How to get an ADHD evaluation for an adult or a child

Where to start

For a child, the usual first call is the pediatrician or family doctor. They know your child's history, can check for other things that look like ADHD, and can either do the evaluation themselves or refer you to a specialist.

For an adult, you can start with your primary care provider or go straight to an outpatient psychiatry practice. Many psychiatry practices offer ADHD evaluations directly, but not all of them see adults for ADHD, and not all see children, so ask before you book.

Before you call anyone, check whether your insurance requires a referral from primary care to see a specialist. Some plans do and some do not, and finding out after the visit is the expensive way.

Who can diagnose ADHD

According to the CDC, ADHD can be diagnosed by a mental health professional such as a psychologist or psychiatrist, or by a primary care provider such as a pediatrician. In practice that usually means one of these:

• A pediatrician or family doctor, often for straightforward cases in children.
• A psychiatrist, who can diagnose and also prescribe medication.
• A psychiatric nurse practitioner, who can diagnose and prescribe as well.
• A psychologist, who may do more detailed testing but in most states does not prescribe.

What the evaluation actually involves

There is no single test for ADHD. The CDC describes diagnosis as a process with several steps, and part of it is ruling out other things that can look similar, such as sleep problems, anxiety and depression. For children that can include checking hearing and vision.

Expect a long conversation about current difficulties, history, health, sleep, mood and family background, plus questionnaires or rating scales. Some practices complete the evaluation in one visit; others spread it over two or more. It is fair to ask how many visits to expect and whether each is billed separately.

The diagnostic criteria clinicians use, summarized by the CDC, look for several symptoms present before age 12 and showing up in two or more settings, such as home, school or work. That is why history matters so much, including for adults. Something from childhood that shows how you were doing then can be genuinely useful.

What to bring

Gather what you can. You do not need all of it, and missing pieces will not stop an evaluation.

• Insurance card and photo ID, plus any referral your plan requires.
• A list of current medications and supplements, with doses.
• Notes on specific examples: what is hard, where it happens, and since when.
• For children: recent report cards, teacher comments and any school evaluation or support plan.
• For adults: old report cards if you have them, or a parent or sibling willing to answer questions about your childhood.
• Records of any earlier evaluations, therapy or medication for attention, mood or sleep.

For children: school and teacher input

The CDC notes that the American Academy of Pediatrics recommends providers ask parents, teachers and other adults who care for the child about behavior in different settings. Many practices send rating forms for a teacher to fill out. Ask for them when you book, so the forms come back before the appointment rather than after it.

You can also ask your public school to evaluate your child. The CDC notes that school systems provide free evaluations for children 3 and older, and early intervention programs offer free or low-cost evaluations for children under 3. Put the request in writing. A school evaluation looks at whether your child needs support at school; it is not the same as a medical diagnosis, and you can pursue both at once.

If your child is diagnosed, treatment for young children usually starts with behavior approaches. CDC guidance for ages 4 to 6 lists parent training in behavior management and classroom behavior support first, with medication considered if those are not enough. For older children it describes medication alongside those approaches. Decisions about medication are always for you and the prescriber.

What to say when you call

A short call can tell you whether a practice is the right fit before you wait weeks for an appointment.

• "Do you do ADHD evaluations for [adults / children of age X]?"
• "Is the evaluation one visit or several, and roughly what does it cost with my insurance?"
• "Do you need teacher forms or school records before the first visit?"
• "If there is a diagnosis, can the same clinician manage treatment, or would I be referred elsewhere?"
• "Do you have a waitlist, and can you call me if something opens earlier?"

If you are in Tennessee

TennCare is Tennessee's Medicaid program, and it is delivered through managed care plans. If you have TennCare, ask the practice whether it is in network with your specific plan, not just whether it "takes TennCare".

For children under 3, Tennessee runs the Tennessee Early Intervention System (TEIS). The state says TEIS eligibility evaluations are provided at no cost to families. TEIS looks at developmental delays generally rather than diagnosing ADHD, but it is the right door for a very young child with concerns.

The outpatient practices listed in Tennessee, including around Nashville, are on the Tennessee page of this directory. Each listing shows what that practice says it offers; confirm ADHD evaluations and age ranges when you call.