Evaluation & Treatment for ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder that commonly presents initially during childhood and is characterized by developmentally atypical levels of inattention and/or hyperactive-impulsive behavior. For a person to be diagnosed with ADHD, symptoms of inattention and/or hyperactive-impulsive behavior must cause significant impairment in two or more major life activities, including interpersonal relations, educational or occupational goals, and/or cognitive or adaptive functioning.

There is no simple definitive test for the disorder, and there is significant geographic variation in the diagnosis. Treatment always includes behavioral strategies to improve functioning. In addition, medications may sometimes be helpful. Educational institutions may make accommodations for learning and testing.

Evaluation and Treatment for ADHD at UHS

The University Health Service (UHS) has adopted the following guidelines for students who request prescription medications for ADHD. Please consider the following options to determine the appropriate course of action:

If you ARE NOT requesting medications:

You do not need to do anything further. If you should request ADHD medications in the future, including on a temporary and/or urgent basis, please use the information below.

If you ARE requesting medications, and you have:

NOT PREVIOUSLY been diagnosed with ADHD by a qualified physician, psychologist, or other qualified health care provider:

You will need to undergo comprehensive testing and assessment by a trained professional. This type of evaluation is NOT available through UHS and not all initial outside assessments are sufficient; having an outside assessment does not, in any way, guarantee that a UHS clinician will prescribe controlled substances even if the outside assessment includes recommendations regarding medication. See the list of documentation requirements below.
It may be appropriate for UHS clinicians to discuss the results with the outside clinician who did the evaluation. If so, we will need your permission to release that information. Providing this permission, formally and in advance, may streamline the evaluation process. For more information about the release of patient information, see Immunization and Medical Records.

PREVIOUSLY been diagnosed with ADHD by a qualified physician, psychologist, or other qualified health care provider.

You must provide recent documentation of the diagnosis, including supporting material from the clinician who made the diagnosis; however, outside documentation alone will not necessarily be considered diagnostic. Minimally, documentation must be on letterhead, typed, dated, and signed by a qualified physician, psychologist, or other qualified health care provider.
Supporting documentation from a family member alone is insufficient.

Documentation Requirements

Documentation must be in the form of an evaluation/treatment summary, and/or (neuro) psychological assessment supporting the diagnosis. Progress notes alone are not sufficient. The diagnostic report should, where appropriate, include:

History of onset of the problem or symptoms
Methodologies used to determine the diagnosis
Assessment of possible comorbid diagnoses including learning or anxiety disorders
Observer information from parents/adults documenting past and current symptoms in two or more settings
Diagnostic statement and and a list of medications that have been prescribed
If medications have been prescribed, a record of this must also be provided.
Description of the current functional limitations of the disabling condition as they relate to the major life activity impacted by the diagnosis
Suggested accommodations
In addition to the professional report, students should submit a written current description of self-identified symptoms and/or functional difficulties in at least two settings

Submitting Documentation: Documentation should be sent to the University Health Service by one of the following ways:

Fax (585-756-0263)
E-mail (hhf@uhs.rochester.edu)
Mail to UHS, Box 270617 – Medical Records Office, Rochester, NY 14627
Hand delivered to the receptionist in the UHS office on the first floor of the UHS Building on the River Campus. Please indicate that the information should be given to the Medical Records Office.

Medication Treatment

In part due to the complexity of appropriately determining whether the presentation and history warrant an ADHD diagnosis and consideration of treatment with a controlled substance, UHS providers do not currently provide ADHD-targeted controlled-substance stimulants at initial visits; it is important for students who chronically take prescribed controlled-substance stimulants to work with their current non-UHS providers to facilitate appropriate access to medication while student is exploring the possibility of UHS-prescribed controlled-substance stimulants.

If a controlled substance is going to be prescribed by a UHS health care provider, you will be asked to sign the UHS Controlled Medication Agreement.

This agreement will be reviewed and signed by your primary care provider or psychiatrist when you receive your first prescription for ADHD medications. The purpose of this agreement is to assure compliance with all applicable state and federal laws regarding controlled medications and to prevent misunderstandings about the proper use of these medications. Lost or stolen medications will not be replaced. Periodic urine drug screening may occur. Medications for ADHD are potentially lethal, as well as having been associated with substance use disorder. Giving or selling medications to others is against the law and a violation of University policy.

Requesting Classroom Accommodations

Students seeking academic accommodations should contact the Office of Disability Resources, meet with an access coordinator, and submit supporting documentation in accordance with the University of Rochester Equal Opportunity Policy. Students with ADHD often find Study Skills Counseling beneficial. Study skills consultants at the Center for Excellence in Teaching and Learning (CETL) can provide assistance related to time management, test-taking strategies, and motivation. Additionally, CETL offers a 1-credit study skills course, Methods of Inquiry.