Red flags & when to go in person for ADHD (Adult) - Evaluation Pathway

Audience: pediatric

Attention Deficit Hyperactivity Disorder (ADHD) in adults can affect many parts of life, including work, relationships, and daily activities. Telemedicine can help start the evaluation process by providing education and initial screening. However, some signs mean an adult should see a healthcare provider in person. These include sudden changes in behavior, severe mood problems, or safety concerns. This guide helps pediatric readers understand when telemedicine is helpful and when in-person care is needed for adult ADHD evaluation. It also explains red flags to watch for, how to prepare for a tele-visit, and what to expect afterward. Remember, telemedicine is a helpful tool but not a full replacement for face-to-face medical care when urgent or complex issues arise.

Red flags — go in person / ER

• Thoughts or plans of self-harm or harming others — seek emergency care immediately.
• Sudden severe mood changes or confusion — arrange urgent in-person evaluation.
• Signs of substance misuse or overdose — call emergency services or go to the emergency room.

What telemedicine can do

• Initial symptom discussion and education about adult ADHD.
• Basic screening and history gathering for ADHD symptoms.
• Providing guidance on next steps and when to seek in-person care.
• Supporting medication adherence and monitoring mild side effects (with follow-up).

What telemedicine cannot do

• Performing physical exams or neurological assessments.
• Managing severe mood disorders or psychiatric emergencies.
• Prescribing or monitoring controlled medications without in-person evaluation.
• Diagnosing complex or overlapping medical conditions requiring tests.

What is Adult ADHD?

Adult ADHD is a condition where a person has ongoing problems with attention, hyperactivity, and impulsiveness. These symptoms can cause challenges at work, school, or home. Adults with ADHD may find it hard to focus, stay organized, or control impulses. Understanding these symptoms helps families support their loved ones and seek the right care.

How Telemedicine Can Help

Telemedicine allows adults to talk with healthcare providers using video or phone calls. It can be a good first step to discuss symptoms, get information, and decide if further evaluation is needed. Tele-visits can save time and make it easier to access care, especially when travel or mobility is difficult.

When to See a Provider In Person

Some situations require an in-person visit to ensure safety and proper diagnosis. These include:

If any of these occur, it is important to seek in-person care promptly.

Red Flags to Watch For

Certain warning signs mean immediate medical attention may be needed:

If you notice these, call emergency services or go to the nearest emergency room.

Preparing for a Telemedicine Visit

To get the most from a tele-visit, consider these steps:

These preparations help the provider understand the situation better.

After the Telemedicine Visit

After your visit, you may be advised to:

Staying engaged in care is important for managing ADHD effectively.

How to prepare for your tele-visit

• Choose a quiet, private space with good internet or phone connection.
• Prepare a list of symptoms, concerns, and questions.
• Have information about current medications and medical history ready.
• Consider having a trusted family member or friend join the visit for support.
• Ensure your device is charged and the telemedicine platform is tested beforehand.

After your tele-visit

• Follow any recommendations for in-person evaluation or testing.
• Keep a symptom diary to track changes and challenges.
• Schedule follow-up appointments as advised by the provider.
• Reach out promptly if red flag symptoms develop or worsen.
• Engage with support services such as counseling or ADHD coaching if recommended.

FAQs

Can telemedicine diagnose adult ADHD?

Telemedicine can help start the evaluation by gathering information and screening symptoms. However, a full diagnosis often requires in-person assessments, including physical exams and sometimes psychological testing.

What should I do if I notice sudden mood changes in my adult family member?

Sudden mood changes, especially if severe or involving thoughts of self-harm, require urgent in-person medical evaluation or emergency care. Do not wait to seek help.

Is medication management possible through telemedicine?

Some aspects of medication management can be done via telemedicine, such as discussing side effects or adherence. However, starting or adjusting certain medications may require in-person visits for safety.

How can I support an adult with ADHD during telemedicine visits?

You can help by preparing questions ahead, providing relevant history, and offering emotional support during the visit. Being present can help the provider get a clearer picture of the challenges faced.

What if my adult family member refuses to see a doctor in person?

Encourage open conversation about their concerns. Explain the importance of in-person care for safety and accurate diagnosis. If urgent symptoms appear, seek emergency care regardless of their preference.

Sources

1. Attention-Deficit / Hyperactivity Disorder (ADHD) in Adults — MedlinePlus, U.S. National Library of Medicine.
2. Attention-Deficit / Hyperactivity Disorder (ADHD) — Centers for Disease Control and Prevention (CDC).
3. Adult ADHD: Symptoms, Diagnosis, and Treatment — Mayo Clinic.
4. Telehealth: Delivering Care Safely During COVID-19 and Beyond — Agency for Healthcare Research & Quality (AHRQ).
5. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents — American Academy of Pediatrics (AAP).

This telemedicine education guide is for informational purposes only and is not a substitute for professional in-person medical care, diagnosis, or treatment. If you or someone you care for experiences any emergency symptoms or red flags, seek immediate in-person medical attention.