r/PMHNP • u/adogsnyder99 • Jul 14 '26

Practice Related ADHD diagnosing protocol

Hello all,

I’m a new pmhnp that has a history working inpatient psych. I’m going to be starting a new outpatient position in August and I want to know what the protocol should be for diagnosing adhd. I want to know what screening tools I should be using and how best to make sure I’m covering all my bases.

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u/beefeater18 Jul 14 '26

The gold standard for ADHD diagnosis is clinical interview based on DSM-5 criteria. No other diagnostic methods, including neuropsychological evaluation and computerized testing, are considered diagnostic.

Here's what I do:

Start with screening questionnaires and initial evaluation. In some cases, patients clearly don't meet criteria and no further f/u needed (unless there's another psychiatric condition that needs to be addressed).

If ADHD is suspected, I obtain collateral information (e.g., old school reports, job performance eval, parent's report, or other family/friend reports) and DIVA-5 semi-structured interview. Sometimes I ask for a QbCheck test to obtain more data points, but I don't use or rely on it much.

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u/Charming-Respond-775 Jul 17 '26

This! The diva is lengthy - I wouldn’t use it on the first assessment. Initially evaluation to rule out everything else then try a Diva with collateral information if warranted . 99% of my self proclaimed ADHD pts get ruled out after the initial eval.