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CCP0010.1177/1359104521996765Clinical Child Psychology and PsychiatryWright

Article
Clinical Child Psychology

Psychological and
and Psychiatry
2021, Vol. 26(3) 783­–794
© The Author(s) 2021
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of attention-deficit/hyperactivity DOI: 10.1177/1359104521996765
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disorder assessment

A. Jordan Wright
New York University, New York, NY, USA

Abstract
The identification and diagnosis of attention-deficit/hyperactivity disorder (ADHD) is extremely
important in order to help change the trajectory of an individual’s life outcomes. A review
of the current state of evidence-based assessment of ADHD is dominated by the DSM-5’s
conceptualization of behaviorally-oriented diagnostic criteria. This assumption that the DSM-5’s
method for identifying ADHD is the gold standard underlies the research base that evaluates
the incremental validity of measures and methods for diagnosing it. That is, when evaluating
whether a measure is useful in the identification of ADHD, the ‘right answer’ is based on the
DSM-5’s behaviorally-oriented definition. An alternative model for considering the fact that
ADHD is a neurodevelopmental disorder, with its roots in executive dysfunction, is proposed.
Using neuropsychological and cognitive tests to identify executive functioning problems can be
combined with rating scales and interviews to diagnose ADHD in a way that does not ascribe
entirely to a behavioral definition of the disorder.

Keywords
Attention-deficit/hyperactivity disorder, neuropsychological testing, comprehensive assessment,
diagnosis

Identification of Attention-Deficit/Hyperactivity Disorder (ADHD) is extremely important, as peo-

ple with ADHD tend to have significantly lower life achievement than their similarly abled peers,
including lower education and work achievement and higher rates of unemployment (Currie &
Stabile, 2006; Farone et al., 1996; Frazier, et al., 2007; Kessler et al., 2005). Further, children with
ADHD often have difficulties with interpersonal relationships, both with peers and within their
families (Hoza, 2007; Johnston & Mash, 2001). These are some of many difficulties suffered by
individuals with ADHD (e.g., Coghill & Hodgkins, 2016; Danckaerts et al., 2010; Loe & Feldman,
2007). Identifying and treating ADHD can help kids change their trajectory through treatment and
symptom management.

Corresponding author:
A. Jordan Wright, Steinhardt School of Culture, Education, and Human Development, New York University, 246
Greene Street, 8th Floor, New York, NY 10003, USA.
Email: [email protected]
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ADHD identification
The assessment of ADHD has become a battleground of ideologies, opinions, and conflicting evi-
dence. At the heart of the debate is the very definition of ADHD and how it is diagnosed. On one
side, the American Psychiatric Association (2013) in the DSM-5 has developed behavioral markers
of symptoms of the disorder, such as not seeming to listen when spoken to and having trouble hold-
ing attention on tasks. Based entirely on these criteria, the evidence-based techniques for assess-
ment quite neatly consist of rating scales and checklists of observed behaviors and symptoms, most
often from parents/guardians and teachers, as well as additional scales and checklists for other
disorders (Owens et al., 2020).
While this primarily behavioral definition of ADHD makes identification relatively straight-
forward, many neurocognitive differences between individuals with and without ADHD have
been identified. This is true across cognitive and neuropsychological skills (Pievsky & McGrath,
2018). There has been much evidence implicating frontal cortex functioning problems in ADHD
(Barkley et al., 1992; Konrad et al., 2006). Frontal dysfunction has been supported by brain
imaging research as well, which has identified underactivity in both frontostriatal and frontopa-
rietal networks (Faraone et al., 2015). These networks have distinguished ADHD and non-
ADHD individuals, and they are also highly related to the self-regulation skills referred to as
executive functions (EF). These include self-regulation of cognitive processes (including atten-
tion, self-monitoring, organization, and planning, among others), emotions, and behaviors (i.e.,
impulse control).
Additionally, other neurobiological systems have been implicated in the etiology of ADHD,
including the corticostriatal system (Mueller & Tomblin, 2012). The neurological, biological, and
cognitive (not just behavioral) roots of ADHD have further been underscored by the significant
alleviation of symptoms by medications, which not only improve direct ADHD symptoms, but also
seem to bolster performance on EF tasks (Schachar et al., 1997). These neurocognitive findings
relating ADHD to cognitive systems and EF have given rise to multiple theories of the etiology of
the disorder, which could have significant implications for identification.
Pennington and Ozonoff (1996) posited that ADHD symptoms, including distractedness, prob-
lems sustaining attention, and problems with controlling behavioral impulses, come from deficits
in EF. Barkley (1997) similarly theorized that the central deficit in ADHD is behavioral inhibition,
such that individuals cannot inhibit their automatic responses (or those that are likely to elicit
immediate reinforcement), delay or pause already-initiated behaviors, or remain focused when
competing stimuli are vying for response resources. Sonuga-Barke and Castellanos (2007) simi-
larly identified ADHD individuals as unable to turn off their default mode network (the pattern of
activity in the brain that occurs when one is at rest) when they need to engage in a task. All of these
theories implicate EF as underlying the disorder of ADHD, as do many others (e.g., Castellanos
et al., 2006; Diamond, 2005; Nigg & Casey, 2005; Rubia, 2011; Sergeant et al., 2003). This would
suggest that identification of EF deficits should be extremely useful in the diagnosis of ADHD, that
EF deficits actually constitute the ‘symptoms’ of ADHD.
The DSM-5 itself classifies ADHD as a neurodevelopmental disorder with executive dysfunc-
tion as a specifically associated characteristic (though not an etiological mechanism; American
Psychiatric Association, 2013). However, the DSM-5 has been identified as an inadequate system
for classifying ADHD because of the overreliance on behavioral symptoms rather than biological
markers, brain functions, or cognitive performance (Kinderman et al., 2013; Malla et al., 2015;
Timimi, 2014). Of note, it is likely that this behavioral focus underlies significant under-detection
in girls, as they tend to exhibit fewer prototypical behavioral symptoms (most often related to
hyperactivity) than boys (Gershon, 2002; Quinn & Madhoo, 2014).
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While research has found medium effect sizes for neurocognitive differences in ADHD versus
non-ADHD samples (Pievsky & McGrath, 2018), others have found much larger effect sizes for
behavioral differences (Willcutt et al., 2005). However, the identification of ADHD and non-
ADHD groups in these studies was made based on the behavioral markers listed in the DSM. Thus,
it is not surprising that behavioral indicators would be better at predicting who was categorized
based on behavioral indicators. Even meta-analyses looking at the diagnostic predictive ability of
specific cognitive tests have ruled out studies that did not adhere strictly to the behavioral, DSM-
identified diagnostic criteria in their groups (Frazier et al., 2004).
Even when EF was evaluated, behavioral indicators of those (via surveys) better identify DSM-
diagnosed ADHD than neuropsychological tests (Barkley & Fischer, 2011; Barkley & Murphy,
2011; Biederman et al, 2008). While Barkley and Murphy (2011) hypothesized that this may be
because of low ecological validity and generalizability of neuropsychological tests, the groups for
comparison were identified using behavioral indicators of ADHD. As such, behavioral predictors
(in this case, of EF) are very likely to more robustly predict behaviorally-categorized groups.
The basic question of what are truly ADHD symptoms reveals a driving assumption adopted in the
overwhelming majority of ADHD research. The gold standard for identifying who should be in an
ADHD or non-ADHD group is diagnosis based on the DSM-5 diagnostic criteria, which are inherently
behavioral and, to many, inadequate. If ADHD is truly a neurodevelopmental disorder, as the DSM-5
itself categorizes it, then why are neurodevelopmental (cognitive) symptoms (including performance
on EF tasks) summarily ignored in the diagnostic criteria? The argument over the utility of neuropsy-
chological testing in the identification of ADHD needs first to address the question of whether the
DSM-5 diagnostic definition of ADHD is adequate. If and when it is assumed that it is indeed ade-
quate, then behavioral surveys and interviews will of course emerge as primary in evidence-based
identification. If, however, the fundamental assumption that behavioral markers are adequate for iden-
tifying a neurodevelopmental disorder is challenged, a different outcome may emerge.
A complicating factor in the question of what should contribute to a diagnosis of ADHD is the
controversy regarding its subtypes: inattentive, hyperactive/impulsive, and combined. The contro-
versy centers on whether these are truly three different subtypes of the same disorder – which would
imply that they have similar cognitive substrates and, more importantly, similar protocols for effec-
tive treatment – or if they are distinct disorders, which has certainly been argued by many (e.g.,
Milich et al., 2001). It is highly possible that behavioral definitions of hyperactive/impulsive ADHD
disorders are entirely appropriate, whereas combining neurocognitive and behavioral definitions of
inattentive ADHD disorders may more effectively diagnose, inform treatment, and improve
outcomes.

Incremental validity of neuropsychological tests

A review of the incremental validity of neuropsychological tests in the identification of ADHD is
fraught with the significant caveat that the overwhelming majority, if not all, of the studies utilize
DSM-driven diagnosis to differentiate individuals with and without ADHD. This will fundamen-
tally suppress at least some of the value of performance-based measures over and above behavioral
symptom reports. However, it is still important to consider the utility of neuropsychological tests,
even in the potentially flawed diagnostic process.
First and foremost, with regard to specific studies to evaluate the incremental validity (improv-
ing diagnosis above and beyond other methods) of neuropsychological testing in the identification
of ADHD, there is some early evidence that neuropsychological tests add value to outcomes
(Pritchard et al., 2014). Historically, performance-based tests have performed somewhat poorly in
the identification of (behaviorally-determined) ADHD. However, comprehensive and integrative
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methodologies that include self- and collateral-report symptom ratings, family history of ADHD,
and neuropsychological test performance have demonstrated better predictive performance than
identical batteries without neuropsychological tests (Nikolas et al., 2019). Similarly, while con-
tinuous performance tests (CPTs; widely used performance-based neuropsychological measures of
selective and sustained attention, impulse control, vigilance, response speed, and other related EF
variables) have not emerged as diagnostically useful alone, they have proven to improve diagnostic
accuracy when there are discrepancies or other elements that render parent and teacher reports
inconclusive (Jarrett et al., 2018; Tallberg et al., 2019). This aligns with a generally significant
(medium effect size) relationship between CPT performance and discrimination between ADHD
and non-ADHD individuals (Willcutt et al., 2005).
Other neuropsychological tests have performed somewhat similarly in the discrimination
between ADHD and non-ADHD individuals, generally hovering around the medium effect size
(again, utilizing behaviorally-defined ADHD and non-ADHD groups). Specifically, working
memory, set shifting, and interference control have all shown significant group differences. Several
meta-analyses have identified medium effect sizes for auditory/verbal working memory and even
larger effect sizes for nonverbal working memory in the identification of ADHD (Martinussen
et al., 2005; Willcutt et al., 2005). Set shifting, often measured by the Wisconsin Card Sorting Test
and related to changing one’s strategy mid-task, also emerged with significant but small to medium
effect sizes in the identification of ADHD (Frazier et al., 2004; Willcutt et al., 2005). The Trail-
Making Test, which requires set-shifting using a new strategy that is specifically directed, emerged
with a stronger relation to ADHD diagnosis (Frazier et al., 2004; Willcutt et al., 2005).
Finally, interference control, usually measured using the Stroop Test, which involves suppress-
ing the automatic response of word reading when presented with word color names and naming
only the color of the font, emerged similarly overall with a medium effect size, though different
meta-analyses ranged from small to large (Frazier et al., 2004; Hervey et al., 2004; Homack &
Riccio, 2004; Van Mourik et al., 2005). Each of these seems to be tapping something in the differ-
ences between those with and without ADHD, even when those groups are determined based on
the DSM’s behaviorally-oriented symptom criteria.
It should be noted that there is some speculation that other mental health disorders – especially
depression – may in fact significantly affect neuropsychological (especially EF) test performance.
However, research largely does not support this. That is, most research has failed to demonstrate a
significant reduction in attentional and EF performance on neuropsychological tests in children
with depression (Favre et al., 2009; Rohling et al., 2001; Vilgis et al., 2015). This demonstrates an
important benefit of these tests to distinguish between attentional difficulties attributable to ADHD
(neurocognitively) and those attributable to depression, both which can look similar on rating
scales asking about everyday attention. This may not be as clean for diagnoses of schizophrenia
and bipolar disorder though, which have been found to be associated with some deficits on neu-
ropsychological tests of EF (e.g., Afshari et al., 2019). Future research may need to look at the
specificity of these tests for distinguishing patterns of deficit between those with ADHD and those
with schizophrenia or bipolar disorder (and indeed those with comorbidities).

An integrative model for identifying ADHD

The predominant model of identifying and diagnosing ADHD requires three components, which
should be multi-informant and integrative in nature (Anastopoulos & Beal, 2020; Owens et al.,
2020). First, there need to be discernable attentional symptoms. Second, these symptoms need to
have been present early in development. Third, and this is the toughest part for diagnosis, the
symptoms should not be attributable to another disorder. For example, if one only asks for
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Figure 1. A model for multimethod assessment of ADHD.

symptoms related to difficulty with attention in everyday life, it cannot be stated explicitly that
these are not attributable to another disorder like depression, which counts problems with concen-
tration among its DSM-5-defined diagnostic criteria (American Psychiatric Association, 2013).
Comprehensive assessments of ADHD should clearly evaluate each of these three components to
build a cohesive argument for or against the diagnosis. The model presented here (see Figure 1)
includes specific focus on the final step.
First, an assessment should determine if there are discernable symptoms related to a client’s typi-
cal, everyday attentional and EF functioning. Doing so accomplishes two things – it provides evi-
dence of problems related to attention and EF, across contexts, as well as evaluating some sort of
impairment. This is aligned with the DSM-5 model of diagnosing ADHD (though is only the first
step in a comprehensive evaluation). The major methods used to evaluate typical functioning in a
client’s everyday life are self- and collateral-report measures, whether interviews or surveys. Some
broader semi-structured or structured interviews, like the Schedule for Affective Disorders and
Schizophrenia for School-Age Children (K-SADS; Kaufman et al., 1997), include modules on
ADHD symptoms. Others were developed specifically to assess ADHD symptomatology, such as
the Young DIVA-5 (Kooij et al., 2010b). These interviews typically ask about current symptoms –
generally based on the behaviorally-defined, DSM symptoms – and their impact on the client’s life.
In addition to these interview measures, a slew of self- and informant/collateral-report survey
questionnaires provide a normative (nomothetic) accounts of current ADHD-related symptoms,
sometimes their impact, and sometimes EF correlates. Again, some broader measures, like the
Behavior Assessment System for Children, Third Edition (BASC-3; Reynolds & Kamphaus,
2015), have individual attention- and EF-related scales. Other measures, like the Behavior Rating
Inventory for Executive Function, Second Edition (BRIEF-2; Gioia et al., 2015) and the
Comprehensive Executive Function Inventory (CEFI; Naglieri & Goldstein, 2013), were devel-
oped specifically to evaluate attention and EF symptoms. These survey measures, most able to be
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completed by multiple informants (including the client themselves, parents/caregivers, and teach-
ers), elucidate current attention and other EF difficulties.
The second step for identifying is to determine the developmental nature of the symptoms. That
is, symptoms need to have been present in childhood (though this is often relatively straightfor-
ward in child evaluations). Most of the widely-used measures do not include a specific investiga-
tion into the age of onset of attentional and related difficulties, with most assessments relying on
unstructured interviewing practices to gather this information (Anastopoulos & Beal, 2020; Owens
et al., 2020). However, the Young DIVA-5 and the DIVA-5 (Kooij et al., 2010a, 2010b) specifically
ask for and elicit examples from (earlier) childhood, in addition to asking for current symptoms
and impairment. The current state of the ADHD assessment landscape, though, relies heavily on
less formal methods for determining whether or not symptoms and impairment were present in
childhood and specifically when they were first noticed.
The third step in a comprehensive ADHD evaluation typically requires the ruling out of other
disorders that could be responsible for the attentional and other self-regulation difficulties. The
present model proposes breaking this into two separate steps: the determination of whether every-
day attentional difficulties are attributable to neurocognitive deficits, and an evaluation of other
disorders, whether comorbid or predominantly underlying the everyday problems with attention
and EF. While broadband measures and general clinical interviews can help determine the presence
or absence of other disorders (step 4), they are not as adept at determining, if another disorder is
present, if it is comorbid with ADHD or the driving force behind pseudo-ADHD symptoms. For
example, for a client who presents with depression and attentional problems, the depression may
be comorbid with and masking ADHD or primarily responsible for the attention problems
(McIntosh et al., 2009). Measures that reveal both depression and attention problems cannot them-
selves help a clinician determine whether or not ADHD is actually present.
Bornstein’s (2011) conception of a process-focused model in assessment can inform how to
accomplish this distinction. Specifically, he discusses the fact that different types of measures
(methods) engage different psychological processes, and thus present quite different data, even
when scales or indices have similar names. One distinction that can be made is between typical-
functioning measures and optimal-functioning measures. Self- and informant-reports are typi-
cal-functioning measures; they show a client’s typical, everyday functioning (such as in school,
at home, etc.). They are based on observable behaviors and self-knowledge accumulated in an
ongoing, daily way. Neuropsychological and cognitive (performance-based) measures, on the
other hand, are optimal-functioning measures. They evaluate not what an individual’s brain does
in everyday life, but rather what the brain can do under ideal circumstances (i.e., most often in a
quiet room free from distractions, with one-on-one attention of a typically friendly evaluator,
etc.). This distinction, and especially a comparison between a client’s typical and optimal func-
tioning, can help determine whether the deficits in attention and other EF are attributable to
neurocognitive difficulties or something else. That is, if typical functioning (e.g., attention,
organization, planning, etc.) is problematic but optimal functioning is adequate (meaning that
under ideal circumstances, they can adequately self-regulate their cognitive processes), it is very
likely that other factors are ‘to blame’ for the ADHD-like symptoms. If, however, both typical
and optimal functioning show signs of problems, it is much more likely a neurocognitive prob-
lem. Again, individuals with depression, despite poor reported attention and concentration, gen-
erally perform adequately on tests of EF.
The fourth and final step in these evaluations is to determine other mental health struggles that
may be underlying (or comorbid with) the attentional and EF difficulties. That is, in cases where
an individual struggles with everyday attention, but there is evidence that their brains have no
neurocognitive deficits in these areas (i.e., they perform adequately on the optimal functioning
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tests of EF), other psychological factors are likely underlying the attention and EF problems.
Alternatively, though, ADHD can be comorbid with other problems, and so this step should be
undertaken in all evaluations. Many broad-based measures of mental health help identify psycho-
logical conditions other than ADHD.
An interesting ethical and clinical dilemma arises when individuals meet criteria for ADHD
in the DSM-5 but are tested and determined not to have ADHD (using this method). Critics
(likely including psychiatrists, pediatricians, and even many psychologists) will argue that
meeting the DSM-5, behavioral criteria for ADHD is all that is necessary for receiving the
diagnosis and, ultimately, ADHD treatment. This is especially problematic with psychostimu-
lant medication, which has shown attentional and EF benefits even in children without ADHD
(Bagot & Kaminer, 2014). Clinicians may need to consider a social justice perspective, advo-
cating for children to receive appropriate treatments and accommodations in these cases, which
at times may require the ADHD diagnosis, and at other times require clear argumentation as to
the alternative underlying factors for attention difficulties. A similar concern arises when an
individual exhibits EF deficits (both in typical and optimal functioning tests), but does not
technically meet the requisite number of behavioral criteria for ADHD in the DSM-5. The
recourse for the clinician in this case is to defer to either an ICD-10 diagnosis of Frontal Lobe
and Executive Function Deficit (World Health Organization, 2004) or a DSM-5 diagnosis of
Other Specified Neurodevelopmental Disorder.

Discussion
Although the DSM-5 identifies ADHD as a neurodevelopmental disorder, it defines its diagnostic
criteria not in neurodevelopmental terms, but rather in behavioral terms (American Psychiatric
Association, 2013). This has obvious benefits, as behavioral indicators are observable and more
easily identified by clinicians (though also by others, such as teachers, which is likely to have con-
tributed to the wide-spread over-diagnosis of the disorder by those not qualified to do so;
Davidovitch et al., 2017; Dyck, 2019; Havey, 2007). Psychiatrists (the primary authors of the
DSM-5) have an obvious vested interest in maintaining the ability, within their scope of practice,
for identifying and diagnosing ADHD, and maintaining behaviorally-defined indicators of the dis-
order accomplishes this.
However, there is a great deal of evidence that ADHD is actually a neurocognitive disorder,
with neurocognitive deficits related to self-regulation and EF. This includes deficits in work-
ing memory, selective and sustained attention, impulse control, planning, organization, self-
monitoring, set shifting, and other related controls over cognitive (and relatedly emotional and
behavioral) processes. What stagnates the field, though, is that nearly all or all of the research
conducted to evaluate neuropsychological measures’ incremental validity is based on the
underlying premise that the behaviorally-driven, DSM-5 diagnostic criteria are the gold stand-
ard for diagnosing ADHD. That is, when determining whether neuropsychological measures
(as well as behavioral rating scales, etc.) are ‘correct’ in determining whether or not someone
has ADHD, the answer lies in the measure’s agreement with (usually ‘expert’) decisions based
on the DSM-5’s behavioral criteria. This is a premise – an assumption – that should not go
unchallenged.
If researchers and clinicians can agree upon a few underlying assumptions about the identifica-
tion and diagnosis of ADHD, this can serve as a starting point. First, there need to be identifiable
symptoms – related to attention and EF – that are currently impairing functioning in some way.
Second, the problems are developmental in nature, such that they began in childhood. Third, the
problems are not attributable to another underlying disorder or contextually-driven problem (this
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is why the symptoms should be present across contexts, so that it is clear that they are not solely
due to some difficulty in one context). These underlying assumptions are present in the DSM-5.
The divergence in practice, when neuropsychological testing is utilized, is the determination of
what constitutes the symptoms. Those who promulgate the use of rating scales and interviews as
the most evidence-based way to determine a DSM-5-oriented diagnosis of ADHD are justified in
doing so. Rating scales of behaviors will absolutely align with the behaviors required by the DSM-5
for diagnosis. It is the questioning of a behavioral definition for the identification of ADHD – a
cognitive, neurodevelopmental disorder – that underlies the assumed utility of neuropsychological
tests in practice. Behaviors can be multiply-determined; for example, the reason an individual has
attentional difficulties may be because of ADHD, because of depression, or because of both. It is
the brain’s ability to self-regulate under ideal circumstances (without the emotional interference of
classmates, for example, or the lack of structure that allows for rumination) that determines whether
there are actual, functional frontal lobe deficits. Indeed, the empirical inquiry headed by the
National Institute of Mental Health (NIMH) on Research Domain Criteria (RDoC; Sanislow et al.,
2015) has begun to try to more clearly and cleanly identify neurobiological markers of ADHD,
though this research is in its infancy (Levy, 2014).
Perhaps most importantly, shifting the definition for what identifies ADHD has the poten-
tial to improve treatment outcomes significantly. That is, not all individuals diagnosed with
ADHD benefit from medication, not all benefit from behavioral treatments, and not all benefit
from EF intervention (Pritchard et al., 2012, 2014). With the careful and clear identification of
specific deficits in attention, EF, and even behavioral control, clinicians can highlight specific
areas that need targeted intervention (e.g., medication for attention; behavioral treatments for
impulsivity).

Next steps
Future research should endeavor to evaluate the utility and incremental validity of neuropsycho-
logical tasks and tests (as well as those of rating scales and other measures) not based solely on the
DSM-5 definition of ADHD, but on a broader conceptualization that encompasses neurocognitive
functioning and functional consequences. Of course, this is difficult to accomplish, as the DSM-5
has a stranglehold on the diagnostic definition of the disorder, and alternative conceptualizations
are not readily available. However, being truly integrative with the data that emerge from an assess-
ment – from behavioral rating scales, interviews, and cognitive and neuropsychological tests – may
ultimately prove to be the most diagnostically useful strategy, even though it is often not the most
economically practical. Despite this, though, future research should focus on integrative diagnostic
conceptualizations of ADHD, the functional correlates of a revised definition (i.e., whether diag-
nosis based not solely on behavioral symptoms better reflects problems in actual functioning, such
as educational, social, and other areas), and differential treatment outcomes based on different
neurocognitive presentations of ADHD.
Clinicians are encouraged to embrace a multimethod approach to assessment more broadly, as
it has the potential to cover ‘blind spots’, not just of the clinician, but also of our current diagnostic
classification systems. Many have offered guidance for methodically utilizing data from different
methods to better understand human functioning (e.g., Hopwood & Bornstein, 2014; Wright,
2020). Although more time consuming, potentially expensive, and infinitely more difficult to
accomplish effectively, multimethod approaches to understanding both diagnoses and their associ-
ated features have the potential to improve the work clinicians do and ultimately the outcomes for
those they work with. Indeed, those educating graduate students should be focusing on the critical
thinking skills required for integrating data from multiple methods – and reconciling their
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discrepancies – from early on in training (American Psychological Association, 2020), so that this
work becomes comfortable and commonplace throughout their careers.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publi-
cation of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD
A. Jordan Wright https://orcid.org/0000-0002-8317-6727

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Author biography
A. Jordan Wright is core faculty and director of the Center for Counseling and Community Wellbeing at New
York University. He is the author of Conducting Psychological Assessment: A Guide for Practitioners (2nd
ed.; Wiley, 2020), co-author of the Handbook of Psychological Assessment (6th ed.; Wiley, 2016), and pri-
mary author of the Essentials of Psychological Tele-Assessment (Wiley, 2021). He has served on the Board
of the Society for Personality Assessment, as President of Section IX (Assessment) of APA’s Division 12, and
as Chair of the task force to develop the APA Guidelines for Education and Training in Psychological
Assessment in Health Service Psychology.