#disability testing

Finding a Clinic: 

I have insurance that doesn’t require me to get a referral and I don’t have a primary care doctor, so I just googled “ADHD screening adult chicago” and started looking at websites. If you have insurance that requires a referral, you may need to speak to whoever you normally see about your health. A lot of places will still do the evaluation without coverage, but it may be a significant cost.

While researching, I made a google sheet that listed the URL, name of the clinic, and their appointment phone/email. I started contacting them one at a time and logging when and how I contacted them. If I didn’t hear back within 24 hours, I moved on. I’d had an initial bad experience with a place that repeatedly failed to respond, which Yelp informed me was a chronic issue, so I resolved not to bother with anywhere that wouldn’t hit me back promptly. I ended up going with the third place I contacted, which was the first place I heard back from. 

What to look for:

You want a place with a website that lists a clear way to contact them, their physical location so that you can make sure you can get there, and at least a few of the staff, with brief bios and qualifications. I avoided single-person clinics because I wanted somewhere with more extensive resources for evaluation. I leaned towards clinics affiliated with medical centers. 

I also leaned towards sites that offered resources for people with ADHD and that had discussions of the evaluation process. If the website doesn’t discuss the evaluation process that’s not necessarily a no-go, but you should be sure when you speak with them that either they offer more information or they answer clearly with that information when asked for it. If they get defensive about it when asked, dump them and move on. 

For example, I got an initial email about how it’s a five-hour evaluation with a psychiatrist. As we moved through the process I was also told that no studying is required, I should bring water and snacks, that a bathroom would be available, and we could break if I needed to. You don’t necessarily need to get all of that but you should know what’s going to happen, in a general sense, ahead of time.  

What’s going to happen?  

First I was sent documents to fill out -- a medical history, an insurance form, and an initial questionnaire. Because I was coming in without a referral, they did an intake via zoom where I spoke with someone who asked about my history and set me up with an evaluation. I did more history at the start of the evaluation, including a discussion of my familial relations -- my brother’s autism and how that has impacted me, my family life growing up, etc. We also discussed you guys! I told her a bit about my social media readership and what kinds of things I talk about on tumblr. (”So you run a blog about organization?” “Oh no. It’s mostly pop culture analysis. Some photos of my cats. Fandom.” “Oh! Fandom! That’s fun.” If you’re reading this, Dr. M., you were great.)  

As far as I’ve seen, most evaluations involve questionnaires, and some but not all that include cognitive tests along with the questionnaires. Cognitive testing isn’t necessarily better, but I did go out of my way to find a place that would do cognitive testing because I preferred the additional data. Questionnaires on their own seem fine. Cognitive testing on its own I would avoid; you want your lived experience to be included in consideration. 

During the evaluation, I took a number of questionnaires about my behavior as a child and as an adult, my social relationships, my views on myself and others, and my drug and drinking habits (a lot, to the point where I was like “Bro do you know something about my drinking that I don’t?” but that could be unique to the clinic I went to.)  

Based on conversations with friends, I answered as I would if I didn’t have coping mechanisms, or as one friend put it, “on a bad day”. While I don’t lose things because I’ve spent decades training myself to give everything a “place to live”, I know that if I don’t do that I will lose stuff often, so I answered “often” to the statement “I lose everyday belongings more than most people.” However, I’ve never been an impulsive person so I still answered “no” to questions like “I am a daredevil” and “I often do dangerous things without thinking.” 

Scattered throughout these questionnaires were cognitive tests. I was asked to assemble blocks in certain shapes, listen to lists of words and numbers and recite them back, match patterns in colors and shapes, watch a video of flashing letters and hit a button after certain letters, et cetera. When doing the cognitive testing, as with the questionnaire, I avoided using “memory tricks” that I would normally use. (For instance, she read a list of words that began “Truck, cabbage, giraffe,” and I deliberately stopped myself from building a mental image of a giraffe driving a produce truck, a learned skill I would normally employ in order to cue myself to remember the list.)

They were nonjudgmental about my performance on these tests, which were given in a quiet, private room with good lighting and appropriate accessibility tools. For some tests she read aloud instructions that were also on a tablet screen in front of me, and whenever she couldn’t give me more help on a test she said so. 

Afterward

At the end of the  evaluation, they gave me a timeline for when I might hear back (early April; I have no idea if that length of time is normal but it’s not especially surprising) and next steps -- regardless of diagnosis they’d meet with me again to go over the information, and if I had a diagnosis we would discuss my options in terms of treatment. I fully expect that if I do get a diagnosis and we decide to try medication, I’ll have some fairly detailed discussions with them about options, side effects, life impact, and given the nature of ADHD medication, addiction and withdrawal.