Once I have completed the clinical interview, scored the ADD rating scales, administered standardized measures, and screened for additional disorders, I ask the patient what information they have about ADHD. Some who come seeking evaluation for themselves or their children are very sophisticated in their understanding of ADHD. They have learned much about the diagnosis and treatment of this disorder from reading, taking courses, or talking with others who are well informed. Others come to the initial evaluation with very limited information about ADHD, and with many misconceptions. Once I ascertain what is already known, I try to provide information about ADHD at an appropriate level. I believe that teaching the patient and family about ADHD is a very important part of the initial evaluation.
I provide a concise description of the primary symptoms of ADHD impairment using clear examples to illustrate each one. Usually I do this in a format something like the description of symptom clusters in Chapter 2. After each symptom cluster has been described, I pause and ask the patient and family members present to indicate the degree to which the described symptom cluster fits or does not fit the patient's experience. I use follow-up questions to probe for relevant details or examples from the patient's daily experience. This process can enrich the patient's understanding of the disorder as well as yield additional information valuable for determining the diagnosis.
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