Psychologists’ Diagnostic Decision Making in ADHD and Autism in Children

The decision-making experiences of psychologists who diagnose children with attention deficit hyperactivity disorder (ADHD) and high-functioning autism referred to as autism spectrum disorder - level 1 (ASD-1) when symptoms of either one or both are present in children were explored in this hermeneutic phenomenological study. These two common neurodevelopmental disorders share characteristics and symptoms that could lead to diagnostic confusion. There has been an absence of research on psychologists’ experiences with diagnostic decision making since the publications of the Diagnostic and Statistical Manual of Mental Disorders-5. Exploration of psychologists’ diagnostic decision-making processes can aid in providing early intervention and accurate treatments. The purpose of this study was to bridge the gap in literature related to how psychologists approach diagnosis when making decisions associated with ADHD, ASD, or both as they occur comorbidly. A semi-structured interview protocol was used with seven participants who were asked to reflect upon their diagnostic decision-making processes when evaluating children for ADHD and ASD-1. An interpretive phenomenological approach was used to identify the themes that emerged from the interviews and concepts that provided meaning to the experience of psychologists as decision makers. The findings from this study may provide a foundation for bringing about a positive social change within the mental health field, since it pertains to the diagnostic processes employed to identify ADHD, ASD-1, or both as they occur comorbidly. Understanding how the psychologists approached this led to understanding that each chose what they were most comfortable with based on each individuals training.