Adult ADHD Assessment in Adults (NICE NG87 Framework)
Assessment of ADHD in adults requires a structured and evidence-based approach to ensure diagnostic accuracy and medico-legal robustness. NICE guidance emphasises careful evaluation of core symptoms, developmental history, functional impairment, and exclusion of alternative explanations. This page outlines a clinically grounded framework for adult ADHD assessment in line with UK guidance.
Core Components of Adult ADHD Assessment
A robust adult ADHD assessment requires a structured approach that goes beyond symptom screening. Core components include evaluation of current symptoms, confirmation of childhood onset, assessment of functional impairment across settings, and exclusion of alternative explanations. This framework is central to diagnostic accuracy and aligns with NICE NG87 guidance.
Developmental History and Childhood Onset
NICE NG87 emphasises that ADHD is a neurodevelopmental condition with onset in childhood. Adult assessment therefore requires careful exploration of early symptoms, educational functioning, and behavioural patterns across development. Collateral history, where available, strengthens diagnostic confidence.
Assessment of Functional Impairment
Diagnosis of ADHD requires evidence that symptoms result in clinically significant functional impairment. Assessment should consider occupational, academic, social, and daily living domains. Symptom presence alone is insufficient without demonstrable impact on functioning.
Exclusion of Alternative Explanations
Many psychiatric, medical, and psychosocial conditions can mimic ADHD symptoms in adults. Differential diagnosis should actively consider anxiety disorders, mood disorders, sleep disorders, substance use, neurodevelopmental conditions, and medication effects. Careful exclusion of alternative explanations is essential for diagnostic accuracy.
Clinical Judgement and Documentation
While structured tools and rating scales can support assessment, diagnosis ultimately rests on clinical judgement. Clear documentation of diagnostic reasoning, evidence considered, and exclusion of alternatives supports medico-legal robustness and continuity of care.
An overview of our CPD-certified approach to adult ADHD assessment and diagnosis is available on the homepage.
This framework has been developed by ADHD Clinical Academy as part of its CPD-certified training in adult ADHD assessment and diagnosis. It reflects a NICE NG87–aligned approach and is provided for educational purposes. Further structured teaching and applied clinical examples are covered within the full course.
This content is intended for healthcare professionals and does not replace formal clinical training, supervision, or adherence to local governance requirements.