Passing your National Licensing Exam
Getting licensed can open up incredible opportunities, but the exam can seem daunting. Our podcasts make passing more achievable and even fun. Dr Hutchinson and Stacy’s energy and passion for this content will get you motivated and confident.
We break things down in understandable ways - no stuffiness or complexity and focus on the critical parts you need so your valuable study time counts. You’ll come away feeling like, “I can do this!” Whether it’s nailing down diagnoses, theoretical approaches, or applying ethics in challenging situations, we help you get into a licensed mindset. Knowledge domains we cover in these podcasts include:
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Intake, Assessment, & Diagnosis
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Passing your National Licensing Exam
Neurodevelopmental PT 2 ADHD
The line between genuine ADHD and everyday distractibility can feel blurry—until you know what to look for. We open the case file and walk through a clear, practical way to identify ADHD: symptoms that begin before age twelve, persist over time, and cause real impairment across settings like home, school, and friendships. No shortcuts, no vibes—just a grounded approach that blends criteria with real-life context.
Together, we unpack what inattention really looks like beyond “spacing out,” and how hyperactivity differs from normal kid energy by its severity, persistence, and resistance to willpower. You’ll hear the exact questions we use when assessing teens and adults, how to gather collateral from parents and teachers, and the surprising role sleep plays in amplifying or masking symptoms. We also map the classroom realities: the fidgeting that never ends, the detours under desks, and the conversational zigzags that jump tracks from hot dogs to Hawaii.
Differential diagnosis is the make-or-break step, so we draw sharp lines between ADHD and common lookalikes. Depression can tank concentration, but usually in episodes; PTSD may mimic restlessness and distractibility in kids, especially when hypervigilance is high; intermittent explosive disorder shares impulsivity but adds consistent aggression. Understanding these differences protects against misdiagnosis and steers better care—behavioral strategies, school supports, coaching, and when appropriate, medication. If you’re studying the DSM-5-TR or navigating a possible diagnosis for yourself or a child, this conversation gives you a field-tested checklist and a narrative lens to see the whole person, not just a list of symptoms.
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Okay, ADHD is up next. Hannah, why don't you give us an overview of that disorder?
HANNAH:All right. Moving right along here. We're talking about attention deficit, hyperactivity disorder, commonly referred to as ADHD. So we talk about ADHD, it's going to involve persistent patterns of inintention or hyperactivity, impulsivity that interferes with the person's functioning or their actual development. So I want you to think six. So think six. So to meet criteria for this disorder, think six. Children need at least six symptoms of inintention or six symptoms of hyperactivity and impulsivity. But if the client is older, you only need five. So think age 17 and older, they actually only need five symptoms. So it is crucial to understand that in order to meet the criteria for ADHD, you do have to show symptoms before the age of 12. Before the age of 12. I will always reiterate that because it is neural developmental. So when you're understanding it, you need to ensure there's there needs to be collateral uh before the patient age of 12. You're either born with it or you're okay.
STACY:Right. You didn't just develop it when you were in your 50s.
HANNAH:Just no, no, you have ADHD suddenly.
LINTON:If you're seeing a client that's 15, how are you gonna know that that it happened before age 12?
HANNAH:I mean, honestly, for or at least for me, I talk to mom and dad. Usually are guardians, grandparents, I contact any teachers that, hey, what school do they go to? Can I, you know, fill out obviously ROI to let me have that conversation? Any doctors, somebody who's been in their life before the age of 12, any, you know, relatives. You're basically looking, you know, I've even had people bring me in work from that age. So say like elementary school, like schoolwork, do you have some of the habits you do in school? I would have them bring that in and I would review that. And so you're looking just for that evidence that like this has been an issue, you know, this has this is not me just developing this. Because if it's just you now having it, I'm looking more at like anxiety, right? Like, I'm looking more for like you're probably in this area versus ADHD. But if you can show me you've had it or people have really can tell me that you did, we can now kind of move forward with more, you know, investigation towards that.
STACY:Gotcha. And and what if so what if you're seeing an adult then? What would you would you be asking them particular questions about tell me about your childhood or like, you know, not just focused on what's currently going on for them, but you'd be taking it back aways?
HANNAH:I'd be taking it back a ways. Yeah. I would be taking it, you know, one of the I don't know what's the easiest, but one of the easiest ways is just talk about school, talk about their academic career. You know, how were you in school? Did you get in trouble a lot? You know, did people ever tell you to slow down? Oh, that's a big one, right? So did you slow down a lot? Was it ever hard to really pay attention when you were in school? Did you get, you know, did you get detention because you were up and down out of your seat a ton? You know, so you're it's just you're asking these very pointed questions and then with the at home, were you ever the same way? You know, how is your sleep? I'm always people get so annoyed. I'm always asking about sleep. But like it's true, like, you know, the research has shown a lot about how that can correlate as well. And so we are diving into that. You're really looking holistically and at a very comprehensive level to ensure that these are the symptoms that are lining up. And it's not just that you were a high energy kid, right? It's not that you were just a child with you were just rambunctious. It's you had a very severe case of I even if I want to, I can't do it. I can't stand still, I can't pay attention. You know, it's so it's it's just a really I always say put your detective hat on and look for clues. You're always looking for clues in the history. Always, always, always.
STACY:Yeah. Linton, I've been seeing you smiling as Hannah's talking. Looks like maybe some of these are childhood.
LINTON:You know, I always thought detention was my second home.
STACY:No, this is just normal. We know where I go every Thursday. Yeah. So let's talk a little bit about the inattention aspect. So um, so when we're talking about inattention, um, it's different than just occasionally spacing out or like getting temporarily distracted, right? With ADHD, the inattention is much more severe and it's persistent over time. I think that's really the key, right? It's not just a one-off where you're having a really high stress, you know, season or something.
LINTON:Right, right. For example, the child may frequently make careless mistakes in schoolwork, struggling to stay focused during activities, seem like they're never listening to you, fail to follow through on instructions, have trouble with organized tasks, avoid activities requiring sustained mental effort, like pulling weeds or doing homework, getting distracted by irrelevant things or forgetting to take care of their daily responsibilities, like brushing their teeth or washing their hands or all that kind of stuff.
STACY:Got it. Well, that was a really good summary of those typical symptoms uh that you'd see with inattention. And how about going back to the hyperactivity portion, which I think is a little bit more of the like people think of ADHD and think of just really hyper? Aren't kids kind of known for their high energy levels, right? Like when does it really cross that line into clinical?
HANNAH:That's that's actually a really important distinction to make. And I get that question quite often working with kids and parents and families. So we know that children are naturally just hyperactive. Like they just they love it. They're ambunctious, they can be impulsive, like they don't have a frontal lobe yet. Like it's not there yet, it's not developed. So when we look at ADHD, we're looking at the hyperactivity as like you were mentioning, more severe and persistent. So it's definitely one of those things to where, like I said before, where the child will want to do the thing, but they literally cannot. They literally can't stop their body from moving or paying attention. And they've tried and tried and tried and tried. So they may frequently fidget. Um, a lot of kids fidget, a lot of kids tap things, either may it be their hands, their fingers, they're playing with their hair, the buttons on their shirts, they're wiggling around in their seat, which is often the case in schools. You'll see a lot of children where they're up and down. I've seen cases where children were underneath the desk, right? They just could not sit at their, you know, their chair. They wanted to be underneath the desk, they were across the room. They were like, oh, that looks cool. Let me walk over there. They're walking across like they're just like wherever their impulse is taking them is where they're going. You can often see kids like run and climb at inappropriate times, it's struggle to play quietly, and it's not just, oh, you're being too loud, it's a very, again, severe, persistent display of loudness. You're looking for kids who talk excessively, which in my experience, talking excessively often like, oh, that kid's outgoing, or oh, that's just you about that's just how they are and stuff. But if it's consistent and you're noticing even just kind of odd social patterns where they are cutting people off, or you're talking to them kind of directly, and then they're not responding to anything you just said, and instead they're they're going off on their their own hyperfixation, right? Trains, cars, like they're like, I don't even care what you just said. Did you see this cool thing? You know, so we're looking for that type of thing. Um, but it's true. Uh blurting out stuff, um, trouble waiting their turn, which every kid has, but again, severity. We're we're looking at kids as if they're driven by a motor. I love that description because I think it really helps put in our mind of how much these kiddos are just truly driven by endless amounts of this hyperactivity impulsivity heart. They rush into things without thinking, right? Impulsive. So just want to really emphasize that word severe because all of these other things, like you're probably nodding your head and being like, Yeah, that sounds like a six-year-old or seven-year-old, right? But we're looking, we're talking about kids who are really sticking out from that crowd, right? They're the ones that even if they're talking to a friend, say a seven, eight-year-old, but they're be they're fidgeting with their, you know, whatever, and their their conversation patterns are so tangible that you're like, how did we even get to start talking about Hawaii when we were talking about hot dogs, right? Like, somebody in it, you know, and it it'll it'll end up being like that. So we're it's sometimes a child who will also like get in trouble. Kind of when I was joking about like, oh, they get detention all the time. But it's kind of in a way where, like me, when I was a school counselor working in schools full-time, I would get kids sent to the office, they would come see me, and it was like, oh miss, I don't know why I couldn't sit still, or I I just didn't want to stand in line, so I ran off in the hallway. And you know, and so they don't truly even understand their own behaviors, and even if they want to listen and want to stand in line, their little bodies and brains and and stuff just they just take off. So um we're looking for that kind of thing. So it's just important when we're looking at any disorder to how it'll present in real life. People are not criteria, people are people. So it's really important to think to ourselves how would this look like in a real person? And then that really can help us be able to one, understand it better, but two, be able to really spot it from being just a normal kid reaction.
LINTON:Yeah, and it's not enough for a person to just have six symptoms of inattention or six symptoms of hyperactivity and policyspathy, but uh to meet the criteria for ADHD. You know, several of the symptoms must be presented, like you said, before the age of 12 and are present in more than one situation. In other words, it just doesn't happen at school, it happens at home, it happens with friends. And basically the the they're negatively impacted by the client's functioning.
STACY:And that's really the key here. So just because you have a messy desk, just like the laundry, those piles seem to mysteriously multiply overnight, or you're prone to misplacing your phone in very weird places like the chicken coop. Yes, I have actually done this. Um, that does not mean that you have ADHD. Or they're like my husband and he has his little messy piles at home, which I've come to love. But then, you know, in an office somewhere, he can have the neatest desk. So you're really looking at like more than one setting, right? Like not just your home turf, but elsewhere. Yes. Yes. Exactly.
LINTON:Yeah. Now on to differentials, which is Hannah's favorite, I think. And I noticed that list that you have of uh differentials for ADHD is longer than the checkout line at Publix on sushi on Wednesday.
STACY:Linton, you have a very uncanny ability to casually sort of sneak in sushi into practically any conversation. And I wonder what Freud would say about that. Oh, that's a good point.
LINTON:Well, before we go down that rabbit hole, let's go over a few of the differentials for ADHD, okay, Hannah?
HANNAH:Okay, but seriously, guys, I do love sushi.
STACY:So my stomach is grumbling right now.
HANNAH:I did grow up in Japan, so I am very, you know, I could literally probably eat it every day. Um but anyway, okay, so onwards. So yes, the CVS receipt, if you know, you know, there's a lot of differentials. There's a lot of differentials. Um, but one of the tricks to differentials is to think of them as disorders that are alike in some way. And I always say they overlap the symptoms, right? So, for example, if you're talking about ADHD and intermittent explosive disorder, both like high levels of impulsive behaviors. But clients with intermittent explosive disorders also show that aggression, that aggression, which is not characteristic of ADHD. So ADHD, and you can add in some broad strokes of understanding, but ADHD affects the executive functioning center of the brain. So, like our frontal lobe, we were talking about earlier, how this everything kind of works together. That's really effective when we talk about the ADHD. 85% of children who have ADHD will have symptoms in adulthood. They just manifest differently. I always like to say when we're talking about ADHD, that it is a disorder to which the brain is just or really just the frontal low of the executive functioning part of your brain is really just behind a couple years every time. So anytime I give this diagnosis, I'm having this conversation because it's really important for people to realize that some people do what I call play catch-up. And that is when you are given therapies at a young age, you have that early intervention timeline you can hop on. You're giving these interventions to where they can learn how to manage their behaviors. Will ADHD always be there? Probably, yes. Will it seem as if they grew out of it later on in life because they've been doing all these things since a young age? Also, yes. Right. So there are these ways to where when we're explaining this disorder, you really want to have a solid understanding of brain development and basic, and like we talked about a bunch was basic neuroanatomy. You really have to be able to have those conversations and understand that in adulthood things, or even I would say even elder adolescents will see will see this look very, very different. Um but one of the things is a similarity between ADHD and depression. So one of the symptoms that we often see in depression is that difficulty concentrating. So that a lot of people will come to and say, Oh, just having this difficulty. And we also know that's also part of that inattentive type of ADHD, when someone says, Oh, I just can't pay attention. I can't, I can't, I don't even know what was said. I got distracted by the fly on the wall, you know. So, but the thing we're gonna look at is if that depression inattentiveness is that only there during a depressive episode. Outside of that are you able to pay attention. Outside of that are things okay. With ADHD, it's constant, it's every single day. It's not nothing can change it. It's always gonna be there, it's always very, very effortful to even try to pay attention. We also can talk about the post-traumatic stress disorder. So PTSD. PTSD in children can mimic ADHD symptoms. This is a very careful thing to talk about with people who've experienced trauma and just remaining very trauma-informed. But young children will present with trauma-related symptoms like anattention, poor concentration, restlessness. You can even say the high anxiety, you know, behaviors where they're fidgety, um, they have headaches a lot. You know, it's really, really important to be able to differentiate and distinguish between those two. And using comprehensive assessments and just checking for any previous exposure to trauma can be extremely helpful in order to rule out that it's not trauma-based. It is very much this ADHD presentation.
STACY:Yeah, that makes a lot of sense. Um, so as you are studying for your exam, we really encourage you to familiarize yourself with your DSM5TR and definitely, definitely take a look at that list of differential diagnoses for the um disorders. Uh, it's really not as intimidating as it seems when you remember that a differential diagnosis is, as we've been talking about, a disorder that shares some features in common with another disorder. So for these neurodevelopmental disorders that we're talking about, their differential diagnoses will always have some kind of a symptom, sign that is kind of overlaps with another disorder.
