Who should undergo an ADHD evaluation?

If you have concerns regarding your child’s ability to focus, pay attention, or succeed in school, please schedule a visit with your child’s primary care provider (PCP) to discuss them further.  Your PCP may determine that a more thorough evaluation is warranted by themselves or a clinician in our Behavioral Health Center of Excellence.  Examples of such concerns include:

• Difficulty with attention/focus interfering with learning or participation in activities
• Hyperactive and/or impulsive behavior causing disruptions at home or school

How is ADHD diagnosed?

ADHD is diagnosed when a patient displays symptoms and behaviors that meet specific diagnostic criteria. ADHD can be diagnosed by a primary care clinician using a combination of a structured interview and assessment forms from the parent(s)/guardian(s) AND either teachers, coaches, or anyone else who may be familiar with the patient and their behavior. ADHD can also be diagnosed through neuropsychological testing by a clinical psychologist, psychiatrist, or neurologist.

How do I schedule an ADHD evaluation? Will the visit be with my regular pediatrician?

If you or your child’s teacher have any concerns about possible ADHD, please speak with your child’s primary care clinician first. Based on your discussion, they may recommend a separate, more comprehensive evaluation either with themselves or with a member of our Behavioral/Mental Health Center of Excellence (COE). ADHD evaluations can be scheduled by contacting your local CPCMG office.

Do I need authorization from my health insurance to have an ADHD evaluation?

No. Health plans do not require prior authorizations for these visits.

Are telehealth visit options available?

We recommend that most initial appointments be in-person, allowing for more personal engagement with patients and their families. However, we understand that certain circumstances make a telehealth option more practical. Please contact the health care team before your appointment to discuss this possibility.  Follow-up visits are frequently offered either in person or via telehealth.

Does my child need to be physically present for the visit?

Yes, we strongly recommend that the patient be present and participate in the visits. If you have extenuating circumstances, please discuss them with your health care team before the day of the visit.

Once the appointment has been scheduled, what should we expect?

A series of electronic questionnaires will be available for you to complete on MyChart before the visit.  A separate paper questionnaire will also need to be completed by your child’s teachers, tutors, and/or coaches who are familiar with your child’s behavior. More than one individual is allowed to complete these forms, and often receiving feedback from multiple individuals who know your child well can be helpful. If your child is in middle or high school, it is recommended that at least three separate teachers complete the form with emphasis on core subjects (e.g., English, math, science, history). Completing and submitting these forms before the visit date will ensure an adequate review of all questionnaires and will make the best use of the time allotted during the appointment.

If you do NOT have an active MyChart account, please contact your local CPCMG office to sign up. If you cannot activate your account before your appointment, please arrive at least 30 minutes before the visit to complete all questionnaires.

How should we prepare for the visit?

If your child has been evaluated by an outside psychiatrist, psychologist, or counselor, a copy of the latest note or evaluation--including a list of any medications used in the past--will be essential. Please provide a copy if your child already has an individualized educational plan (IEP) or 504 plan. Please make every effort to submit these electronically (or bring multi-page documents to the office) BEFORE the appointment day.

Why are some questionnaire items so personal?

A comprehensive understanding of your child and family’s medical, behavioral, and social history helps with accurate diagnosis and developing an effective treatment plan. Please know that we respect your child and your family’s privacy, and all information shared will remain confidential. However, we are legally bound to notify appropriate authorities of any safety concerns about your child or family members.

How long will the visit last, and what happens if we run out of time?

Most initial visits last 30-60 minutes. To make the best use of the appointment time, please complete all questionnaires and provide relevant records to your healthcare team BEFORE the visit. When more time is needed, a follow-up appointment will be scheduled to complete the evaluation. Some clinicians may also request that initial evaluations be performed as a two-visit process.

What should we expect to occur during the visit?

The visit will consist of an interview with you and your child. If your child is 12 years or older, we may also request a private, confidential interview with them as long as they are comfortable with it. All information discussed during the visit will be confidential unless concerns about your child’s or family's safety are raised. 

EXAMINATION

The visit will start with your child’s weight, height, heart rate, and blood pressure measurements. These are important for assessing baseline health. Some medications can affect these vital signs, so regular measurements must be taken. A brief exam may also be necessary to listen to the heart rhythm and look for signs of underlying conditions.

Are therapists or psychologists available at CPCMG?

A limited number of CPCMG offices have Integrated Health Therapists (IHTs) at the clinics. However, most patients need to find a therapist or psychologist outside the medical group. You can contact your health plan to check which therapists are within your network. You can also contact your primary care clinician for recommendations. Finally, the Psychology Today website is a good place to start an online search for a therapist.

Will my child be prescribed medication during the visit?

Not all patients diagnosed with ADHD require medications.  However, some may find them helpful to focus better, become less distracted, and regulate their behavior and emotions better.  The decision to add medication or not will largely be determined by how much your child’s ADHD symptoms have been disruptive to their learning, relationships with family and peers, and ability to participate in desired extracurricular activities.  Recommendations will be made individually and the need for medication will be discussed in detail with your child’s clinician.

Will my child or teen have time with the clinician without me in the room?

We offer all patients 12 years and older time to discuss their concerns and thoughts privately with the clinician if they feel comfortable doing so. In certain circumstances, a private interview may also be offered to younger patients.

What types of information might the clinician keep confidential from me as a caregiver, and what might be reported to an official entity such as the police?

If your child discloses any information that indicates they may be unsafe, this will be shared with you. All appropriate measures will be taken to ensure your child’s safety. If concerns are raised that your child or family is at risk for domestic violence, abuse, or neglect, Child Protective Services (CPS) and/or the police will be notified. All other information will be kept confidential unless your child grants permission to share it.

How often will we follow up?

If your child is prescribed medication, a follow-up visit is required at least every two to four weeks while the dose is adjusted. Once a stable medication and dose are established, a visit is required once every six months. These visits can be either in-person or by telehealth, and questionnaires need to be completed before each appointment. We request that you always schedule the follow-up visits with the clinician who regularly manages your child’s medication.

If medication is NOT started, a follow-up appointment may still be recommended to ensure your child remains safe and well.

Do I need a MyChart account?

Yes. An active MyChart account (AND a teen MyChart account for patients 12 years and older) is needed to complete questionnaires, communicate with your child’s clinician, request medication refills, schedule follow-up visits, and conduct telehealth visits.

When should my child see a psychiatrist instead of a pediatrician?

While our pediatricians and advanced practice providers diagnose and manage many behavioral and mental health conditions, we are not trained to manage ALL disorders. Your child may be referred to a psychiatrist if multiple complex co-existing diagnoses are suspected, if their symptoms do not respond to standard treatment interventions, or if they have rapidly worsening symptoms.