ADD and ADHD Testing, Diagnosis and Treatment Effectiveness Review Toronto & Across Ontario

FOCUS FORWARD 360: Our Multi-Expert Attention Assessment for Children, Teens and Adults.

Could it be ADD or ADHD?

Have you ever wondered if you or a member of your family has ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder)? People with ADD and ADHD share a common story; they are smart and have goals and dreams. They can all focus—on some tasks for a very long time, very intensely. But they struggle to regulate their focus, which means their attention isn’t something they can count on consistently. Beyond these similarities, stories diverge. Some individuals aren’t doing as well as they could be at school or work, missing deadlines and struggling to start and finish tasks. Other individuals do well at school and work, but they are frustrated by needing to exert tremendous effort over long hours to succeed.

Individuals with attention challenges might be described as “unmotivated” or “lazy”—descriptions you know are unfair and untrue. Others are doubted—their long hours of hyperfocus, intelligence, and commitment to work tasks are seen as proof that they don’t have an attention problem. But, in fact, they may have inconsistent focus that requires treatment.

Whether it’s unfair comments, or unfair assumptions, being misunderstood is hurtful and unhelpful. But what can you do?

It’s important to figure out whether ADD or ADHD can explain the challenges you are seeing, especially since treatments for ADD and ADHD can be incredibly effective. Help is available, and science shows that specific treatments can make a big difference!

Here are answers to questions we are often asked about assessing attention challenges at the Possibilities Clinic.

You might have heard that ADD and ADHD aren’t “real” disorders. Well, science says that viewpoint is wrong. ADHD is a real, physical, neurobiological brain difference. Thousands of scientific studies have proven that fact, so don’t let anyone tell you otherwise! Attention deficit disorders can look different in different people. A common theme is difficulty focussing, but some individuals are more hyperactive and impulsive, while others tend to daydream and are not at all hyperactive or impulsive.

A detailed examination of attention can help you figure that out. And no, this is not something you need to figure out on your own. We can help. We’ve assessed thousands of children, teens, and adults at the Possibilities Clinic. We specialize in investigating, testing, and treating ADD and ADHD—so we know the best practices and strategies for success that can support a brighter future for you and your family.

Yes. When it comes right down to it, the word “deficit” in ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) is misleading. It’s not that people with ADD or ADHD have no attention. More accurately, they can pay attention, but the brain struggles to regulate that attention. So, when ADD or ADHD is present, the brain can hyperfocus during activities that are very interesting, but attention drops rapidly for tasks the brain would rather not do. To be clear—a person with ADHD does not choose to be interested in some tasks and disengaged from others. Differences in brain circuitry and in naturally occurring brain chemicals (called neurotransmitters) that support attention in individuals with ADD and ADHD mean that attention is not consistent across situations, no matter how hard someone tries to stay focussed. ADD and ADHD would be better named Attention Dysregulation Disorders, in our opinion, rather than Attention Deficit Disorders. It’s not the absence of attention that’s the challenge; it’s regulating attention so it’s available across all kinds of tasks—easy and difficult, interesting and less interesting.

Yes. Diagnosing ADD and ADHD is complicated. No person with ADD or ADHD is alike. How well the brain can focus changes with tasks the brain is working through and with time of day. To complicate matters further, symptoms that look like ADD or ADHD might not signal an attention disorder. Figuring out what’s going on takes time, detailed investigation, and expert knowledge. Bottom line: Diagnosing ADD and ADHD can’t be done with a simple checklist. It can’t be done in 15 minutes.

Yes, treating ADD and ADHD is very complicated—and possible. There are many medication and non-medication options out there. Some have scientific support and others don’t. How do you know what’s right for you or your family? How do you know what’s going to make real change happen? With our team of physicians, mental health, and educational professionals, we’ll devise a Treatment Plan that helps you achieve bigger goals and better outcomes. And we’ll only offer treatments that are supported by science. So, yes, treating ADD and ADHD is complicated. But we’re confident our experts in attention—and in disorders that can go along with ADD and ADHD like depression and anxiety—will create a Treatment Plan that is backed by science and right for you.

At Possibilities we offer Focus Forward 360, an exciting service where expert clinicians take an in-depth look at attention—whether for you or your child—and make recommendations backed by science to support functioning going forward. We also examine more than attention since challenges with focus can be associated with mental health and learning concerns. 

There are 5 sessions you’ll attend in our Focus Forward 360 service:

• In an intake session, you’ll meet with a physician. The doctor will take a detailed medical and developmental history and ask about current and past functioning. 
• In another session, you’ll meet with a psychologist. You’ll discuss symptoms and challenges. You’ll also talk about your strengths and goals, and strategies you’ve used in the past that have or haven’t been helpful.
• In a third session, you’ll meet with a psychometrist who will do direct testing of your attention and other cognitive functions like working memory, which is the ability to hold and process multiple pieces of information in your mind at once. The psychometrist will administer additional tests and questionnaires to screen for academic challenges and possible mental health concerns. Responses from others—like teachers or colleagues if you grant permission for us to send questionnaires to them—will help us get a detailed, 360 degree view of attention.
• Before you see our experts again, the 360 Assessment Team will meet and review all of the information you have provided, as well as the testing results. The team will examine report cards we’ll ask you to provide, too, since documented challenges in early elementary school are an important component of an ADD or ADHD diagnosis. After reviewing all information and test results, your 360 Assessment Team will determine whether a diagnosis of ADD/ADHD can be made. The team will also discuss what Treatment Plan is right for you or your child, and document the plan in a report that you and/or your child will receive. 
• Next, you’ll meet with the psychologist from your team to discuss the results, any diagnoses that may have been made, and the Treatment Plan. The psychologist will focus on non-medication options for any diagnosis that may have been made—like coaching to support success with ADHD, therapy for anxiety that may be occurring along with attention challenges, or tutoring to support learning differences.
• In your last session, you will meet with a physician from the Focus Forward 360 service to discuss the findings from a medical perspective. Maybe you aren’t sure if medication is the right choice for you or your child. Or maybe you’re eager to explore medication, choosing to integrate medication and non-medication therapies for ADD or ADHD. You’ll be able to ask the physician about medication therapies in detail during this session, so you can make an informed decision that’s right for you. If you choose to proceed with medication, a detailed Medication Plan will be sent to your physician or child’s pediatrician.

Attention is a critical component in everything adults, teens, and children do. Whether we are reading, driving, talking, listening, learning, or playing, attention is a key ingredient for doing all tasks safely, accurately, and well. What attention looks like at any time, and in any activity, varies. To understand focus well, we can’t think of attention as one thing that looks and acts the same in all situations for all people at all times. We need to take a 360 degree perspective, thinking about focus in different situations and at different times for you or your child. That way we can figure out when focus is at its strongest and at its weakest—with various levels of strength in between—and begin to devise a Treatment Plan that helps make focus more reliable. The “Forward” part of the Focus Forward 360 name reminds us that it’s critical to investigate attention at regular intervals moving forward, to increase the chances of being successful as expectations in life change and demands increase. With a 360 view, we can develop a comprehensive, personalized, and meaningful profile to direct our decisions about diagnosis and treatment options now and going forward. 

At Possibilities we approach assessments from a unique team perspective. That means we involve experts from multiple health fields—like psychology and medicine—in every single assessment that we do, including our comprehensive analysis of attention in our Focus Forward 360 service. Our experts in ADD and ADHD, and in other conditions that can mimic or contribute to attention problems, meet as a team to examine and discuss the data before we make any decisions about whether ADD or ADHD can be diagnosed. A team approach to ADHD—where experts from multiple health fields like psychiatry, pediatrics, family medicine, and psychology come together in real time to discuss your results—makes our assessments of attention comprehensive, firmly grounded in current brain science, and unique. 

Our 360 degree perspective is also noteworthy when it comes to treatment. Our specialists have deep expertise in conditions beyond ADD and ADHD. That’s important because ADD and ADHD often occur with other challenges. If we hyperfocus on attention, we might miss other concerns. If that happens, treatment won’t be as successful as it could be. Experts on the 360 Focus Forward team have rich expertise in attention deficit disorders and in other conditions like anxiety, depression, learning challenges and tic disorders. So our specialists, working as a team, can think meaningfully about focus in context and determine how best to treat all challenges that may be present in your profile to maximize success.

No, it is not. People can find it hard staying focused for many reasons. A student may have poor focus during math class—not because of ADHD but because of specific challenges with math. A parent may feel scattered and forgetful—not because of ADHD but because of job and parenting demands that leave little room for planning and organization. A corporate executive may feel overwhelmed at work—not because of ADHD but because she is doing the work of three people. Focus Forward 360 offers an in-depth analysis of attention by multiple experts through clinical interviews, direct testing, questionnaire ratings, and an investigation of medical history, how development unfolded years ago, and how focus operates at various times and in different contexts. At the end of the process, ADD or ADHD might be diagnosed, or it might not. You’ll receive information to help you or your child maximize focus and follow-through in various situations, whether a diagnosis is made or not.

Anyone who is concerned about their focus, or their child’s focus, can benefit from our Focus Forward 360 service. If an assessment has never been done, but you wonder if ADD or ADHD can explain challenges, then our service is right for you. If you’ve already been diagnosed with ADD or ADHD—or your child has been diagnosed previously—then our service is right for you. Even if you’re already getting treatment for ADD or ADHD, then our service is right for you. Our experts don’t see focus as a static thing. Focus is dynamic—it expresses itself differently over time and across different situations. So our expert team needs to understand how attention is behaving right now in current situations to know how best to treat it for maximum success. 

Yes, if you want to work with our Assessment Team—including the physicians who prescribe medications as part of our personalized Focus Forward 360 service—you or your child will need to participate in the entire assessment. In terms of testing, ways of determining whether someone has ADD or ADHD varies from clinic to clinic. Focus isn’t static either; it can vary over time and over tasks. All experts on the Focus Forward 360 team make recommendations only after an extensive analysis of focus is completed using our 360 process. We do not regard ADD or ADHD as something an adult, teen or child either has or doesn’t have based on an assessment at a previous point in time. How focus is functioning—right here and right now in all kinds of situations—is our biggest concern. Of course, we’ll look at the results of your previous assessment if you would like us to. But we’ll pursue our own comprehensive 360 analysis of focus in context so we can propose targeted treatments to optimize functioning in areas causing difficulty. 

No problem! We can see you or a family member as usual! You or your child would have access to our complete Assessment Team through our Focus Forward 360 service. As part of that service, you will meet with a physician directly to discuss various treatment options, including medication. The physician on your Focus Forward 360 team would then consult with your doctor about the ADHD medications that are best for you or your child based on all the information our team collects. You will also be advised on additional treatment options like coaching and therapy to maximize success. Feel free to provide us with results from your previous ADHD assessment; those results can be useful in our information gathering. However, because our assessments are comprehensive and involve extensive data collection about focus in context—including direct testing of attention with our unique 360 process—our team of experts from psychology, psychometry and medicine will not be swayed by previous assessment results in a way that decreases our accuracy in making the right diagnosis. 

Yes! At Possibilities, our expert team works with you to coordinate medication and non-medication treatments in one clinic. Our specialists know that recommendations can’t be general, and they can’t be vague. Recommendations must be targeted, specific, and supported by science. And they must be personalized for you or your child. For example:

• For the college student moving away from home, we can request a single residence room if we have concerns about poor sleep and high distractibility
• For students who struggle to start work and meet deadlines, we can offer programs like ADHD Coaching or therapy
• For the corporate executive challenged with increasing demands, we can identify a plan to parse work and hit targets through ADHD Coaching that adds a corporate lens  
• For the person requiring medication support, we can provide a medication plan to the referring physician

Yes. Experts on our Focus Forward 360 team recognize that demands for attention change over time. New grades, new jobs, new circumstances all present new challenges for attention as time goes on. We recommend a complete Focus Forward 360 analysis of attention, along with the multi-expert treatment review that goes along with our analysis, every 2 years.

The cost for our Comprehensive Multidisciplinary ADHD Assessment through the Focus Forward 360 service is $1950. This cost is often covered by private insurance plans. Post-secondary students may be eligible for an OSAP bursary that covers a portion of the assessment cost.

No! We are excited to announce that our assessments of attention are now available throughout Ontario over secure video. We conduct direct testing of attention and cognitive functioning over the internet, as well as all interview sessions with clinicians. If you have a computer and a high-speed internet connection, all your appointments and testing can be done from the comfort of your home. During the COVID-19 pandemic, all assessment and therapy sessions offered at the clinic are being conducted through secure video sessions. For your convenience, no matter where you live in Ontario, we will continue to offer video sessions for our Focus Forward 360 service even after the threat of the pandemic has subsided. 

Unfortunately, at this time, all our physicians and psychologists are only licensed to see people in Ontario. If you live anywhere in Ontario, you can be accessed remotely. If you do not live in Ontario, you or your child can still be assessed but you will need to come down to our central Toronto office. We may be able to change this rule in the future, so stay tuned!

Yes. Specialized physicians are involved in all of our team ADHD assessments, so a doctor’s referral is required. If you are not seeking an assessment of attention, but wish to proceed directly with therapy or coaching, a doctor’s referral is not required.

Good news! Your doctor can obtain advice about ADHD medication from our medical experts using an eConsult on the OTN platform if you have received an ADHD assessment elsewhere. Talk to your doctor about this eConsult option. This doctor-to-doctor e-consultation is fully publicly-funded. To be eligible for this service, the ADHD assessment you received elsewhere must meet the same high standards of diagnostic investigation that define the assessments we conduct at Possibilities. We request that your ADHD diagnosis be derived from a Psychoeducational Assessment or a comprehensive ADHD Assessment that includes data from direct testing, relevant information derived from detailed clinical interviews, and ratings from standardized, norm-referenced questionnaires. These diagnostic assessments must be relatively current, and not more than 3 years old. Since we will base our eConsult with your doctor on this previous assessment, you will not be seen directly by our physicians. Instead, we will advise your doctor on potential medication treatment based on the information garnered from the assessment you received elsewhere.

Complete the intake forms on our website at https://possibilitiesclinic.com/age-3-17/ for children and https://possibilitiesclinic.com/age-18/ for adults. Once we have this form and the physician referral, our team will call you to set up an appointment.

For any questions, email us at info@possibilitiesclinic.com or call 1-833-482-5558 to speak with one of our Care Coordinators.