one of the two universities or on public assistance). I’m beginning to consider online coaching.

  • I think I might like to be an ADHD Coach someday, but I am nowhere near capable of doing so at this point in my life.
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John -

I encourage you!

When my son was a child, and then teenager/young adult, he benefited greatly from coaching (in addition to meds). My wife and I are convinced that without coaching, to help him develop understanding, strategies, and self-confidence, he would not have been as successful in life as he has been.

As I have posted here before, from his initial aspiration to become an auto mechanic (absolutely nothing wrong with that) he came to the realization that he was not “stupid” (something which he called himself numerous times growing up) and went on to college and works now as an electrical engineer. It just so happened, that his coach was a woman who had a professional evaluation services for children and adults with respect to ADHD. And perhaps very beneficial she too was a :brain: . . . As was her husband.

And of course Dr. Ed Hallowell is a :brain: too! You are in good company.

Barry
:sunglasses:

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Thanks Barry!

I’m not likely to pursue being an ADHD coach anytime soon, but it’s definitely on my list of “things is like to do”.

(I feel like you’re trying to guess what my first name is. You called me “Josh” once, and now “John”. You still haven’t guessed it. :sunglasses:)

JD
:smile:

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James? Jeremy? Jacob? Julius? Jared? Jack? Julian?

:sunglasses:

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Uses a Name Dictionary and copies and pastes lol

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It might be one of those, or it might not be… (I’m just going to stick with “JD” and my air of mystery for now :wink:)

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So there’s hope . . . even if not now . . . but then only you can determine when!

:sunglasses:

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