What actually happens in an ADHD assessment

People arrive at assessments expecting a test with a pass mark. It is closer to a long, structured conversation in which a specialist is continually weighing one explanation against several others.

Before the appointment

You complete validated screening questionnaires. These do not decide anything — they focus the appointment, so that your time with the consultant is spent on the parts that need clinical judgement rather than on box-ticking.

Where possible you are also asked for input from someone who knew you as a child. A parent, an older sibling, or old school reports. If none of that is available, say so; many adults are assessed without a childhood informant, and a good clinician will tell you honestly how that affects confidence in the conclusion.

During the appointment

• Current difficulties across every domain — work, study, home, relationships, money, sleep
• Developmental history, because ADHD is by definition present from childhood
• Physical health, medication and family history
• Systematic consideration of what else could account for the picture

That last point is the part that separates a real assessment from a checklist. Anxiety, depression, trauma, autism, sleep disorders and thyroid dysfunction all produce overlapping symptoms, and several commonly co-occur with ADHD rather than replacing it.

Afterwards

You should receive a clear diagnostic opinion, the reasoning behind it, and a written report. The report matters more than people realise: it is what a GP needs in order to consider shared care, and what an employer or university needs in order to put adjustments in place.

If a service offers a diagnosis without a developmental history, or without addressing what else it might be, that is worth questioning before you book.