Online and remote ADHD assessments

Some providers assess only online. An ICB tells patients to understand the format before choosing, and NICE describes an assessment that spans the settings of everyday life, a full developmental and psychiatric history, and observer reports and assessment of the person's mental state.

Remote assessment is now normal on this pathway, and it is usually presented as a convenience. It is better understood as a fit question, because the thing being assessed is how someone functions across the settings of their life.

What the commissioners tell patients

NHS West and North London ICB lists it among the differences between providers, noting that some providers only offer online assessments, alongside the observations that some also have exclusion criteria and that providers have different treatment options after diagnosis.

NHS South West London ICB builds the same point into its step list. Before making your choice, it says, it is important you understand how each provider would carry out the assessment, online or remotely or in person, and if they would provide ongoing support or medication should you or your child be diagnosed.

Neither says one format is better. Both treat it as information you need before choosing, which is the right framing.

What an assessment has to cover regardless of format

NICE guideline NG87 states that ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD, on the basis of a full clinical and psychosocial assessment of the person, which should include discussion about behaviour and symptoms in the different domains and settings of the person's everyday life, and alongside it a full developmental and psychiatric history and observer reports and assessment of the person's mental state. Those are three components, not one, and they are the checklist against which a short appointment can be judged.

That is the bar a format has to meet. The practical questions that follow are about evidence gathering: whether the provider seeks information from someone who knows you in another setting, what documentation it asks for, and how long the appointment is.

Questions worth asking about format

• Is the assessment delivered by video, by telephone, or in person, and is there a choice?
• How long is the appointment, and is it split across more than one session?
• Does the provider ask for information from a parent, partner, teacher or employer, and how is that collected?
• What documentation should be sent in advance, and by when?
• What are the technical requirements, and what happens if the connection fails part way through?

Where it matters most

For a child, the practicalities of a remote appointment differ from an adult's, and the evidence gathering usually involves more people. For anyone who finds video calls hard to sustain, a long remote appointment is a real consideration rather than a preference.

This site takes no view on which format produces a better assessment, because no source checked when it was built compared them.

Questions people ask about this

Where this came from

• NHS West and North London ICB: ADHD and ASD.
• NHS South West London ICB: ADHD and autism, Right To Choose.
• NICE NG87: Attention deficit hyperactivity disorder, diagnosis and management.

Read next

• Questions to ask a Right to Choose provider
• Who can diagnose ADHD
• Provider exclusion criteria explained
• Adult and child pathways are not the same