Adult ADHD Diagnosis Referral

Gender *

Referral Information

ADHD in Adults

Attention deficit hyperactivity disorder (ADHD) are problems with concentrating (inattention), and being too active and having difficulty staying focused (hyperactivity). The difficulties caused by ADHD vary from mild to severe. It is a pattern of behaviours which first appear during childhood, and the symptoms of ADHD include:

  • Overactivity.
  • Being easily distracted, and unable to stick to anything for any length of time.
  • Being impulsive, and doing things on the spur of the moment or without thinking.
  • Being unable to concentrate for any length of time.

Many of us might have one or more of these features but they are more severe and cause problems with day-to-day activities for people with ADHD. In ADHD, these difficulties interfere with how you get on with other people, and how you get on at work.

How common is it?

  • About 5 in every 100 school-aged children have ADHD.
  • The symptoms of childhood ADHD persist into adulthood in up to 65 in 100 children with ADHD.
  • Therefore ADHD affects about 3-4 in 100 adults.

Symptoms of ADHD in adults:

Attention deficit hyperactivity disorder (ADHD) is suspected in adults if there are at least five inattention symptoms and/or at least five hyperactivity-impulsivity symptoms that have:

  • Started before 12 years of age.
  • Occurred in two or more settings, such as at home and work.
  • Been present for at least six months.
  • Clearly interfered with, or reduced the quality of social, academic or occupational functioning.
  • Not been better explained by another disorder such as oppositional defiant disorder or conduct disorder.

Inattention symptoms include:

  • Failing to give close attention to detail or making careless mistakes in work, or other activities.
  • Difficulty in maintaining concentration when performing tasks.
  • Appearing not to listen to what is being said, as if the mind is elsewhere, without any obvious distraction.
  • Failing to follow through on instructions or finish a task (not because of oppositional behaviour or failure to understand).
  • Difficulty in organising tasks and activities.
  • Reluctance, dislike, or avoidance of tasks that require sustained mental effort.
  • Losing items necessary for tasks or activities, such as pencils, mobile phones, or wallets.
  • Being easily distracted.
  • Forgetfulness with regards to daily activities.

Hyperactivity and impulsiveness symptoms include:

  • Fidgeting with or tapping hands or feet, or squirming when seated.
  • Leaving the seat, where remaining seated is expected, such as in a work meeting.
  • Being or feeling restless where inappropriate.
  • An inability to engage in leisure activities quietly.
  • Being ‘on the go’ all the time, restless and others finding it difficult to keep up.
  • Talking excessively.
  • Blurting out an answer before a question has been completed.
  • Difficulty waiting their turn.
  • Interrupting or intruding on others.

Note, these symptoms are not exclusive but some examples which can impact functioning.

To learn more about ADHD in adults visit: www.patient.info/signs-symptoms/adhd-in-adults

Additional Questions

Include examples of inattention, hyperactivity or impulsiveness, using the reference of symptoms from the above list.
E.g. School reports, mental health reports etc.
Have you previously been diagnosed with ADHD? *
If you received treatment, including duration and response to treatment. Include any evidence you have. If this is not available, please state the reasons.
Please provide specific examples which have occurred over the last 6 months if possible.
Are there any other mental health conditions or issues you are currently dealing with or have been diagnosed with in the past? *
Do you have any concerns about alcohol and substance misuse? *

Consent for Information Sharing

I hereby authorise the sharing of relevant information between healthcare professionals involved in my assessment and treatment for ADHD.

Use full name

Adult ADHD Self-Report Scale (ASRS-vl.l) Symptom Checklist

Please answer the questions below, rating yourself on each of the criteria shown using the scale based on which option best describes how you have felt and conducted yourself over the past 6 months. /p>

Part A

How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? *
How often do you have difficulty getting things in order when you have to do a task that requires organisation? *
How often do you have problems remembering appointments or obligations? *
When you have a task that requires a lot of thought, how often do you avoid or delay getting started? *
How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? *
How often do you feel overly active and compelled to do things, like you were driven by a motor? *

Part B

How often do you make careless mistakes when you have to work on a boring or difficult project? *
How often do you have difficulty keeping your attention when you are doing boring or repetitive work? *
How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly? *
How often do you misplace or have difficulty finding things at home or work? *
How often are you distracted by activity or noise around you? *
How often do you leave your seat in meetings or other situation in which you are expected to remain seated? *
How often do you feel restless or fidgety? *
How often do you have difficulty unwinding and relaxing when you have time to yourself? *
How often do you find yourself talking too much when you are in social situations? *
When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves? *
How often do you have difficulty waiting your turn in situations when turn taking is required? *
How often do you interrupt others when they are busy? *