Why ADHD May Not Always Look the Way Clinicians Expect |
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ADHD questionnaires can miss difficulties when symptoms are shaped by cultural context.
External structure may mask ADHD until major life transitions overwhelm coping strategies.
Clinical assessment requires interpretation, not just scoring symptom checklists.
A young West African woman recently came to see me for an ADHD assessment after moving to the UK to begin a Master’s programme.
Before the appointment, as is fairly typical practice in many adult ADHD services, she completed a pre-assessment questionnaire based on the Adult ADHD Self-Report Scale (ASRS). A parent informant questionnaire was also completed by her father.
At first glance, the questionnaires did not suggest ADHD.
Most individuals who ultimately meet criteria for ADHD tend to endorse multiple symptoms as occurring “often” or “very often.”
This woman rated almost all symptoms as only “sometimes” or “rarely”. Her father answered “no” to virtually every informant question asking whether she showed difficulties beyond what would be expected for someone her age.
Looking........