Is Neuropsychological Testing Necessary for an ADHD Diagnosis? A Thoughtful Look for Parents and Caregivers
As a parent, few things matter more than understanding how to support your child’s growth, development, and well-being. Whether you're navigating challenges in school, trying to make sense of emotional ups and downs, or wondering whether something deeper—like ADHD—might be at play, it can feel overwhelming to know where to turn or what kind of assessment makes the most sense.
One question I hear often from families is: “Is neuropsychological testing really necessary to diagnose ADHD?”
It’s a fair and important question—especially when time, cost, and access to services are real concerns. Recently, I attended a professional conference where Dr. Jordan Wright—a clinical psychologist, professor, author, and leader in the field of psychological assessment—gave an excellent presentation on this very topic. His talk, based on a research article he authored called Psychological and neuropsychological underpinnings of attention-deficit/hyperactivity disorder (ADHD) assessment, raised thoughtful questions about how we assess ADHD and what we’re really trying to understand in the process.
Let’s take a closer look together.
Behavior vs. Brain: How We Define ADHD Matters
At the heart of this conversation is a fundamental tension: ADHD is classified as a neurodevelopmental disorder, which means it has biological and brain-based roots. Yet, the way we diagnose ADHD—at least according to the DSM-5—is based entirely on observable behavior. Things like:
Trouble following through on tasks
Fidgeting or difficulty sitting still
Being easily distracted
Struggling with time management or organization
These behaviors can be assessed through interviews, rating scales, and observations, and for many children, this is enough to make a clear diagnosis and begin appropriate support.
But here’s where things get a little more complex.
When Behavioral Data Isn’t the Whole Picture
Behavioral symptoms can tell us what is happening—but they don’t always tell us why. Two children may both struggle to complete homework, but for very different underlying reasons. One might have true attentional difficulties tied to executive functioning differences. Another might be anxious, bored due to giftedness, or dealing with trauma or sensory sensitivities.
That’s where neuropsychological testing can come in.
Rather than just looking at behavior on the surface, neuropsychological assessments dive deeper—examining how a child’s brain is working across different areas, including:
Attention and executive functioning
Working memory and processing speed
Visual and verbal learning
Emotional regulation and social thinking
This broader view can uncover patterns that aren't obvious in a simple interview or checklist, and it helps us understand whether symptoms that look like ADHD may stem from something else entirely—or may be part of a more complex picture that includes learning differences, anxiety, or other co-occurring conditions.
Is It Always Necessary?
Here’s the truth: I don’t believe neuropsych testing is necessary in every case. Many children are accurately diagnosed through careful clinical interviews and behavior checklists completed by parents, teachers, and the child themselves. Especially in situations where access to care is limited, I fully support reducing unnecessary barriers to diagnosis and treatment.
That said, in my work with families, I’ve seen time and again how helpful this deeper assessment can be—particularly when:
There’s confusion or disagreement about what’s going on
A child has already tried interventions that haven’t worked
There are concerns about learning, social development, or emotional regulation in addition to focus and attention
Parents are seeking a fuller picture to guide long-term support at home and at school
When used thoughtfully, neuropsychological testing can be a powerful tool to better understand your child’s unique brain and learning profile—not just for the sake of a label, but to help guide the next steps with more clarity and confidence.
The Goal: Compassionate, Informed Support
What I appreciate most about Dr. Wright’s work is that it invites us to ask better questions—not just “What diagnosis does my child meet criteria for?” but “What’s actually going on here, and how can we best support them?”
Whether or not neuropsychological testing is part of your child’s path, the ultimate goal remains the same: to understand them more deeply, affirm their strengths, and help them navigate the world with the tools they need to thrive.
Comprehensive ADHD Testing in Tigard, OR and Camas, WA
If you’re looking for ADHD testing in the greater Portland metro area or Southwest Washington, I offer comprehensive, individualized assessments from my offices in Tigard, Oregon and Camas, Washington. Whether your child is struggling with focus, emotional regulation, school performance, or you're navigating concerns about attention or executive functioning, my goal is to help you better understand what's going on beneath the surface—and what can help.
I work with children, teens, and young adults, providing developmental, psychological, and educational assessments that are rooted in curiosity, compassion, and clinical expertise. Many families tell me that receiving a thoughtful, in-depth evaluation brought them a huge sense of relief, clarity, and direction—especially after years of unanswered questions or trial-and-error interventions.
Conveniently located for families in Tigard, Tualatin, Lake Oswego, Beaverton, and the greater Portland area, as well as Camas, Vancouver, Washougal, and East Clark County, both offices offer in-person sessions with flexible scheduling. Virtual consultation calls are also available if you’d like to explore whether testing is the right next step.
If you’re feeling uncertain about how to best support your child, you’re not alone—and you don’t have to figure it out all on your own. I’d be honored to walk alongside you.
Resources:
[Article Mentioned] Wright, A. J. (2021). Psychological and neuropsychological underpinnings of attention-deficit/hyperactivity disorder (ADHD) assessment. Clinical Child Psychology and Psychiatry, 26(3), 783-794.
