The Future of ADHD Care: Redefining Adult Diagnosis and Treatment

SPECIAL REPORT: ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most treatable mental health disorders in psychiatry. Yet an estimated 65 million adults in the United States suspect they may have undiagnosed ADHD.¹ Despite this, adult ADHD remains misunderstood, underdiagnosed, or misattributed to anxiety, depression, or trauma. As a result, one of the clearest opportunities for effective treatment is often overlooked.

However, a shift is underway in how clinicians approach ADHD diagnosis and treatment. Integrating objective testing with traditional assessments, particularly in virtual and hybrid care environments, is at the center of this change. This combination has the potential to deliver faster, more accurate, and more equitable care for adults with ADHD.

Problems With Subjective Testing

Diagnosing ADHD in adults presents distinct challenges. Unlike children, whose symptoms may be more overt, adult presentations are often complex or subtle. Although there are no current gold standard guidelines, current diagnostic criteria, drawn largely from research on children (specifically boys), do not fully capture the lived experiences of adults. Many adults learn to mask or develop compensatory strategies that can obscure their symptoms in a standard clinical interview, leaving even skilled clinicians at risk of missing the diagnosis.

The reliance on subjective tools compounds these complexities. Rating scales hinge on patients’ self-perception and willingness to disclose, while clinical interviews are shaped by the clinician’s interpretation. Although useful, these approaches are vulnerable to bias, cultural considerations, and limitations of recall; they are often insufficient in distinguishing ADHD from conditions with overlapping symptoms.

This overlap is clinically significant. ADHD in adults may mimic or coexist with anxiety, depression, trauma-related disorders, or attachment difficulties. Without objective data, it can be difficult, even for the most skilled, to disentangle these conditions and establish diagnostic confidence. By adding this layer of rigor, clinicians gain greater clarity in differentiating ADHD from other conditions with overlapping symptom profiles.

Why Objective Data Matter

Adult ADHD remains a challenging area for clinicians, particularly as complexity in adult patients grows and because there are no standardized guidelines and many clinicians have limited training in adult presentations. Objective data offer a solution: They provide a standardized framework that highlights attention, hyperactivity, and impulsivity patterns, reducing reliance on intuition or pediatric-based criteria. This boosts diagnostic confidence and helps clinicians communicate findings clearly to patients who have struggled for years without validation. Moreover, objective measures allow progress to be tracked over time, guiding treatment adjustments even in the absence of formal adult ADHD protocols.

Effective management of adult ADHD relies on a treat-to-target approach, using measurable outcomes to guide interventions. Objective data allow clinicians to establish a clear baseline of attention, executive function, and cognitive patterns, enabling personalized treatment—whether medication, therapy, or lifestyle strategies. Tracking these measures over time supports timely adjustments, ensuring interventions meet specific goals. It also enhances patient engagement, as seeing measurable progress reinforces adherence and facilitates shared decision-making. By reducing bias and misinterpretation, this approach gives both clinicians and patients confidence in the treatment plan.

Collaborative relationships are the foundation of effective ADHD care: When patients feel heard, validated, and safe, they are more willing to share the nuances of their experience. Pairing this alliance with objective data transforms assessment and treatment. Objective measures that offer highly visual reports provide a neutral reference point that can be shared across provider teams and the patient, validating a patient’s lived experiences while giving clinicians clarity in distinguishing ADHD from overlapping conditions. This combination fosters shared decision-making, builds treatment engagement, and allows progress to be tracked over time, creating a feedback loop that strengthens patient confidence and clinical effectiveness.

Equally important is the balance between thoroughness and timeliness in ADHD management. Clinicians aim to be comprehensive in their diagnostic approach, but they also recognize the urgency of providing patients with effective support as quickly as possible. Because ADHD is among the most treatable psychiatric disorders when accurately identified, delays in diagnosis can postpone life-changing interventions. Objective testing provides the additional information needed to act confidently and efficiently, ensuring patients receive the correct diagnosis and treatment.

Objective testing does not replace the clinician’s role; it enhances it. By combining professional expertise with objective data, providers can deliver more timely, confident diagnoses, ensuring patients receive appropriate treatment without delay.

Meeting the Demands of Hybrid Care

The rise of virtual and hybrid care models has been both necessary and inevitable, particularly in extending access to patients who might otherwise go untreated. Yet these models also raise important challenges for clinicians tasked with diagnosing ADHD accurately.

A key concern is the difficulty of conducting behavioral observations during telehealth encounters. In virtual settings, clinicians often see only the patient’s head and shoulders, limiting their ability to notice subtle movements or restlessness that may indicate hyperactivity. This limitation can complicate the diagnostic process, especially when trying to differentiate ADHD from other psychiatric conditions.

Hyperactivity becomes particularly complex as a person ages (Figure 1). It is rarely expressed in the stereotypical manner associated with young boys, running around or visibly unable to sit still. Instead, adults may demonstrate hyperactivity through subtler behaviors such as fidgeting, tapping a foot, or restlessness, which can be missed on screen. Women and girls are even more likely to present with less overt signs, potentially due to masking behaviors and/or compensatory strategies developed over time. Without careful assessment, these patients risk being overlooked or misdiagnosed.

The difficulty is compounded by the proliferation of unregulated tools marketed as ADHD assessments. Many of these lack a strong evidence base, making it hard for clinicians to determine which are reliable. Already facing heavy caseloads and burnout, clinicians may not be able to vet tools for reliability, validity, sensitivity, and specificity.

FDA-cleared, evidence-based objective testing offers a solution. These tools can supplement the gaps left by virtual observation by providing standardized data on attention, impulsivity, and activity. They allow clinicians to maintain diagnostic rigor in telehealth and hybrid models, ensuring patients receive accurate assessments and timely treatment (Figure 2).

Safeguarding Standards

Objective testing provides an essential safeguard in ADHD care by providing data on activity, impulse control, and attention, which is norm referenced by age and sex at birth. Subtle expressions of hyperactivity in adults, such as fidgeting, foot tapping, or constant restlessness, are often missed in virtual settings and may not be self-identified by patients. By capturing these behaviors, objective testing strengthens clinical judgment and reduces the risk of missed diagnoses.

Concerns about profit-driven diagnoses and unregulated tools underscore the need for rigor. Many ADHD assessments lack evidence or FDA oversight, and confusing terms such as FDA approved, FDA exempt, and FDA cleared add to uncertainty.² FDA approved applies to drugs and high-risk devices and demands clinical trials; FDA exempt covers low-risk devices with no premarket review; and FDA-cleared tools undergo review to ensure reliability, validity, and clinical utility—protecting clinicians and patients.

Finally, objective data help clinicians navigate the surge of adults seeking evaluation, many influenced by social media. By grounding decisions in subjective and objective evidence, providers can more accurately distinguish ADHD from overlapping conditions, improving diagnostic confidence while maintaining patient trust.

An Accessible, Accountable Future

Expanding access to ADHD care remains a significant challenge in the United States, particularly in remote and underserved areas. Hybrid and virtual care models are key to addressing this gap, but they must be implemented with safeguards to ensure accuracy and consistency.

ADHD is highly treatable once identified. The task now is to make that identification more reliable and accessible for all patients. Integrating objective testing into modern care models represents a pivotal step toward a future that is more accessible, accountable, and equitable. This is the future of ADHD care—where clinical expertise and objective science come together to deliver consistent, equitable, and life-changing outcomes for patients.

Dr Weir is the lead clinical adviser at Qbtech, where she supports clinicians worldwide in delivering evidence-based ADHD assessment and care. Based in Texas, she previously worked in academia and as a psychologist in a pediatric psychology department in the UK. She is a Health and Care Professions Council–registered psychologist and earned a master’s degree in health psychology; her doctoral research focuses on the cross-cultural use of psychological rating scales.

References

1. Survey finds 25% of adults suspect they have undiagnosed ADHD. Press release. The Ohio State University Wexner Medical Center. October 14, 2024. Accessed October 7, 2025. https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/survey-finds-25-percent-of-adults-suspect-they-have-undiagnosed-adhd

2. About FDA: patient Q&A. FDA. November 2024. Accessed October 7, 2025. https://www.fda.gov/media/151975/download