Who can diagnose ADHD
NICE reserves it to named professions, on the basis of a full clinical and psychosocial assessment. No questionnaire, screener or website can do it, including anything on this site.
The short version
- NG87 reserves diagnosis to a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD.
- It must rest on a full clinical and psychosocial assessment of the person.
- That assessment has three components: discussion of behaviour and symptoms across the different domains and settings of everyday life, a full developmental and psychiatric history, and observer reports and assessment of the person's mental state.
- A screening tool can tell you whether a conversation is worth having. It cannot give you an answer.
This is the shortest guide on the site and the one that constrains everything else on it. It is worth stating in the guideline's own words rather than in a paraphrase.
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; this should include discussion about behaviour and symptoms in the different domains and settings of the person's everyday life and a full developmental and psychiatric history and observer reports and assessment of the person's mental state.
What each part of that rules out
The profession clause rules out a diagnosis from someone without the stated training and expertise, however confident the opinion.
The full clinical and psychosocial assessment clause rules out a diagnosis from a questionnaire score alone, whoever administers it.
The different domains and settings clause rules out a diagnosis built on one setting or one account. It is also the reason an assessment tends to ask for information from someone who knows you in another context, and the reason old school reports and work records are worth digging out.
The developmental and psychiatric history clause rules out an assessment that looks only at how things are now. ADHD is a developmental condition, so the guideline expects the clinician to go back through your history, and to consider what else might explain the picture.
The observer reports and mental state clause rules out an assessment built on self-report alone. This is the component most likely to be missing from a short appointment, and it is the one worth asking a provider about directly before a referral is sent: whether the assessment gathers an account from someone who knows you, and whether it includes an assessment of your mental state.
What screening tools are for
Validated screening questionnaires exist and have a role. The Taskforce is careful about what that role is, recommending that providers and integrated care boards consider screening wait lists using evidence-based clinical screening tools but not on their own, because such tools can over and under-identify ADHD.
The same caution applies to anything you fill in online. A score can help you decide that a conversation with your GP is worth having, and can help you describe what you have noticed. It cannot tell you whether you have ADHD, and any tool that claims otherwise is claiming something NICE reserves to a clinician.
What the checker on this site does
Questions people ask about this
Can an online test diagnose ADHD?
No. NICE guideline NG87 states that ADHD should only be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional, on the basis of three things together: a full clinical and psychosocial assessment including discussion of behaviour and symptoms across the different settings of everyday life, a full developmental and psychiatric history, and observer reports and assessment of the person's mental state. A screening questionnaire can help you decide whether to speak to your GP, and the Taskforce warns that such tools can over and under-identify ADHD when used on their own.
Does a GP diagnose ADHD?
A GP's role on this pathway is to decide whether a referral for assessment is clinically appropriate and then to make it. NICE NG87 reserves the diagnosis itself to a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in diagnosing ADHD.
Where this came from
- NICE NG87: Attention deficit hyperactivity disorder, diagnosis and management.
- NHS England: Report of the independent ADHD taskforce, part 1.