Adult Attention Deficit Hyperactivity Assessment and Treatment Service

The Adult Attention Deficit Hyperactivity (ADHD) Service offers comprehensive, state-of-the-art diagnostic evaluation and treatment for affected individuals with known or suspected ADHD. We also evaluate and treat adolescents in college or preparing for college. Once a consultation is completed, diagnostic information and treatment recommendations will be provided. The Adult ADHD service can provide ongoing medication management and skills enhancement therapy for the symptoms of ADHD.  We can also provide documentation of the condition, its diagnosis, and recommendations for accommodations in school, examination settings, or in the workplace.

ADHD often begins early in childhood and consists of symptoms of inattention, hyperactivity and/or impulsivity. Inattention symptoms can include distractibility, difficulty sustaining attention or paying attention to details, organizational difficulties, task avoidance and forgetfulness.  Impulsivity and hyperactivity can appear as feeling “on the go,” talking excessively, fidgeting, exhibiting impatience and interrupting others. Often these symptoms persist into adulthood and can affect functioning in multiple areas of life. Furthermore, people with ADHD can be more susceptible to fluctuating mood including depression, anxiety and substance abuse. We can provide treatment for these disorders as well.

The evaluation begins with a thorough interview by a faculty member of the Columbia University Department of Psychiatry. If indicated, the individual will be referred for a neuropsychological assessment (testing of attention and other aspects of cognitive ability) which can be affected in ADHD. If appropriate, the evaluation can be focused which reduces the cost of this assessment. In addition to focusing on ADHD symptoms we can provide additional treatment as needed for symptoms of other psychiatric disorders.

Medication: Several classes of medications have been proven to be very effective at treating ADHD. These include stimulants (dextroamphetamine, methylphenidate, and mixed salts amphetamine) as well as non-stimulant medications (atomoxetine). Furthermore, these medications come in different formulations (short and long acting, oral and patch delivery systems) that have an impact on duration of effect and side effects. Your doctor will work with you to develop an individualized regimen that takes into account your prior history and current needs. If there is evidence of non-response to first line treatments, sensitivity to medication or complicating medical or psychiatric symptoms, we will suggest alternatives. This can include different medications as well as psychotherapy. Once an effective medication strategy is begun we will closely monitor you for improvement in symptoms and functioning as well as side effects.

Skills Enhancement Therapy

At times individuals may choose skills enhancement therapy in addition to medication or as an alternative. Skills enhancement therapy of adult ADHD at Columbia consists of the following three components:

	Cognitive Skills Training: We assist in the areas of time management, organization, professional and academic development and provide training to enhance cognitive skills such as listening, reasoning, paying attention and memory.
	ADHD coaching: We help adults handle the problems associated with ADHD in needed intervention such areas as social skills, behavior management and family relations.
	Educational consultation: First, psychoeducation is provided for the patient and family about adult ADHD, its impact on function in the academic and vocational setting, and the persistence of its symptoms when untreated. We investigate educational options and monitor progress to ensure placement in an academically and socially appropriate learning environment. We can also provide letters to request accommodations in educational settings for ADHD, such as extended time on tests.  Test results which document any areas of impairment or disability for which accommodations would be appropriate will also be included.

The director of the service is Dr. Laurence Greenhill, a national leader in the research of ADHD. Dr. Alice Medalia, a leading scientist in the field of cognitive rehabilitation, supervises the skills enhancement program. Dr. Wilfred van Gorp is the director of the Neuropsychology Assessment Service and Dr. Ann Marcotte is the director of Pediatric Neuropsychology.  Dr. David Gutman is the Director of Psychopharmacology at Columbia Presbyterian Eastside.

Staff:

Laurence Greenhill, M.D.
Director
Ruane Professor of Clinical Child and Adolescent Psychiatry

Alice Medalia, Ph.D.
Director of Psychiatric Rehabilitation Services

Wilfred G. van Gorp, Ph.D., ABPP
Director, Neuropsychology
Professor of Clinical Psychology

Ann Marcotte, Ph.D.
Director of Pediatric Neuropsychology
Associate Clinical Professor

David Gutman, M.D.
Director of Psychopharmacology, Columbia Presbyterian Eastside
Assistant Clinical Professor of Psychiatry

Referrals

The patient, a family member, psychiatrist, therapist or other physicians may make referrals.

Financial Information

Payment is made directly by the patient at the time of service. Major credit cards are accepted. The neuropsychological assessment can either be comprehensive (testing for the presence or absence of a learning disability or other psychiatric condition) or focused (specifically testing for symptoms of an attentional disorder). In the focused evaluation, the fee is commensurate with the more limited nature of the examination.

Contact

To schedule an appointment, make a referral, or for additional information, please contact the referral service – (212) 305-6001.