I’m two minutes in and close to tears. Thank you. Undiagnosed adhd poured out into every other aspect of my life in the form of feelings of inadequacy and self hatred. When I finally paid the 1000 USD copay to get tested since I was struggling in school, I passed these tests with flying colours and instead got a diagnosis for anxiety, was recommended for therapy, and was given antidepressants. As an Asian woman trained from a young age to cram for tests people kept telling me I was just seeking attention and I felt like my struggles were invisible. I fought with adhd my whole life and it took me an extra year to graduate college. It wasn’t until a year ago that I finally advocated enough for myself and got a diagnosis. It has been life changing for me.
Sorry you had to go through that experience. Many clinicians do testing in the sincere belief that it can be diagnostic because that is what they were taught but i5 is not.
So glad you finally received a correct diagnosis. I was diagnosed as an adult. When I had to change insurance companies, I went to 3 different psychiatrists who in the initial visit, challenged my diagnosis and wanted to take me off of my stimulant Rx which was/is very helpful. I knew that they didn’t even know me. I finally called up the new insurance co. and they found someone for me that turned out to be vastly more educated about ADHD. It was such a relief.
I passed those tests with good scores as well. Only working memory part was under the average. For me it was confusing even when I took the test because it looked more like an IQ test for me, but I've always been good in such exercises. Thankfully I eventually got my diagnosis, but it was so frustrating when they told I can't have ADHD because I got good scores.
I have very intelligent friends who’ve been denied diagnoses their whole lives because of these tests. Thank you so much for this video. I think when women in particular show ADHD symptoms as more inattentive instead of hyperactive, the ADHD diagnosis is a lot less pursued. People love to berate others, particularly women, on their “moral failings”. I’ve spread your research/content around my friend group like a virus, and all of us are really turning our lives/conditions around. Thanks again! PS, the fact that I always watch all the way through your videos, without you dumbing them down or making them “flashy”, is a testament to your fantastic presentation skills, not to mention faith in your audience.
My pleasure, thank you. The word does need to get out about this as thousands of times every week adults with ADHD may be denied protections and entitlements on the basis of flawed tests.
@@lambs5258After losing sickness benefits from a back injury because I was masking pain well and had a good day. I'll never trust a 'screening' diagnosis again. Find out what the answers should be and fill them in or work out what you're masking. This only helps if you know what might have though so is crap for much of society
I went through neuropsych testing seeking an ADHD diagnosis and was essentially told I'm too smart to have ADHD, especially considering I have a master's degree and performed well in school. But I performed well in school, because I'm deadline driven and I perform well under pressure. Of course I performed well on the neuropsych testing! It's a test! I'm still trying to get my diagnosis, but I'm hopeful that my daughter's recent diagnosis will help my case as well. She's basically my clone.
This is exactly my story! My daughter was diagnosed years ago, and my sister was also diagnosed recently. I received one diagnosis of anxiety and sleep disorder after NP testing. Now I'm seeking a second opinion and was told I can't get a diagnosis without NP testing. It's so frustrating!!!
Might it be ADD (vs. ADHD) you have then, since you are saying you did well in school & were able to meet deadlines? Asking because there are some experts who say that hyperfocus can be a feature of ADD. But it is very counterintuitive and difficult to make sense of how that could fit w/ADD (at least to me and some 2nd opinion psychiatrists I spoke with)....
I received pretty average results in those tests, and good results in the memory tests. However, I still received an ADHD diagnosis recently at my age of 35. I have been struggling to accept the diagnosis because I dont want to claim something I might not be, but I can say that your videos are helping me to see the different manifestations of it. I have serious executive functioning issues, always have, and I struggle deeply with emotional regulation. I thank you for giving us this commentary and your continued passion to educating the world about ADHD, an often misunderstood disorder.
Just took my test. This is super interesting and I could totally see it. I was hyperfocused during the test, I’m sure I did well, but my executive functioning is fucked up. This is great research and mirrors my subjective experience well. We’ll see what my results are.
Thank you Dr Barkley. I have just been through this circus - Bender Gestalt, Digit Span, etc etc. I show as having some "ADHD traits" but I did very well on the tests. So, the psychologist diagnosed anxiety and mood disorder. Yet, when I've completed ADHD Executive Function ratings scales I solidly present with ADHD. My family has looked at the ratings scales and say "yep, that's you - you have ADHD. No surprise there." I am working with a different therapist who is not so hide-bound and who feels the last psychologist was way over-testing. But, since that's ALL HE DOES in semi-retirement, if he doesn't keep administering these expensive test protocols he's losing income. Therefore he has no impetus to change. I'm sharing this video with my new psychologist.
Thank you for this video. I've been seeing a therapist who identified (correctly, I and my family and friends believe), that I am an adult with undiagnosed ADHD and that's why I've been struggling to get my life together for so many years. I go to see one of the psychiatrists at that same mental health group, and she tells me that the Creyos cognitive functioning test I took for memory and attention is an objective way to test for ADHD and that I do not have it since I scored average on the test. According to her, I have anxiety and am so overwhelmed that I just don't want to do anything. I have had more intense anxiety before (been diagnosed and treated for a difficult period of my life), and it does not feel or present like this. This caused a lot of heartache on my part, thinking do I even know my own self? I did some research into it, discovering that there is no single test that can diagnose ADHD and found your video. Just wanted to say thanks for getting this out there and that it is still helping people.
In France, neuropsych testing for ADHD and ASD diagnoses is still pushed somewhat heavily, not as a strict requirement but probably for economic and logistic reasons. It's hard to get a psychiatrist or neurologist appointment (which are fully or partly reimbursed by national health insurance), and it's easy to get an appointment with a neuropsychologist (which are often private practice and not covered by national health insurance). Doctors are the only ones who can actually diagnose and prescribe, but they’re overbooked and not looking for patients. Neuropsychologists are looking for patients and they are advertising (not heavily, but comparatively more than doctors). So when people look for how to get an ADHD or ASD diagnosis, they find neuropsychologists, end up paying €300-€600 for tests, only to be told at the end that they need to get an appointment with a doctor. I wouldn't go as far as calling it a scam, but I question the ethics of having people pay 1 or 2 weeks of salary out of pocket for tests which do not constitute a diagnosis and do not give people any access to medication or disability rights, without first telling them that those tests do not constitute a diagnosis and they will still need to see a doctor for a clinical diagnosis anyway.
Sir you are wonderful. I am a medical professional have my DPT and it was hell to get it. I learned how to cram at a very early age and could never pay attention in school or on tasks that required lists and would always make careless mistakes. When I took neuropsych testing I was told I was too smart and my problem solving abilities were too high. Yet I struggled in math, and would have to repeat things in my head multiple times just to remember. Got evaluated by an expert and received my diagnosis. I am now thriving and feel like I’m finally the person I’m supposed to be. Neuropsych testing is useless when it comes to diagnosis ADHD, and for those with high IQ it is so easy to power through those because when when under high stress, those of us with ADHD tend to function better. Thank you sir!
I got a referral for neuropsych testing ! My mind races a lot and it’s hard to concentrate. I also have trouble remembering things or I get confused with things
I saw a psychiatrist that did his residency at Riley Children’s hospital and spent most of his career working with kids who have ADHD and now he works with adults helping them, so I would just make sure it’s someone that has a lot of experience working mostly with the ADHD population and knows what it looks like. Can always get a second opinion too if you don’t agree with neuropsych results.
It's difficult to even find a psychiatrist to treat you these days, never mind one with ADHD expertise. I've been meeting with a therapist regularly for 18 months. It took me more than a year to find a psychiatric nurse practioner that took my insurance and was accepting new patients. They both believe I show all the signs of undiagnosed ADHD, and I've seen some slight symptom improvements from Stratera. Also my daughter was diagnosed as a child and my sister was just diagnosed a few years ago. My mother and my grandmother both displayed signs of undiagnosed ADHD, so there is family history as well. I'm told I need another neuro-psych evaluation to be given an official diagnosis and stimulant meds. I already had testing done a little less than a year ago and was told by someone who saw me for an hour over zoom before the test that I couldn't have ADHD because I passed the tests. So there is a good chance either my insurance won't pay for more tests or I will pass them again.
THANK YOU!! My daughter had good scores in the tests. She found them fun and as a game. And yes she has pretty high iq. But she still struggles a lot in life, and is NOT performing at any where near her giftedness in school or life and is struggling in ways that make me wonder how she will cope in adult life when we parents doesn't smooths things over and help her with the daily life tasks. (Getting into and out of bed at time, managing her practical stuff etc.) I hope they still see the big picture and give her the diagnosis, because she needs help.
I passed the Conners Test with flying colors, even though I impulsively pressed the space bar nearly every time an X showed up on the screen. Took the TOVA test today and quit after 15 seconds. I would have to be severely mentally impaired to not pass that test. It was the easiest test I’ve ever taken. None of these tests had anything to do with my executive functioning issues.
I'm gradually learning that the testing I did involved the Conners Test and learning that I spent money on a test that doesn't test for what I believe I have is pretty frustrating (even if I got a discounted rate due to sliding scale payments).
Executive functioning can be assessed across settings using measures like the BRIEF2. But situational testing, while not diagnostic, can reveal the degree of impairment experienced in auditory working memory, for example, that is so pervasive that it appears in the novel testing setting. Especially in school, these measures determine the types of accommodations needed. In ADHD and SLD, one size does not fit all.
I'm pleased to say that as a clinical psychologist who assesses ADHD in adults in New Zealand, I'm not aware of anyone here using neuropsyc testing as part of ADHD assessment.
France looks like a mixed bag. Out of 3 neurologists I either saw or heard of recently in my region: one dismissed the very idea of adult ADHD and sent a friend away; one did an assessment without neuropsyc testing; one did an assessment with neuropsyc testing but still diagnosed ADHD based on the rating scales and clinical interview, not based on the inconclusive neuropsych testing results.
@@fvsch Here in NZ a neurologist wouldn't even attempt an ADHD assessment. They'd send a person to a psychiatrist. You'd think after doing a few neuropsycs they would realise they were pretty useless for ADHD. Either that of they'd do a lot of false negative diagnoses and cultivate the idea that ADHD is a rare disorder and lots of people think they have it when they don't, when it's actually pretty well the opposite for both.
I'm in Australia and had to do the WAIS and TOVA. Just received my report today and diagnosis was declined on that basis even though Conners report was markedly atypical. Not sure what to do from here...
@@gwannandale9632 Can you find an ADHD patients association (some are primarily focused on parents of kids with ADHD, but still know a thing or two about adult ADHD)? They might know which providers don't rely on neuropsychological testing, or give advice on how to talk to the providers you saw.
Accommodations for ADHD, especially in high school and college, can make or break so much for a student, impacting their GPA, which leads to college entry, which leads to grad school, etc etc. I am so grateful that I didn't "pass" the neuropsych eval I was required to take for extra time on tests in college. I ended up with just a little over a 3.2, enough to get into grad school 20 years later, where I eventually graduated w/ a MA in CMHC with a 4.0 (no tests, only writing/counseling skills-based, which is why I did so well). Now a mental health clinician and mother of three who all qualified for the ADHD diagnosis, I don't know how to say it more clearly than this: diagnosis should not come down to these stupid tests. They may capture some information, for some, but they aren't the definitive answers coming down from Mt. Olympus. Far too much faith is put into them.
I got above average on all the executive functioning tests, but always felt the reason i did well on those tests was because they were fairly short and felt like games, because there are games like them which I had played previously, where I had learned 'strategies' to do well in those specific games. So there was a level of competitiveness that motivated me as well. Yet, the only way for me to study "properly" back then was to set an alarm for the middle of the night, force myself to get up, then start reading and writing notes. Because it was considerably easier to fight against a mind who's single distracting voice was "i want sleep" than multiple, in normal waking state, that was pulling me in all directions all at once. Fortunately, I still received the diagnosis, and got on meds... The difference was insane. I remember trying to learn piano pieces, how frustrated i got to the point i started hitting myself, because I failed so badly at focusing and how long it took me to memorize a single line. But now, now I can go through a whole page in the same time it took me to get through a single line.
@@walidsarwary7626 It was various tests selected as standard tests at the place i took them, they may use different ones wherever you're at. Some of them were such as 'towers of hanoi' 'trail making test' 'wcst' and so on, you can google executive function tests and read if you want. Other than that, it was visual and auditory memory tests, language tests, etc.
I agree. They are not necessary for the actual diagnosis in the vast majority of cases. HOWEVER, many times ADHD comes along with associated cognitive weaknesses and, especially in children, clarifying and quantifying what those weaknesses can be very helpful. Especially if those weaknesses are not ones that tend to get better with medication, such as processing speed, learning efficiency, and organization.
I'm still upset that the neuropsych clinic my adult daughter went to years ago told her she didn't have executive dysfunction even though it was one of the main reasons she went in for an eval. My autistic daughter is in the "very superior" IQ range, and her strong suit is verbal skills. Part of the Delis-Kaplan test looks at verbal fluency, and she was asked to name animals (her special interest), so she got a 99.9% on parts of that test. They also gave her an inventory to fill out about her executive functioning skills, but downplayed it in favor of the neuropsych testing they did. Oh and their computer test to look for ADHD said she didn't have it. Fast forward a few years, and she now has an ADHD diagnosis as do I and all of my other kids.
Thank you for this, I have received a negative diagnosis last week despite most of my adult behavior pointing towards ADHD based on: - i couldn't recall enough early childhood memories of adhd behavior as a child - i wasnt hyperactive/disruptive as a child and called out for it in school - i performed well on the cognitive IQ tests (even though my IQ is tested at 128 and i'm an experienced gamer who excels under timed challenges) Currently completely clueless at what to do.
What about that new "eye movement impulsivity test" that is described as really reliable due to impulsive and uncontrollable eye movements people with ADHD "seemingly" have? I always wondered about that one and because it's accuracy got pushed so hard, seemingly, from what I know.
The tradition of psychometric testing is believed to have originated earlier lasts century over there. Regardless, many professionals there, as here, believe that objective tests are better than interviews and rating scales for assessing psychological symptoms despite the limited evidence for doing so for many abilities apart from IQ, achievement skills, and a few others.
Dr. Barkley, would you mind please helping your viewers understand what exactly is a "neuropsychological test?" In layman's terms, what do these tests look like, what kinds of questions are being asked or what kinds of activities are clients instructed to complete? Thank you.
In the NP testing I was given, I was given a list of words to recall over and over again, number sequences to recall, pattern sketches to draw from memory, patterns to replicate using blocks, and a computer test to measure reactions to visual cues. I scored average to high average on all of the tests except the reaction one and was told I couldn't have ADHD. If you are even remotely good at pattern recognition, you will pass these tests.
No. Pattern recognition is a right parietal function. I would expect someone with ADHD to do fine on visuospatial tasks, generally, except perhaps if fluid reasoning is involved IF the deficit can be explained by trouble with the frontal lobes ability to inhibit intrusive thoughts. Yoy caneasire this with certain measures. Or, right orbito frontal dysfunction may result in mood lability which could interfere.
Wrong answer. The TOVA is a superior CPT,better than the Connors. But no CPT alone can dx ADHD. An examiner needs to observe bx, look at hx, record what is told by the client and informants, and ascertain how well this aligns with objective measures whilst ruling out other conditions. This is thorough and considered. Asking someone who thinks they have ADHD to fill out questions aski g about trouble with inattention,amd then getti g a positive response, shouldnt be shocking. Its a lazy analysis and why many of my physician friends laugh at our field. And also why there is a massive rise. Barkley is promoting his product and citing his research.
There are no tests for diagnosing ADHD. But a clinician should do a brief IQ test and brief screening of academic skills to see if intellectual disability or learning disorders could be comorbid conditions. The latter occur in a substantial minority of cases.
@@htspencer9084 interestingly high IQ can exist with or without ADHD. However, even if the person has a high IQ, they may have a slower processing speed or poor working memory. Ultimately If the ADHD is not addressed, a high IQ would be like a Ferrari without gas.
@@priyabriggs659no, totally not. But you just skip all formal education. You can still learn programming etc. on yourself. Its just that adhd also affects other parts of your life. So you might get problems by taking too much risks etc.
Is there already a general idea or consensus about examining work/life related impairments or testing of things like organisational skills? Because from my point of view it's downright malicious and sadistic to let people run through batteries, they pass the test, are being told they're ok and then try to work just to fail over and over again like I did? I tried to study twice, am now severely indebted, but couldn't learn certain things, and at some exams I was succesful on the 2nd try only I literally had to get help. I did several trainee ships over the year in different branches and profession but this anxiety of failure has never left me. I basically haven't earned a single penny in over 12 years because I either had to work as a trainee for free or because of unemployment and this feeling of insufficiency, not being like other people and basically damned to stay poor for the rest of my lifeeats my alive. While many of us get essentially get gaslighted for being lazy, careless, unmotivated, stupid - just to name a few things, unable to even prove our impairments. Imagine, when I bring topics up from your videos I watched my psychiatrist basically tells me things like "It can't be that bad" or "You don't punch people in the face or are aggressive" and "that's not part of the symptoms, you can't have it" - it's just devastating.
Im 14, i just started ny first session with my psychologue (i knew i had adhd since i was 10 but i thought i was acting out or sone shi,and i couldnt tell my parents bcs they were still not so open minded about seeing a psychologue and stuff, maybe it could have being diff if i told them at that age who knows?) ive being strugglin alot in school, to memorize or pay attention ive being dealing with this almost 3years now, making alot if efforts just to end up gettng an horrible grade. 2 weeks now i went to a psychiatrist who told me i should see a psychologue who will explain my behaviors more, yesterday was my first session with that psychologue, from what we were saying i conclude that i actually have more than adhd, i was planning about only telling her about my behavior who might be related to adhd, and anger issues but she was asking me too much stuff that i ended up opening up about other stuff a bit tooo much(about dezrealisation,emptiness,mood swings,my personality changes alot), i still have two sessions where i will have to tell her about everything (idk if i can trust her) to be ready for the neurological assessment, i dont feel okay since last session idk why , i should feel good bcs im going to get better? But i just have that voice saying "what if u dont have adhd?" "I hate being diagnosed with mental issues" i got that absurd feeling idk how to explain, should i do that neurological assessment or not? Maybe ill just be wasting money but i will feel so bad if i dont, it will keep ruining my life! I mean m still positive abt it ngl but i just dont know
One question:Did i Unterstand correctly that the tests don't work in children and adults or just in adults as you seem to imply in the end? Ps: Thank you for your ongoing work
Okay sorry for the dumb question but is this about those tests where you have to press a button when a certain thing happens like a shape comes up on a screen? I strongly suspect I have ADHD, teachers recommend I get tested because of my behavior as a child, but it was ruled out due to a set of those computer attention tests coming back “normal”
What should a parent do if a school is requiring evals for a child and want neurological testing? What should we watch out for to avoid misdiagnosis or under diagnosis of adhd ?
write to my email address and I can send you an article on which this video is based that you can share with the school so they can learn that testing is not useful.
At least a neuropsych test is better than a questionairre test it's the quesstionairre test's that are inaccurate, I believe to properly diagnose ADD/ADHD the clinician should use neuropsych assesments and brain scans as well as questioairre tests.
Have you considered that maybe its the diagnostic criteria is wrong? Scales dont objectively measure executive functioning. By your own admission, ADHD is a disprder of executive functioning. A behavior presenting as executive dysfunction is not the same as having executive dysfunction. If we can actually measure, objectively, a construct, then why say it is inaccurate? Your standard is the criteria. Yet, what is it based on. In the EU, they usea more rigid criteria. The influence of big pharma is also absent. As with other neurocogntive disprders, developme tal disprders need to show discrepencies. Certainly, not all executive dysfunction is due to ADHD,but you fail to not thatthe DSM states these other conditons (mood disorder, intellectual delay, ect.) need to be ruled out.
TLDR: I'm sure it's not going to be the most accurate factual response but I'll try to explain Russell's arguments to the best of my ability in this and the next comment It seems like you didn't watch the video, he does address most if not al your "questions" in it!! It's all about comparing the effectiveness of the diagnostic criteria and the EF tests to help identify ADHD individuals. The criteria was really accurate with up to 98% success rate, meanwhile the testing was absurdly inaccurate identifying at best 50%, basically useless data
The long response: -Have you considered the diagnostic criteria is wrong? This is one of the main topics of the video, he compares the results of both the criteria and the tests with the people actually accepted to be diagnosed with ADHD. From this he concludes that the criteria is way more accurate at identifying the ADHD individuals, that's a big portion of the video and the point of the graphs, please rewatch and actually pay attention to the information given -If we can measure it, why say it's inaccurate? Because it is??? Again, the research presented shows people accepted to have ADHD taking this tests where the results produce too many false negatives, which means, the testing is too inaccurate and doesn't give us any valuable information about the individual in terms of ADHD -What is the standard criteria based on and why is it the standard? The criteria is based on research and real life results!! Again, if you paid attention to the studies, the criteria identifies ADHD individuals with insanely greater accuracy, up to 98% accuracy!! that's an actually objective way to measure EF problems and help diagnose ADHD!! -BIG FARMA!!! simple nonsense unrelated to this conversation -Fail to say other conditions need to be ruled out according to DSM He does acknowledge there are multiple other conditions that affect EF but it isn't the main purpose of this video so he doesn't go in much depth but I insist he mentions it Finally, you seem to be biased one here, discrediting all he says by asking questions he addresses on the video itself!! you're acting in bad faith or can't understand simple logic, either way please rewatch the video and try to comprehend it and PLEASE check your spelling next time lil bro
![Breast Cancer Tx.2 by Dr. Hussein Khairy [30.Part1]](http://i.ytimg.com/vi/m_PTina8co8/mqdefault.jpg)
I’m two minutes in and close to tears. Thank you. Undiagnosed adhd poured out into every other aspect of my life in the form of feelings of inadequacy and self hatred. When I finally paid the 1000 USD copay to get tested since I was struggling in school, I passed these tests with flying colours and instead got a diagnosis for anxiety, was recommended for therapy, and was given antidepressants. As an Asian woman trained from a young age to cram for tests people kept telling me I was just seeking attention and I felt like my struggles were invisible. I fought with adhd my whole life and it took me an extra year to graduate college. It wasn’t until a year ago that I finally advocated enough for myself and got a diagnosis. It has been life changing for me.
So glad your story has a (hopefully?) happy ending and good job on your part! Cheers and hope the good things keep coming
Sorry you had to go through that experience. Many clinicians do testing in the sincere belief that it can be diagnostic because that is what they were taught but i5 is not.
@@Chizuru94as
So glad you finally received a correct diagnosis. I was diagnosed as an adult. When I had to change insurance companies, I went to 3 different psychiatrists who in the initial visit, challenged my diagnosis and wanted to take me off of my stimulant Rx which was/is very helpful. I knew that they didn’t even know me. I finally called up the new insurance co. and they found someone for me that turned out to be vastly more educated about ADHD. It was such a relief.
I passed those tests with good scores as well. Only working memory part was under the average. For me it was confusing even when I took the test because it looked more like an IQ test for me, but I've always been good in such exercises. Thankfully I eventually got my diagnosis, but it was so frustrating when they told I can't have ADHD because I got good scores.
Russ, the ADHD World Wide Community would be in a precarious and greatly distressed situation if not for your life’s work. Thank you. 🇦🇺👴🏻
I have very intelligent friends who’ve been denied diagnoses their whole lives because of these tests. Thank you so much for this video.
I think when women in particular show ADHD symptoms as more inattentive instead of hyperactive, the ADHD diagnosis is a lot less pursued. People love to berate others, particularly women, on their “moral failings”.
I’ve spread your research/content around my friend group like a virus, and all of us are really turning our lives/conditions around. Thanks again!
PS, the fact that I always watch all the way through your videos, without you dumbing them down or making them “flashy”, is a testament to your fantastic presentation skills, not to mention faith in your audience.
My pleasure, thank you. The word does need to get out about this as thousands of times every week adults with ADHD may be denied protections and entitlements on the basis of flawed tests.
@@lambs5258After losing sickness benefits from a back injury because I was masking pain well and had a good day. I'll never trust a 'screening' diagnosis again. Find out what the answers should be and fill them in or work out what you're masking. This only helps if you know what might have though so is crap for much of society
I went through neuropsych testing seeking an ADHD diagnosis and was essentially told I'm too smart to have ADHD, especially considering I have a master's degree and performed well in school. But I performed well in school, because I'm deadline driven and I perform well under pressure. Of course I performed well on the neuropsych testing! It's a test! I'm still trying to get my diagnosis, but I'm hopeful that my daughter's recent diagnosis will help my case as well. She's basically my clone.
hello, can you please name the test you were given what kind of test it was ?????
@@walidsarwary7626I'd like to know as well.
I literally just did testing today. I'm getting my doctorate right now and I'm worried. I have always had issues though.
This is exactly my story! My daughter was diagnosed years ago, and my sister was also diagnosed recently. I received one diagnosis of anxiety and sleep disorder after NP testing. Now I'm seeking a second opinion and was told I can't get a diagnosis without NP testing. It's so frustrating!!!
Might it be ADD (vs. ADHD) you have then, since you are saying you did well in school & were able to meet deadlines? Asking because there are some experts who say that hyperfocus can be a feature of ADD. But it is very counterintuitive and difficult to make sense of how that could fit w/ADD (at least to me and some 2nd opinion psychiatrists I spoke with)....
I received pretty average results in those tests, and good results in the memory tests. However, I still received an ADHD diagnosis recently at my age of 35. I have been struggling to accept the diagnosis because I dont want to claim something I might not be, but I can say that your videos are helping me to see the different manifestations of it. I have serious executive functioning issues, always have, and I struggle deeply with emotional regulation. I thank you for giving us this commentary and your continued passion to educating the world about ADHD, an often misunderstood disorder.
Just took my test. This is super interesting and I could totally see it. I was hyperfocused during the test, I’m sure I did well, but my executive functioning is fucked up. This is great research and mirrors my subjective experience well. We’ll see what my results are.
Thank you Dr Barkley. I have just been through this circus - Bender Gestalt, Digit Span, etc etc. I show as having some "ADHD traits" but I did very well on the tests. So, the psychologist diagnosed anxiety and mood disorder. Yet, when I've completed ADHD Executive Function ratings scales I solidly present with ADHD. My family has looked at the ratings scales and say "yep, that's you - you have ADHD. No surprise there." I am working with a different therapist who is not so hide-bound and who feels the last psychologist was way over-testing. But, since that's ALL HE DOES in semi-retirement, if he doesn't keep administering these expensive test protocols he's losing income. Therefore he has no impetus to change. I'm sharing this video with my new psychologist.
Thank you for this video. I've been seeing a therapist who identified (correctly, I and my family and friends believe), that I am an adult with undiagnosed ADHD and that's why I've been struggling to get my life together for so many years. I go to see one of the psychiatrists at that same mental health group, and she tells me that the Creyos cognitive functioning test I took for memory and attention is an objective way to test for ADHD and that I do not have it since I scored average on the test. According to her, I have anxiety and am so overwhelmed that I just don't want to do anything. I have had more intense anxiety before (been diagnosed and treated for a difficult period of my life), and it does not feel or present like this. This caused a lot of heartache on my part, thinking do I even know my own self? I did some research into it, discovering that there is no single test that can diagnose ADHD and found your video. Just wanted to say thanks for getting this out there and that it is still helping people.
In France, neuropsych testing for ADHD and ASD diagnoses is still pushed somewhat heavily, not as a strict requirement but probably for economic and logistic reasons. It's hard to get a psychiatrist or neurologist appointment (which are fully or partly reimbursed by national health insurance), and it's easy to get an appointment with a neuropsychologist (which are often private practice and not covered by national health insurance).
Doctors are the only ones who can actually diagnose and prescribe, but they’re overbooked and not looking for patients. Neuropsychologists are looking for patients and they are advertising (not heavily, but comparatively more than doctors).
So when people look for how to get an ADHD or ASD diagnosis, they find neuropsychologists, end up paying €300-€600 for tests, only to be told at the end that they need to get an appointment with a doctor.
I wouldn't go as far as calling it a scam, but I question the ethics of having people pay 1 or 2 weeks of salary out of pocket for tests which do not constitute a diagnosis and do not give people any access to medication or disability rights, without first telling them that those tests do not constitute a diagnosis and they will still need to see a doctor for a clinical diagnosis anyway.
And the neuropsych tests not being any good at screening ADHD only adds insult to the monetary injury.
I was going to schedule an appointment for a test with a neuropsychologist in Tahiti. You just saved me money. I hope you get as much but 100th fold.
I'll link people to this video when they ask me about neuropsy testing.
Thank you sir.
Thank you!
Sir you are wonderful. I am a medical professional have my DPT and it was hell to get it. I learned how to cram at a very early age and could never pay attention in school or on tasks that required lists and would always make careless mistakes. When I took neuropsych testing I was told I was too smart and my problem solving abilities were too high. Yet I struggled in math, and would have to repeat things in my head multiple times just to remember. Got evaluated by an expert and received my diagnosis. I am now thriving and feel like I’m finally the person I’m supposed to be. Neuropsych testing is useless when it comes to diagnosis ADHD, and for those with high IQ it is so easy to power through those because when when under high stress, those of us with ADHD tend to function better. Thank you sir!
Where did you go ? What kind of expert was it ?
I got a referral for neuropsych testing ! My mind races a lot and it’s hard to concentrate. I also have trouble remembering things or I get confused with things
I saw a psychiatrist that did his residency at Riley Children’s hospital and spent most of his career working with kids who have ADHD and now he works with adults helping them, so I would just make sure it’s someone that has a lot of experience working mostly with the ADHD population and knows what it looks like. Can always get a second opinion too if you don’t agree with neuropsych results.
It's difficult to even find a psychiatrist to treat you these days, never mind one with ADHD expertise. I've been meeting with a therapist regularly for 18 months. It took me more than a year to find a psychiatric nurse practioner that took my insurance and was accepting new patients. They both believe I show all the signs of undiagnosed ADHD, and I've seen some slight symptom improvements from Stratera. Also my daughter was diagnosed as a child and my sister was just diagnosed a few years ago. My mother and my grandmother both displayed signs of undiagnosed ADHD, so there is family history as well. I'm told I need another neuro-psych evaluation to be given an official diagnosis and stimulant meds. I already had testing done a little less than a year ago and was told by someone who saw me for an hour over zoom before the test that I couldn't have ADHD because I passed the tests. So there is a good chance either my insurance won't pay for more tests or I will pass them again.
THANK YOU!! My daughter had good scores in the tests. She found them fun and as a game. And yes she has pretty high iq. But she still struggles a lot in life, and is NOT performing at any where near her giftedness in school or life and is struggling in ways that make me wonder how she will cope in adult life when we parents doesn't smooths things over and help her with the daily life tasks. (Getting into and out of bed at time, managing her practical stuff etc.) I hope they still see the big picture and give her the diagnosis, because she needs help.
I passed the Conners Test with flying colors, even though I impulsively pressed the space bar nearly every time an X showed up on the screen.
Took the TOVA test today and quit after 15 seconds. I would have to be severely mentally impaired to not pass that test. It was the easiest test I’ve ever taken.
None of these tests had anything to do with my executive functioning issues.
I'm gradually learning that the testing I did involved the Conners Test and learning that I spent money on a test that doesn't test for what I believe I have is pretty frustrating (even if I got a discounted rate due to sliding scale payments).
I am so grateful for you Dr. Barkley. Blessings to you.
Executive functioning can be assessed across settings using measures like the BRIEF2. But situational testing, while not diagnostic, can reveal the degree of impairment experienced in auditory working memory, for example, that is so pervasive that it appears in the novel testing setting. Especially in school, these measures determine the types of accommodations needed. In ADHD and SLD, one size does not fit all.
I'm pleased to say that as a clinical psychologist who assesses ADHD in adults in New Zealand, I'm not aware of anyone here using neuropsyc testing as part of ADHD assessment.
France looks like a mixed bag. Out of 3 neurologists I either saw or heard of recently in my region: one dismissed the very idea of adult ADHD and sent a friend away; one did an assessment without neuropsyc testing; one did an assessment with neuropsyc testing but still diagnosed ADHD based on the rating scales and clinical interview, not based on the inconclusive neuropsych testing results.
@@fvsch Here in NZ a neurologist wouldn't even attempt an ADHD assessment. They'd send a person to a psychiatrist. You'd think after doing a few neuropsycs they would realise they were pretty useless for ADHD. Either that of they'd do a lot of false negative diagnoses and cultivate the idea that ADHD is a rare disorder and lots of people think they have it when they don't, when it's actually pretty well the opposite for both.
I'm in Australia and had to do the WAIS and TOVA. Just received my report today and diagnosis was declined on that basis even though Conners report was markedly atypical. Not sure what to do from here...
@@gwannandale9632 Can you find an ADHD patients association (some are primarily focused on parents of kids with ADHD, but still know a thing or two about adult ADHD)? They might know which providers don't rely on neuropsychological testing, or give advice on how to talk to the providers you saw.
@@fvschThanks, I'll try that.
Accommodations for ADHD, especially in high school and college, can make or break so much for a student, impacting their GPA, which leads to college entry, which leads to grad school, etc etc. I am so grateful that I didn't "pass" the neuropsych eval I was required to take for extra time on tests in college. I ended up with just a little over a 3.2, enough to get into grad school 20 years later, where I eventually graduated w/ a MA in CMHC with a 4.0 (no tests, only writing/counseling skills-based, which is why I did so well). Now a mental health clinician and mother of three who all qualified for the ADHD diagnosis, I don't know how to say it more clearly than this: diagnosis should not come down to these stupid tests. They may capture some information, for some, but they aren't the definitive answers coming down from Mt. Olympus. Far too much faith is put into them.
I got above average on all the executive functioning tests, but always felt the reason i did well on those tests was because they were fairly short and felt like games, because there are games like them which I had played previously, where I had learned 'strategies' to do well in those specific games. So there was a level of competitiveness that motivated me as well.
Yet, the only way for me to study "properly" back then was to set an alarm for the middle of the night, force myself to get up, then start reading and writing notes. Because it was considerably easier to fight against a mind who's single distracting voice was "i want sleep" than multiple, in normal waking state, that was pulling me in all directions all at once.
Fortunately, I still received the diagnosis, and got on meds... The difference was insane.
I remember trying to learn piano pieces, how frustrated i got to the point i started hitting myself, because I failed so badly at focusing and how long it took me to memorize a single line.
But now, now I can go through a whole page in the same time it took me to get through a single line.
what is the name of the test you were given , please it is very important for me to know cause i have a plan to give one too .
@@walidsarwary7626 It was various tests selected as standard tests at the place i took them, they may use different ones wherever you're at. Some of them were such as 'towers of hanoi' 'trail making test' 'wcst' and so on, you can google executive function tests and read if you want. Other than that, it was visual and auditory memory tests, language tests, etc.
I agree. They are not necessary for the actual diagnosis in the vast majority of cases. HOWEVER, many times ADHD comes along with associated cognitive weaknesses and, especially in children, clarifying and quantifying what those weaknesses can be very helpful. Especially if those weaknesses are not ones that tend to get better with medication, such as processing speed, learning efficiency, and organization.
Thanks, Dr. Barkley.
You are most welcome.
I'm still upset that the neuropsych clinic my adult daughter went to years ago told her she didn't have executive dysfunction even though it was one of the main reasons she went in for an eval. My autistic daughter is in the "very superior" IQ range, and her strong suit is verbal skills. Part of the Delis-Kaplan test looks at verbal fluency, and she was asked to name animals (her special interest), so she got a 99.9% on parts of that test. They also gave her an inventory to fill out about her executive functioning skills, but downplayed it in favor of the neuropsych testing they did. Oh and their computer test to look for ADHD said she didn't have it. Fast forward a few years, and she now has an ADHD diagnosis as do I and all of my other kids.
Thank you for this, I have received a negative diagnosis last week despite most of my adult behavior pointing towards ADHD based on:
- i couldn't recall enough early childhood memories of adhd behavior as a child
- i wasnt hyperactive/disruptive as a child and called out for it in school
- i performed well on the cognitive IQ tests (even though my IQ is tested at 128 and i'm an experienced gamer who excels under timed challenges)
Currently completely clueless at what to do.
What about that new "eye movement impulsivity test" that is described as really reliable due to impulsive and uncontrollable eye movements
people with ADHD "seemingly" have? I always wondered about that one and because it's accuracy got pushed so hard, seemingly, from what I know.
It is no more clinically accurate then the other tests or the combo exam known as QB as far as I can determine.
Is there any historical reason why Europe/Scandinavia rely so heavily on Neuropsychological and other skills battery testings to validate diagnoses?
The tradition of psychometric testing is believed to have originated earlier lasts century over there. Regardless, many professionals there, as here, believe that objective tests are better than interviews and rating scales for assessing psychological symptoms despite the limited evidence for doing so for many abilities apart from IQ, achievement skills, and a few others.
Because theyre not influenced by big pharma.
Dr. Barkley, would you mind please helping your viewers understand what exactly is a "neuropsychological test?" In layman's terms, what do these tests look like, what kinds of questions are being asked or what kinds of activities are clients instructed to complete? Thank you.
In the NP testing I was given, I was given a list of words to recall over and over again, number sequences to recall, pattern sketches to draw from memory, patterns to replicate using blocks, and a computer test to measure reactions to visual cues. I scored average to high average on all of the tests except the reaction one and was told I couldn't have ADHD. If you are even remotely good at pattern recognition, you will pass these tests.
No. Pattern recognition is a right parietal function. I would expect someone with ADHD to do fine on visuospatial tasks, generally, except perhaps if fluid reasoning is involved IF the deficit can be explained by trouble with the frontal lobes ability to inhibit intrusive thoughts. Yoy caneasire this with certain measures. Or, right orbito frontal dysfunction may result in mood lability which could interfere.
@@Dr.BCAnderson I'm afraid I couldn't follow your reply. Can you explain in layman's terms?
can you please name some of those neurophysiological test names please
Thank you for this! What are your thoughts on the TOVA test?
The same. The TOVA is just another CPT. Be well.
Wrong answer. The TOVA is a superior CPT,better than the Connors. But no CPT alone can dx ADHD. An examiner needs to observe bx, look at hx, record what is told by the client and informants, and ascertain how well this aligns with objective measures whilst ruling out other conditions. This is thorough and considered. Asking someone who thinks they have ADHD to fill out questions aski g about trouble with inattention,amd then getti g a positive response, shouldnt be shocking. Its a lazy analysis and why many of my physician friends laugh at our field. And also why there is a massive rise. Barkley is promoting his product and citing his research.
Dr Barkley which tests would you recommend for diagnostic purposes?
There are no tests for diagnosing ADHD. But a clinician should do a brief IQ test and brief screening of academic skills to see if intellectual disability or learning disorders could be comorbid conditions. The latter occur in a substantial minority of cases.
@@russellbarkleyphd2023is high IQ something that rules out ADHD?
no, see my brief commentary on Giftedness, IQ and ADHD
@@htspencer9084 interestingly high IQ can exist with or without ADHD. However, even if the person has a high IQ, they may have a slower processing speed or poor working memory. Ultimately If the ADHD is not addressed, a high IQ would be like a Ferrari without gas.
@@priyabriggs659no, totally not. But you just skip all formal education. You can still learn programming etc. on yourself.
Its just that adhd also affects other parts of your life. So you might get problems by taking too much risks etc.
Is it possible for HIGH intelligence to cause a false positive?
Is there already a general idea or consensus about examining work/life related impairments or testing of things like organisational skills? Because from my point of view it's downright malicious and sadistic to let people run through batteries, they pass the test, are being told they're ok and then try to work just to fail over and over again like I did?
I tried to study twice, am now severely indebted, but couldn't learn certain things, and at some exams I was succesful on the 2nd try only I literally had to get help. I did several trainee ships over the year in different branches and profession but this anxiety of failure has never left me. I basically haven't earned a single penny in over 12 years because I either had to work as a trainee for free or because of unemployment and this feeling of insufficiency, not being like other people and basically damned to stay poor for the rest of my lifeeats my alive. While many of us get essentially get gaslighted for being lazy, careless, unmotivated, stupid - just to name a few things, unable to even prove our impairments. Imagine, when I bring topics up from your videos I watched my psychiatrist basically tells me things like "It can't be that bad" or "You don't punch people in the face or are aggressive" and "that's not part of the symptoms, you can't have it" - it's just devastating.
Im 14, i just started ny first session with my psychologue (i knew i had adhd since i was 10 but i thought i was acting out or sone shi,and i couldnt tell my parents bcs they were still not so open minded about seeing a psychologue and stuff, maybe it could have being diff if i told them at that age who knows?) ive being strugglin alot in school, to memorize or pay attention ive being dealing with this almost 3years now, making alot if efforts just to end up gettng an horrible grade. 2 weeks now i went to a psychiatrist who told me i should see a psychologue who will explain my behaviors more, yesterday was my first session with that psychologue, from what we were saying i conclude that i actually have more than adhd, i was planning about only telling her about my behavior who might be related to adhd, and anger issues but she was asking me too much stuff that i ended up opening up about other stuff a bit tooo much(about dezrealisation,emptiness,mood swings,my personality changes alot), i still have two sessions where i will have to tell her about everything (idk if i can trust her) to be ready for the neurological assessment, i dont feel okay since last session idk why , i should feel good bcs im going to get better? But i just have that voice saying "what if u dont have adhd?" "I hate being diagnosed with mental issues" i got that absurd feeling idk how to explain, should i do that neurological assessment or not? Maybe ill just be wasting money but i will feel so bad if i dont, it will keep ruining my life! I mean m still positive abt it ngl but i just dont know
السلام عليكم
الشيخ يقصد بالمراجعة القراءة بتدبر
أم التسميع غيباً ؟
One question:Did i Unterstand correctly that the tests don't work in children and adults or just in adults as you seem to imply in the end? Ps: Thank you for your ongoing work
Both. Thanks for watching.
Okay sorry for the dumb question but is this about those tests where you have to press a button when a certain thing happens like a shape comes up on a screen? I strongly suspect I have ADHD, teachers recommend I get tested because of my behavior as a child, but it was ruled out due to a set of those computer attention tests coming back “normal”
Yes, that is one of many of them. That one is called a continuous performance test though it’s brand name could be any of several on the market.
What should a parent do if a school is requiring evals for a child and want neurological testing? What should we watch out for to avoid misdiagnosis or under diagnosis of adhd ?
write to my email address and I can send you an article on which this video is based that you can share with the school so they can learn that testing is not useful.
@@russellbarkleyphd2023 thank you! Email sent !
There is a reason comprehensive exams are impt, Dr. Barkley. There is a reason why most professionals reject your supposition. Maybe theyre not wrong?
At least a neuropsych test is better than a questionairre test it's the quesstionairre test's that are inaccurate, I believe to properly diagnose ADD/ADHD the clinician should use neuropsych assesments and brain scans as well as questioairre tests.
Does this include a QB test?
Yes
Useful :)
🙂
Have you considered that maybe its the diagnostic criteria is wrong? Scales dont objectively measure executive functioning. By your own admission, ADHD is a disprder of executive functioning. A behavior presenting as executive dysfunction is not the same as having executive dysfunction. If we can actually measure, objectively, a construct, then why say it is inaccurate? Your standard is the criteria. Yet, what is it based on. In the EU, they usea more rigid criteria. The influence of big pharma is also absent. As with other neurocogntive disprders, developme tal disprders need to show discrepencies. Certainly, not all executive dysfunction is due to ADHD,but you fail to not thatthe DSM states these other conditons (mood disorder, intellectual delay, ect.) need to be ruled out.
TLDR:
I'm sure it's not going to be the most accurate factual response but I'll try to explain Russell's arguments to the best of my ability in this and the next comment
It seems like you didn't watch the video, he does address most if not al your "questions" in it!! It's all about comparing the effectiveness of the diagnostic criteria and the EF tests to help identify ADHD individuals. The criteria was really accurate with up to 98% success rate, meanwhile the testing was absurdly inaccurate identifying at best 50%, basically useless data
The long response:
-Have you considered the diagnostic criteria is wrong?
This is one of the main topics of the video, he compares the results of both the criteria and the tests with the people actually accepted to be diagnosed with ADHD. From this he concludes that the criteria is way more accurate at identifying the ADHD individuals, that's a big portion of the video and the point of the graphs, please rewatch and actually pay attention to the information given
-If we can measure it, why say it's inaccurate?
Because it is??? Again, the research presented shows people accepted to have ADHD taking this tests where the results produce too many false negatives, which means, the testing is too inaccurate and doesn't give us any valuable information about the individual in terms of ADHD
-What is the standard criteria based on and why is it the standard?
The criteria is based on research and real life results!! Again, if you paid attention to the studies, the criteria identifies ADHD individuals with insanely greater accuracy, up to 98% accuracy!! that's an actually objective way to measure EF problems and help diagnose ADHD!!
-BIG FARMA!!!
simple nonsense unrelated to this conversation
-Fail to say other conditions need to be ruled out according to DSM
He does acknowledge there are multiple other conditions that affect EF but it isn't the main purpose of this video so he doesn't go in much depth but I insist he mentions it
Finally, you seem to be biased one here, discrediting all he says by asking questions he addresses on the video itself!! you're acting in bad faith or can't understand simple logic, either way please rewatch the video and try to comprehend it and PLEASE check your spelling next time lil bro