ADHD Assessment
At Global Education Testing, we provide comprehensive ADHD assessment for international school students and their families worldwide, helping parents and educators understand how ADHD affects learning, behavior, and exam performance.
Every ADHD evaluation combines an in-depth clinical interview, standardized rating scales completed by parents and teachers (such as the Conners-4 and Vanderbilt scales), and objective ADHD testing using the MOXO continuous performance test. The result is a clear, well-rounded picture of each student’s challenges and strengths, backed by hard performance data and documented to the standard examination boards require.
ADHD is diagnosed by a qualified clinician, such as an educational psychologist, clinical psychologist, psychiatrist, or paediatrician, using the diagnostic criteria set out in the DSM-5-TR. reliable ADHD diagnosis is reached by gathering converging evidence from a clinical interview, standardised rating scales completed by more than one observer, direct assessment, and a review of developmental and academic history.
Under the DSM-5-TR, symptoms fall into two clusters: inattention and hyperactivity-impulsivity. Children up to age 16 must show at least six symptoms within a cluster, while older adolescents and adults (17 and over) must show at least five. Several of those symptoms must have been present before the age of 12, must appear in two or more settings such as home and school, must have persisted for at least six months, and must clearly interfere with everyday functioning.
The step that separates a comprehensive ADHD evaluation from a brief screening is differential diagnosis. Anxiety, disrupted sleep, a hearing or vision problem, or a specific learning difficulty such as dyslexia or dyscalculia can each produce inattentive or restless behaviour that looks like ADHD. Our HCPC registered psychologists are trained to tell these apart, which is precisely why a school screening alone is not enough to confirm or rule out the condition.
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects approximately 5-7% of children worldwide and persists into adulthood for around 60% of individuals. Characterized by inattention, hyperactivity, and impulsivity, ADHD disrupts various aspects of life, including academic performance and social interactions. ADHD impacts a child’s ability to focus, organize tasks, and control impulses, making day-to-day activities more challenging. For university students, the symptoms often manifest as difficulties with time management, organization, and relationship management.
The Three Presentations of ADHD
ADHD is not a single profile. The DSM-5-TR recognises three presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Identifying which presentation a student has shapes both what the diagnosis means day to day and the accommodations that follow.
The predominantly inattentive presentation involves difficulty sustaining focus, careless errors, disorganisation, forgetfulness, and appearing not to listen when spoken to. Because these children are often quiet rather than disruptive, this presentation is the one most frequently overlooked, particularly in girls. It was previously known as ADD.
The predominantly hyperactive-impulsive presentation involves restlessness, fidgeting, difficulty waiting a turn, interrupting, and acting before thinking. Because it is more visible in a classroom, it tends to be identified earlier.
The combined presentation, in which a student meets the threshold for both clusters, is the one most commonly diagnosed in clinical settings.
Presentations are not fixed for life: many children who show hyperactive features in their early years present a more inattentive profile by adolescence, which is one reason a current, properly conducted ADHD assessment matters more than an old or informal label.
What Does a Comprehensive ADHD Assessment Involve?
A comprehensive ADHD assessment is a multi-method, multi-informant process, not a single questionnaire. At Global Education Testing, an ADHD evaluation combines a structured developmental and clinical interview, standardised behaviour rating scales completed by parents and teachers, direct cognitive and academic testing, and objective computerised measurement, all interpreted together by a qualified educational psychologist.
The assessment draws on several strands:
Developmental and clinical history. A detailed review of early development, medical and family history, and school reports establishes when difficulties began and how they have changed over time. ADHD symptoms must trace back to before age 12, so this history is essential evidence, not a formality.
Multi-informant rating scales. Standardised tools such as the Conners-4, the SNAP-IV, and the Vanderbilt scales capture observations from parents and teachers across home and school. Self-report scales such as the Adult ADHD Self-Report Scale (ASRS), developed with the World Health Organization, are used for teenagers and adults. Gathering input from more than one source is how an assessment confirms that symptoms appear in multiple settings, a DSM-5-TR requirement.
Executive function assessment. The BRIEF-2 maps the real-world executive skills, including working memory, planning, organisation, and emotional control, that sit beneath the academic difficulties families notice first.
Cognitive and academic testing. A full cognitive assessment, such as the WISC-V for children or the WAIS-IV for adults, alongside academic attainment testing, helps distinguish ADHD from a specific learning difficulty such as dysgraphia and identifies any co-occurring conditions. This standardised data is also exactly what an examination board looks for when considering extra time in exams.
Objective attention testing. A continuous performance test, most commonly the MOXO, adds objective, performance-based data to the clinical picture.
This depth is what allows an ADHD diagnosis to stand up to scrutiny from schools, universities, and examination boards worldwide.
What Is the MOXO Test?
The MOXO test is an online, standardised continuous performance test (CPT) used as part of an ADHD assessment to measure attention objectively. Unlike a rating scale, which records opinion, the MOXO records how a person actually performs on a timed computer task and scores four separate indices: attention, timing, impulsivity, and hyperactivity.
What makes the MOXO distinctive is its built-in distractor system. The test introduces calibrated visual and auditory distractors, such as moving images and everyday sounds, that recreate the kind of busy environment a student faces in a real classroom. This improves the ecological validity of the result, meaning it reflects attention under realistic conditions rather than in artificial silence. In a validation study of 798 children aged 7 to 12, those with ADHD scored significantly differently from their peers across all four MOXO indices (Slobodin, Cassuto & Berger, 2017).
It is important to understand how the MOXO fits in. A continuous performance test is one objective strand within a comprehensive ADHD evaluation, not a stand-alone diagnosis. Its value is in corroborating the clinical interview and rating scales with hard, performance-based data, giving families and schools added confidence in the result.
Can a School Diagnose ADHD?
No, schools cannot officially diagnose ADHD. While teachers and school staff can identify behavioral signs that may suggest a student has ADHD, the diagnosis must be made by a qualified healthcare professional, such as a psychologist, psychiatrist, or pediatrician. Schools can refer students for evaluations but they do not have the authority to make an ADHD diagnosis. This distinction ensures that ADHD is diagnosed based on clinical assessments.
Comprehensive Assessments
At Global Education Testing, we go beyond surface-level screenings to provide a comprehensive and accurate diagnosis. Our ADHD testing offers the clarity and insight that parents are searching for, helping you understand the full scope of your child’s educational challenges. This isn’t just about labeling a problem, it’s about ensuring that your child receives the full range of support in the classroom and in external examinations.
Extra Time in Exams
Only a qualified educational psychologist from a health system comparable to the UK, USA, Canada, Australia, Ireland, or New Zealand can provide the depth, scope, and detail needed for a diagnosis that external examination boards take seriously. Our assessments are critical in unlocking maximum accommodations, such as the maximum extended time for exams, which can make a world of difference to your child’s academic success.
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ADHD by the Numbers
ADHD is one of the most common neurodevelopmental conditions of childhood, affecting an estimated 5 to 8 percent of children and adolescents worldwide. The figures below are drawn from large meta-analyses and national health bodies, and can be cited directly.
Worldwide prevalence. A meta-analysis pooling almost 97,000 children found ADHD in 7.6 percent of children aged 3 to 12 and 5.6 percent of adolescents aged 12 to 18 (Salari et al., 2023).
United States. CDC data indicate that roughly 11 percent of US children aged 3 to 17 have ever been diagnosed with ADHD, with estimates ranging from 6 to 16 percent across states (CDC).
Boys and girls. ADHD is diagnosed in boys roughly twice as often as in girls, at around 10 percent versus 5 percent. Researchers note this gap partly reflects under-recognition in girls rather than a true difference in rates (umbrella review, Ayano et al., 2023).
Most common presentation. Across the general population, the predominantly inattentive presentation is the most common, followed by the hyperactive-impulsive and combined presentations.
Persistence. ADHD continues from childhood into adolescence in 50 to 80 percent of cases, and into adulthood in 35 to 65 percent of cases, with impairing symptoms persisting in a higher proportion still (CHADD; E-Risk longitudinal study).
Co-occurring conditions. Around 6 in 10 people with ADHD have at least one co-occurring condition, and US survey data put the figure as high as 78 percent (CHADD). About 4 in 10 children with ADHD also experience anxiety (CDC), and up to 45 percent have a co-occurring learning disability (Understood).
Academic impact. Around 32 percent of students with combined-type ADHD leave high school without graduating, compared with 15 percent of peers with no psychiatric condition (CHADD).
These numbers underline a simple point: ADHD is common, it frequently travels with other conditions, and without identification and support it carries a measurable academic cost.
How an ADHD Diagnosis Unlocks Exam Accommodations
A formal ADHD diagnosis from a qualified educational psychologist is the documentation examination boards require before they will grant access arrangements such as extra time. The diagnosis on its own does not guarantee accommodations. It is the detailed assessment report, evidencing a substantial, long-term difficulty against the relevant board’s criteria, that unlocks them.
Schools and exam boards need two things: evidence that a genuine difficulty exists, and evidence that it affects performance under exam conditions. A comprehensive report supplies both, with standardised scores, developmental history, and specific recommendations mapped to the framework the student sits under. The main frameworks international families encounter include:
- GCSE, IGCSE, and A-Level (JCQ-regulated boards, including Cambridge International and Pearson Edexcel). Access arrangements may include additional time (commonly 25 percent), supervised rest breaks, a separate room, and use of a word processor. The precise rules are set out in our guide to extra time in exams.
- International Baccalaureate (IB). The IB grants inclusive access arrangements, including additional time and rest breaks, on the basis of recent psychological or medical documentation.
- College Board (SAT, AP) and ACT. US college admissions tests offer accommodations such as extended time, commonly an extra 50 percent, applied for through the board’s disability services with supporting documentation.
- US K-12 schools. Support is delivered through an Individualized Education Program (IEP) or a 504 Plan under IDEA and Section 504.
Global Education Testing reports are written to meet and exceed the documentation standards of these boards, so that a diagnosis translates into the accommodations a student is entitled to.
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Locations
At Global Education Testing, we are committed to providing comprehensive educational assessments no matter where you are in the world. We facilitate testing in every country and location through our proprietary network of qualified educational psychologists from the UK, USA, Canada, Australia, Ireland, and New Zealand.
Whether in urban centers or remote areas, we ensure that our assessments are accessible through in-person evaluations or secure online platforms, offering the same level of detail and accuracy.
Our global reach allows parents and schools worldwide to benefit from the most advanced testing methods, providing clear, actionable insights to support each child’s unique learning needs.
