Damon G. LaBarbera, PhD

Damon LaBarbera, PhD, Licensed Psychologist

Nov 30, 2023
Not infrequently, I get calls from people wanting an ADHD evaluation. These tests are targeted to a single diagnosis or are not particularly helpful.

ADHD is a very real disorder, and medication and therapy can control symptoms,  but it is, in my opinion, sloppily diagnosed.  Most commonly, comorbid diagnoses are overlooked, or other disorders that affect attention are overlooked. Partly, it is the way ADHD is often tested.  A person who suspects they have ADHD will call for "an ADHD evaluation." The resulting evaluation is, from the start, targeted to a single disorder rather than a full evaluation.  When it turns out the attentional problem is really due to anxiety, or hypomania, or some thought irregularity, the client or referral source may be disappointed.  They have come to get their ADHD diagnosis corroborated, and if the psychologist avers that the problem is due to a myriad of other possible disorders, their treatment with their provider is stymied. I corresponded for a while with Kieth Connors, who developed the idea of ADHD in this country as well as many of the tests popularly used. He suggested that ADHD now is vastly overdiagnosed--this coming from the person who worked to get the notion of ADHD accepted in the scientific community.  Another problem with testing is that people with attentional issues of one sort or another will score high enough on the ADHD tests to justify a diagnosis. These reports can be churned out by the industrious psychologist. But if treated only for ADHD, their level of functioning is always a tad lower than it could be otherwise, had they been treated for the correct diagnosis.  Treatment for ADHD may enhance functioning somewhat but there is always a gap between their functioning performance and their potential.  Probably the tendency of some testers to know only a few diagnoses lies at the root of the problem. Without a background in inpatient care, or outpatient care, different ages, experience with neurological problems, and a diverse population, there is a lack of variegation in the diagnostician's menu of diagnosis. The saying, "if all you have is a hammer, everything is a nail," really holds true.