What to Expect at an ADHD Assessment in Australia

An ADHD assessment is a structured clinical evaluation — not a simple questionnaire or brain scan. The AADPA Clinical Practice Guideline recommends a comprehensive, multimodal assessment that typically takes 1-3 hours across one or more sessions.

There's no single "ADHD test." Diagnosis is based on clinical judgement using multiple sources of information. This is true whether you're assessed by a psychiatrist, psychologist, or trained GP.

• The assessment process is designed to answer three questions:
• Do your symptoms meet DSM-5 criteria for ADHD?
• Were symptoms present before age 12 (even if not recognised at the time)?
• Are symptoms better explained by another condition?

A thorough ADHD assessment typically includes:

1. Detailed clinical interview (30-60 minutes) The clinician will ask about your current symptoms, how they affect your daily life, work, and relationships. They'll explore specific examples — not just whether you're "forgetful" but how forgetfulness manifests in your life (missing deadlines, losing belongings, forgetting appointments).

2. Developmental history (15-30 minutes) Symptoms must have been present before age 12 (though you may not have been aware of them at the time). The clinician will ask about childhood behaviour, school performance, peer relationships, and family dynamics. For adults, this often involves retrospective recall — the clinician will help you reconstruct your childhood experiences.

3. Standardised rating scales (10-20 minutes) Questionnaires that measure ADHD symptom severity. You may be asked to complete these before the appointment.

4. Differential diagnosis The clinician will rule out other conditions that can mimic ADHD symptoms: anxiety disorders, depression, sleep disorders, thyroid dysfunction, autism spectrum disorder, bipolar disorder, and trauma. Many of these conditions can coexist with ADHD — approximately 80% of adults with ADHD have at least one comorbid mental health condition.

5. Collateral information (if available) Some clinicians request school reports, or ask a family member or partner to complete a rating scale about your behaviour. This provides an external perspective that can strengthen the assessment.

6. Functional assessment How symptoms impact your work, relationships, education, finances, and daily functioning. ADHD is diagnosed when symptoms cause significant impairment — having some inattentive traits without functional impact doesn't meet the diagnostic threshold.

For an adult ADHD diagnosis, the clinician uses the DSM-5 criteria:

• Inattentive symptoms** (5+ required for adults):
• Fails to give close attention to details / makes careless mistakes
• Difficulty sustaining attention in tasks
• Does not seem to listen when spoken to directly
• Does not follow through on instructions / fails to finish tasks
• Difficulty organising tasks and activities
• Avoids tasks requiring sustained mental effort
• Loses things necessary for tasks
• Easily distracted by extraneous stimuli
• Forgetful in daily activities

• Hyperactive-impulsive symptoms** (5+ required for adults):
• Fidgets or squirms
• Leaves seat when remaining seated is expected
• Runs or climbs inappropriately (in adults: feelings of restlessness)
• Unable to play or engage in activities quietly
• "On the go" or "driven by a motor"
• Talks excessively
• Blurts out answers before questions are completed
• Difficulty waiting turn
• Interrupts or intrudes on others

You need 5+ symptoms in at least one category (inattention or hyperactivity-impulsivity), present before age 12, causing impairment in 2+ settings, and not better explained by another disorder.

Three presentations: Combined (both categories), Predominantly Inattentive, or Predominantly Hyperactive-Impulsive. Women are more commonly diagnosed with the inattentive presentation.

Clinicians use various validated tools during an ADHD assessment. The most common in Australian practice include:

• DIVA 5.0 (Diagnostic Interview for ADHD in Adults) — a structured interview that walks through DSM-5 criteria with concrete examples. Widely used and well-regarded for adult assessment.
• Conners Adult ADHD Rating Scales (CAARS) — self-report and observer-report questionnaires measuring symptom severity
• ASRS (Adult ADHD Self-Report Scale, WHO) — a screening tool often used as part of a broader assessment
• WURS (Wender Utah Rating Scale) — retrospective assessment of childhood ADHD symptoms
• QB Test — a computerised test measuring attention, impulsivity, and motor activity over 15-20 minutes
• TOVA (Test of Variables of Attention) — another computerised continuous performance test

No single tool is sufficient for diagnosis. The AADPA guideline recommends using multiple sources of information. Computerised tests like QB Test or TOVA can support diagnosis but are not required and cannot diagnose ADHD on their own.

Preparing for your assessment makes it more thorough and efficient:

• Essential:**
• GP referral letter — needed for Medicare rebates
• Photo ID and Medicare card
• Completed pre-assessment questionnaires — many clinicians send these before the appointment

• Very helpful:**
• School reports — primary and secondary school reports are extremely valuable, especially comments about behaviour, attention, effort, and "not working to potential"
• Any previous psychological or psychiatric assessments
• A list of your current symptoms — specific examples of how they affect work, relationships, and daily life are more useful than abstract descriptions

• Helpful if available:**
• A family member or partner (in person or available by phone) — they can provide collateral information about your behaviour
• Work performance reviews — these can document attention and organisational difficulties
• Medication history — any current or past psychiatric medications

If you don't have school reports, don't worry. Many adults don't, and clinicians are experienced at working with incomplete information. The assessment can still be thorough without them.

If you receive an ADHD diagnosis, the clinician will typically discuss:

• Treatment options — medication, therapy, coaching, or a combination. The AADPA guideline recommends a multimodal approach combining medication with psychosocial support.
• Medication — if appropriate, a psychiatrist or paediatrician can prescribe immediately. A psychologist will need to refer you to a prescriber. In QLD and SA, a trained GP can also prescribe.
• Titration plan — medication is started at a low dose and gradually increased over 4-8 weeks to find the optimal dose
• Follow-up schedule — regular reviews to monitor treatment effectiveness, typically monthly during titration then every 3-6 months once stable
• Practical strategies — approaches for managing ADHD symptoms in daily life
• Further referrals — to psychologists for ADHD-specific CBT, occupational therapists, or ADHD coaches

If you're not diagnosed with ADHD, the clinician should explain what they found instead and suggest appropriate next steps. A negative result doesn't mean your difficulties aren't real — it means they may have a different cause (anxiety, depression, sleep disorder, autism, or another condition). You're entitled to seek a second opinion if you disagree with the assessment.