ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects attention, executive functioning, impulse control, and regulation of activity level. It is not simply a difficulty with focus — it is a difference in how the brain manages organization, motivation, time, memory, and self-regulation.

ADHD can affect children, adolescents, and adults, often presenting differently at different stages of life.

Types of ADHD

ADHD is categorized into three presentations:

1. Predominantly Inattentive Presentation

• Difficulty sustaining attention

• Forgetfulness

• Disorganization

• Losing items

• Avoidance of sustained mental effort

• Appearing “spacey” or easily distracted

• This presentation is often missed, especially in high-functioning students.

2. Predominantly Hyperactive-Impulsive Presentation

• Excessive movement or restlessness

• Difficulty waiting

• Interrupting others

• Acting without thinking

• This presentation is more commonly identified in younger children.

3. Combined Presentation

Symptoms of both inattention and hyperactivity/impulsivity

ADHD in Children vs. Adults

In Children and Teens

• Academic struggles

• Behavioral concerns

• Emotional dysregulation

• Conflict with parents or teachers

• Difficulty following multi-step instructions

• Symptoms must have been present before age 12 to meet diagnostic criteria.

In Adults

ADHD may look different:

• Chronic disorganization

• Time blindness

• Procrastination

• Underachievement despite intelligence

• Relationship strain

• Workplace difficulties

• Internal restlessness rather than visible hyperactivity

• Many adults were never diagnosed in childhood but experienced lifelong symptoms.

How We Evaluate ADHD at Mindful Minds

ADHD is a clinical diagnosis — there is no single blood test or scan that confirms it. A thorough evaluation is essential. During the initial evaluation, we carefully screen for other mental health conditions that may mimic or coexist with ADHD. These may include anxiety disorders, depression, obsessive-compulsive disorder (OCD), trauma-related conditions, and other mood or behavioral concerns. Because many symptoms overlap, a thoughtful differential diagnosis is essential.

If there is concern for a possible learning disorder (such as dyslexia, dyscalculia, or written expression disorder), I may recommend that the school complete a formal psychoeducational evaluation or guide families toward appropriate neuropsychological testing to better assess academic functioning.

If other co-existing developmental or neurodivergent conditions are suspected — including autism spectrum differences or executive functioning disorders — I will recommend additional screening or comprehensive assessment to ensure a clear and accurate understanding of the full clinical picture.

A thorough evaluation helps ensure that treatment recommendations are targeted, individualized, and appropriate for the whole person — not just a single diagnosis.

Step 1: Comprehensive Intake

The first visit includes:

• Developmental history

• Academic and occupational history

• Family history

• Mental health history

• Functional impairment review

• Screening for anxiety, depression, trauma, sleep issues, and medical contributors

Step 2: Structured Screening Tools

We use evidence-based rating scales tailored to age:

For Children & Adolescents:

• Conners 4

• Vanderbilt Rating Scales

• Brown Executive Function Scales

• CAARS-2 (in older adolescents)

• The Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale (SWAN) (5-18)

• The UPPS-P Impulsive Behavior Scale (13+)

• The Executive Skills Questionnaire–Revised (ESQ–R) (14+)

Teacher rating scales (strongly recommended)

Children and teens benefit from multiple informants, including parents and teachers.

For Adults:

• CAARS-2

• Brown Executive Function Scales

• Wender Utah Rating Scale (retrospective childhood symptoms)

• The ADHD Clinical Outcome Scale (ACOS)

• The Adult ADHD Self-Report Scale (ASRS v1.1)

• The UPPS-P Impulsive Behavior Scale

• The Executive Skills Questionnaire–Revised (ESQ–R) (14+)

Step 3: Diagnostic Interview

For Adults:

DIVA-5 Diagnostic Interview

For Children:

DIVA-5 Young (Diagnostic Interview for ADHD in Youth)

Step 4: A computerized assessment of attention (When Indicated and Optional)

For ages 8 and older, we may administer:

Conners CPT 3 Online (Continuous Performance Test)

A computerized assessment measuring sustained attention, impulsivity, and response control.

Conners CATA Online: Conners Continuous Auditory Test of Attention

Conners K-CPT 2 Online. Conners Kiddie Continuous Performence test 2nd Edition 

These tests provide additional data but do not replace clinical evaluation. They can only be administered in person. 

Read more about these optional tests that may sometimes be helpful here. 

Step 5: Functional Assessment

We evaluate:

• Executive functioning

• Academic or occupational impairment

• Emotional regulation

• Social functioning

• Symptoms must cause clinically significant impairment in multiple settings.

Step 6: Medical Considerations

If indicated, laboratory testing may be ordered to rule out contributing factors such as:

• Thyroid dysfunction

• Nutritional deficiecnies

• Trauma history

• Iron deficiency (ferritin)

• Sleep-related issues including sleep disordered breathing

• Chronic allergies and eczema

• Hearing and vision difficulties 

• Other medical contributors

Treatment of ADHD

Treatment is individualized and may include:

Medication Options for children and adults:

• Stimulants (methylphenidate or amphetamine-based)

• Non-stimulants (atomoxetine, guanfacine, clonidine, others)

Response to medication depends on multiple factors, including:

• Age

• Co-occurring anxiety or mood symptoms

• Sleep patterns

• Sensory profile

• Medical history

• Individual neurobiology

There is no “one-size-fits-all” medication.

Non-Medication Interventions

• Executive function coaching

• Behavioral strategies

• School accommodations (504/IEP support)

• Parent guidance

• Therapy for emotional regulation

• Lifestyle and sleep optimization

• Exercise

• A Thoughtful, Individualized Approach

At Mindful Minds, we take a holistic and integrative approach to ADHD care. We consider cognitive patterns, emotional health, physical well-being, lifestyle factors, cultural context, strengths, and personal goals when developing a treatment plan.

Our goal is not simply symptoms reduction — it is improved functioning, confidence, and long-term well-being.