The accurate assessment of ADHD is crucial, ensuring individuals receive correct diagnosis and access essential resources. In Israel, diagnosis relies on evidence-based assessments in accordance with diagnostic guidelines outlined by the Israeli Ministry of Health, incorporating diagnostic criteria of the DSM-5.

 

Objective: This study aims to assess professionals' adherence to diagnostic guidelines for initial adult diagnoses of ADHD and identify factors impacting clinicians in this process.

 

Method: Three independent raters evaluated reports submitted by individuals as part of the necessary documentation of ADHD required for applications for testing accommodations, in the Psychometric University Entrance Test. Only reports from individuals who underwent first-time diagnosis at age 16 and above were included. Seventeen variables were examined, covering aspects detailed by diagnostic guidelines. Additionally, in corporation with the largest national health services agency relevant clinicians were surveyed regarding the factors influencing their diagnostic process and decisions.

 

Results: findings revealed that a minimal number of reports fully complied with guidelines. Most reports lacked a comprehensive history (72%),

reported an unclear source of information (67%), failed to indicate whether any dedicated questionnaires were used (57%), nor detail the specific ones used (72%). In the majority of reports symptom counts were absent (76%), although they did describe current symptom manifestations (63%). However, many neglected to address environmental and functional impacts (80%). The second part aimed to incorporate relevant clinicians' perceptions to better on the barriers and factors that affect their diagnostic process and decisions is ongoing. 

 

Conclusions: Diagnostic guideline adherence is undeniable essential; however, most initial diagnosis reports lack crucial details. This gap does not necessarily indicate clinician's noncompliance, but may rather reflect deficiencies in reporting. Further gaining better understanding as to the factors and challenges faced by clinicians which that influences them during the diagnostic process, is key to effectively supporting individuals with ADHD. 

Avital is a Learning disabilities specialist and an Applied behavior analyst. She completed her masters in the field of Learning disabilities, and studies in ABA at the Hebrew university of Jerusalem. She is in the process of submitting her PhD proposal on effects of reinforcement learning on sub-optimal decision-making in ADHD. She holds the position of a senior member of the testing accommodations comity at the National Institution for Testing and Evaluation. She also teaches fundamental courses in Applied Behavior Analysis to first year ABA students ant the Hebrew university. Her research interests include suboptimal decisions in ADHD, 'twice exceptional' pupils, enhancing accuracy and efficacy of psycho-educational evaluations.