The ADHD Diagnosis System Is Broken. It’s Time to Redesign It.
I hopped on a Zoom call recently with Dr. Aaron Dodini, a clinical psychologist with 15 years of experience in the ADHD assessment space. We met a few weeks back at a Congressional Briefing in D.C., and while we originally intended just to reconnect and share stories, the conversation quickly deepened. It was fun to bond over our shared, unique past lives touring with musicians, something not many people can say, but we soon found ourselves pivoting to a more pressing topic: our shared calling to fix the broken ADHD diagnosis and treatment system. Before we knew it, we were completely absorbed in unpacking where those gaps exist.
I normally video record conversations, mainly because of my own ADHD and poor memory. And of course, this time the video was turned off, or I would have shared video clips of our conversation, too! But we’ll re-create these conversations for you and share our thoughts and opinions on how things could change for the better. More on that soon…
The Testing Process Was Never Built for the People Who Need It Most
Dr. Dodini didn't start out specializing in ADHD, but quickly found out there were a lot of people living with undiagnosed ADHD.
"I was seeing a lot of, frankly, 30-somethings at the time," he told me. "And I am like, I think these people have ADHD. And the process of getting tested was cumbersome and awful."
And he’s right. The process is cumbersome. It's the reason I was in DC and shared my lived experience about the diagnosis process (or lack thereof). Traditional ADHD testing means many tests, long waits, and a process most primary care doctors were never trained on. Many doctors don’t really even understand what ADHD is.
"Very few primary care physicians have gotten any training at all," Aaron said.
Women Get Told It's Something Else
I know this part firsthand.
After each of my kids, I was depleted in a way that didn't match "new mom exhaustion." I thought it was just post-pardum depression, but looking back I can see how ADHD played a part.
I didn’t get help, just “maybe you should talk to someone.” I was talking to someone. I came to talk to the doctor and left with nothing.
Dr. Dodini sees this pattern constantly, and not just with postpartum depression. Women bring up their attention and focus struggles and get handed a different diagnosis instead.
"It's, you know, oh you're just depressed, or oh, you're perimenopausal," he said. "It wouldn't occur to them to ask for an ADHD evaluation until it's bad or until their kid gets diagnosed."
That was my story exactly. My son was diagnosed around eight or nine, after years of what I can only call chaos. It took his diagnosis to make me ask the question about myself.
Dr. Dodini’s own research backs this up from a different angle. During his PhD, he studied postpartum depression and tried to partner with OB/GYNs on early intervention. What he found stunned him.
"It turns out they're like, well, it's the pediatricians who actually see it. It's not us," he said. "We're not noticing the women by themselves independently."
The Medication Fear Is Costing People Years
We also talked about medication. Stimulant medication carries a reputation problem.
"The way that stimulants have been vilified, the way that the DEA classifies them, there is so much fear, and it's really misinformation," he said. "These medicines are some of the most effective medicines we have, and so many people are terrified to use them and they're suffering needlessly."
I watched this play out with my own son. We tried the diet changes. We tried the earlier bedtimes. We tried everything short of medication first, the way you're “supposed” to, the way everyone tells you to.
"It is a night and day difference with our son when he went on methylphenidate," I told Dr. Dodini. "Massive difference."
Eight or nine years of struggling, and the thing that actually worked was the thing we'd been feeling we should avoid if at all possible. I want to pause here and say that medication is NOT the only way and it doesn’t FIX ADHD. But it’s been a part of our journey, and it gives us the support we need to implement the better behaviors, better diet, better sleep schedules, etc.
Without a Diagnosis, You're Just Guessing
Without a clear diagnosis, every fix you try is a guess. And the marketing world knows it.
"Let's lean in on this hormone, like if you just fix your hormones, you're not gonna have the brain fog," I said, describing the messages that flood women right now. "Or let's start lifting, cardio's not gonna get you there, you need to lean into lifting. Use this supplement, this one is the right one.”
Try one. It doesn't work. Try the next.
"Then you are just pouring money into all of these little things, and nothing seems to work because you don't have that initial diagnosis," I said. "You don't have a clear picture of what you're dealing with."
Dr. Dodini sees the same thing from the clinical side, and he's clear about where nutrition and lifestyle work actually belong.
"The part of diagnosing and getting the medicine to start the process doesn't have to be hard," he said. "But man, if we can streamline the process of getting diagnosed and getting access to medications that work, then we can bring in the support systems, the nutrition, the coaching, the hormones."
Diagnosis first. Everything else builds on top of it. Not the other way around.
What He's Building Instead
Dr. Dodini got tired of watching this play out one patient at a time, so he built something to catch people before the crisis point.
His platform pairs with primary care groups to send free screening links ahead of annual physicals, before anyone thinks to bring up attention or focus on their own. He's also taking the same approach to college campuses, working directly with fraternities and sororities, where he estimates ten to twenty percent of members are dealing with co-occurring ADHD, anxiety, depression, or substance use.
"Let's identify them before it becomes a problem," he said.
The tool itself runs on AI trained across roughly eighty thousand of his own clinical interventions, close enough to his actual judgment that he can still edit in real time, and fast enough to save an hour or two per patient. That's what lets him train more psychologists and see more people without losing the clinical quality that made the old cumbersome process trustworthy in the first place.
Faster and cheaper only matters if it's still right. That's the part he built first.
Where This Goes Next
We didn't plan to record that call, and we almost didn't. Dr. Dodini said it himself near the end: "I just realized we should have recorded this conversation. It's awesome."
I did record it with my Plaud notetaker, and I wish I had some video of our conversation, because you can feel the energy and deep passion we both share for helping people with ADHD.
I think there’s a LOT more conversation to be had with Dr. Dodini about what he’s building, helping people recognize the diagnostic gaps, the misinformation, and what proactive ADHD care could actually look like at scale.
If any part of this sounded like your own story, I’d love to keep in touch. Get on The ADHD Mom email list, and I’ll keep you updated on conversations like this!
