ADHD Testing San Jose
ADHD Testing in San Jose
Most ADHD evaluations look for ADHD. Mine looks for everything else first.
That sounds like a technicality. It’s the whole difference.
ADHD is a diagnosis of exclusion. It can only be assigned once the other explanations have been ruled out — and there are a lot of them. Anxiety produces attention problems. So does depression. So do sleep disorders, trauma, medication, medical conditions, learning disorders, and ordinary life circumstance.
Far too often clinicians only look for what something is, not what something isn’t. The only way to really know what it is, is to know what it isn’t.
ADHD Testing for Children and Adolescents
ADHD can be particularly difficult to evaluate in children because attention problems are not specific to ADHD. Anxiety, autism, learning disorders, sleep problems, mood symptoms, developmental differences, and even a mismatch between a child’s abilities and academic demands can look like inattention.
Children also behave differently across settings. A parent may describe significant problems at home while a teacher sees few concerns, or the reverse. Those differences are not simply inconvenient data to average together. Understanding whya child functions differently across environments can be diagnostically important.
A comprehensive evaluation integrates developmental history, school records, parent and teacher information, academic and cognitive findings, direct measurement of attention when appropriate, and other clinical evidence. The goal is not to prove that a child has ADHD. It is to determine what best explains why the child is struggling and what should be done about it.
ADD or ADHD — what’s the difference?
ADHD is the actual DSM-5 diagnostic term. ADD is a pop-culture term for what the DSM calls the inattentive subtype.
The diagnosis carries one of three specifiers:
- Predominantly Inattentive Presentation — what most people mean when they say ADD
- Predominantly Hyperactive/Impulsive Presentation
- Combined Presentation
It really is that simple. The terminology is the easy part. Finding the cause is not.
What the evaluation actually involves
I developed a neuropsychological testing battery specifically to determine whether or not someone has ADHD. It runs one full day.
It includes:
- Ruling out the psychiatric conditions that produce attention problems
- Searching for pathognomonic signs of neurological dysfunction
- Ruling out language delays and other cognitive explanations for attention deficits
- Measuring attention directly, with instruments, rather than inferring it from a checklist
An evaluation has to be thorough enough to rule out the conditions that present with the same symptoms. If it isn’t, it isn’t an evaluation — it’s a confirmation of whatever you walked in believing.
When ADHD Test Results Don’t Make Sense
ADHD testing is not simply a matter of finding a low attention score and calling it ADHD. Test performance can be affected by fatigue, engagement, misunderstanding, psychiatric symptoms, inconsistent responding, and other factors. Some people also produce unusual or internally inconsistent measurement profiles that do not fit the pattern expected from ADHD or another straightforward clinical explanation.
That does not automatically mean the person is malingering, and it does not automatically mean nothing is wrong. Performance and symptom validity findings are data that have to be interpreted in context. The question is why the pattern occurred, which findings remain interpretable, and whether the test results converge with the developmental history, clinical presentation, records, and other evidence.
This is where understanding the pathogenesis of the condition matters. The pattern of symptoms, when they began, how they developed, and what else could reasonably produce them can be as important as the test scores themselves. An atypical profile should lead to more investigation, not a reflexive diagnosis.
Why getting it wrong is expensive
The DSM-5 is a large book of diagnoses. What’s frustrating is that most of them — if not nearly all of them — have some element of an attention problem.
Here’s the distinction that matters. ADHD is a neurodevelopmental disorder, meaning its underlying processes begin during development rather than appearing suddenly later in life. Attention problems can also arise secondarily from anxiety, depression, sleep disorders, trauma, learning disorders, medical conditions, medications, and other causes.
So if the cause is anxiety and it’s treated as ADHD, you take a stimulant for a problem a stimulant doesn’t solve. If it’s a sleep disorder, the same. If it’s a learning disorder, you get medicated for something that needed accommodations instead.
A wrong answer doesn’t just cost money. It costs years.
Where the testing happens
My office is at 1120 McKendrie Street in San Jose, in the Rose Garden area off The Alameda.
People come here from across Santa Clara County, from Santa Cruz over the hill, and from up the Peninsula. Full-day neuropsychological evaluation isn’t something every practice does, so the drive is normal — and because the battery runs in a single day, it’s one trip, not a series of appointments.
If you’re coming from Santa Cruz, Scotts Valley, Los Gatos, Sunnyvale, Palo Alto, or Fremont, plan for the day. You’ll be likely finished in the day, most of the time, not always. We do what’s necessary.
This is for diagnosis, not accommodations
If you need documentation for the MCAT, LSAT, the Bar, the GRE, or a university — that’s different work, with different requirements and different deadlines. Start here instead.
If you want to know what’s actually causing the problem, you’re on the right page.
What it costs
Diagnostic evaluations run $6,500 to $7,500, depending on complexity. It’s a flat fee. I don’t take insurance, though many people recover part of the cost afterward — here’s how fees work, including why an evaluation costs what it does and what a PPO typically reimburses.
If that isn’t workable for you, say so. If an evaluation isn’t the right thing for your question at all, I’ll tell you that too, and it won’t cost you anything to find out.
Start here
Call. 321-208-1554 or 321-298-8668
Tell us what’s actually going on — not your symptoms, your question. What decision are you trying to make? Jessie will tell you what’s involved, what it costs, how long it takes, and what an evaluation can and cannot determine.
No pressure at any point. Some people who call don’t need an evaluation at all, and we tell them so.
Then we begin the process of finding out what it is — and, just as importantly, what it isn’t.