Late ADHD Diagnosis for Adults in NYC and New Jersey

Being evaluated for ADHD for the first time at 30, 45 or 60 is common, and it raises questions a childhood evaluation does not. How can anyone know what you were like at eight? What if your parents are gone or your report cards were thrown out? What does it mean if the answer is yes after decades of being told you were lazy or careless? This page covers how Dr. Shershow's adult evaluation handles those questions, and the New York and New Jersey details that matter.

Adult diagnosis is the usual path, not the exception

In a CDC survey of US adults conducted in late 2023, more than half of adults with ADHD (55.9%) had received their diagnosis at age 18 or older. The National Institute of Mental Health lists common reasons a diagnosis was missed in childhood:

• Teachers and parents did not recognize the disorder.
• A supportive environment helped you do well despite it.
• Symptoms were milder and manageable until the demands of adult life, especially work, outgrew your coping strategies.
• Symptoms in girls and women are especially likely to have been missed in childhood.

NIMH puts it plainly: it is never too late to seek a diagnosis and treatment. If you were assigned female at birth, see also adult ADHD evaluation for women.

What the criteria require about childhood

Adult ADHD can be diagnosed for the first time in adulthood, but the criteria require that symptoms started earlier, before age 12. Adults need at least five symptoms of inattention or hyperactivity-impulsivity (children need six), and CHADD notes that significant impairment in at least two major areas of life is central to the diagnosis. ADHD that truly begins in adulthood does not meet the criteria, which is why attention problems that began recently lead to a search for other causes. See can you develop ADHD as an adult.

When there are no childhood records

Missing records are normal for adults, and evaluators have established ways to work around them. NIMH says clinicians may ask to talk with people who know you well, such as a partner, family members and friends, and may look at school reports or other childhood records. CHADD adds that people with ADHD often have gaps in memory or downplay symptoms, which is why a loved one's view helps, and that if interviews are not possible, having that person fill out a symptom checklist is a good alternative. A 2024 American Family Physician review lists collateral information as part of the diagnosis.

Useful things to gather, if they exist:

Old medical charts are often gone. New Jersey's Board of Medical Examiners rule (N.J.A.C. 13:35-6.5) requires treatment records to be kept for seven years from the most recent entry, and New York's Education Law requires patient records to be kept for at least six years, with a longer period for records of minors. A pediatrician's chart from the 1990s may simply no longer exist, and that does not prevent an evaluation. If records do exist, New Jersey physicians must provide a copy within 30 days of a patient's request under the same rule. For conversation starters with relatives, see how to ask family about childhood symptoms and ADHD evaluation without childhood records.

What else gets considered in a late evaluation

The longer the life history, the more other explanations there are to check. Dr. Shershow's evaluation covers current symptoms; childhood, school and work history; health, including medical history, medications, sleep and substances; and other explanations such as anxiety, depression, sleep problems or stress, alone or alongside ADHD. It ends with what it found and the treatment options that fit. The answer may be ADHD, another condition, both, or neither; no diagnosis is guaranteed. Related pages: ADHD and anxiety and ADHD and depression.

The emotional side of a late diagnosis

Research on how adults experience a first diagnosis is small but consistent. A 2008 interview study of eight adults diagnosed at a specialist service described a sequence: relief and elation, then confusion and emotional turmoil, anger, sadness and grief, anxiety, and finally accommodation and acceptance. A 2022 review that pooled seven qualitative studies described the diagnosis as both a revelation and a burden, with themes of an unnecessary struggle before diagnosis and a functional life that finally felt possible after it.

Mixed feelings are an expected part of the process. Some people grieve the years before they knew, and some feel anger at the teachers or doctors who missed it. The authors of the 2008 study recommended psychological support starting at the point of diagnosis. The practice does not provide therapy, so if this hits hard, ask your own clinician or insurer about therapists who work with adults with ADHD, or look for an adult ADHD support group in New York or New Jersey.

New York and New Jersey rules that apply to your visits

Dr. Shershow is licensed in both New York and New Jersey, and the rule that matters is where you are physically located during each visit, not your home address. New York's Office of the Professions says a practitioner must hold a New York license when the patient is located in New York, and New Jersey's telehealth law requires a New Jersey license for services provided to a patient in New Jersey. For a video visit you must be in New York or New Jersey at the time of the visit.

If stimulant medication becomes part of the plan and you are located in New Jersey, P.L.2026, c.40 (effective July 8, 2026) applies to adults on a Schedule II stimulant who start by telehealth: an in-person visit within 30 days, a contact at least every three months (in person or by real-time audio-video), and an in-person visit at least once a year. The office will explain how visits are arranged for patients located in New Jersey. In New York, as of October 2026, telehealth prescribing of controlled substances follows the federal telemedicine flexibilities, which run through December 31, 2026.

Visit details are on the appointments and telehealth page. For current fees and how insurance works with the practice, call the office or see fees and insurance.