It’s common lore that folks with ADHD are attracted to flying planes. Whether or not that is true, I do field many questions about ADHD-related restrictions on becoming a pilot. This post explores FAA policy and ADHD.
For example, one question came from the spouse of a commercial airline pilot. Her husband has been diagnosed with ADHD (and, from her report, displays strong symptoms at home). But, she claimed that FAA guidelines prohibit him from taking medication for it. Could this be true? Yes, it is true.
Another example: A young man I know diagnosed with ADHD at age 23 finds this prohibition completely unfair. Becoming a pilot is his lifelong dream; seeing the disappointment on his face is heartbreaking. Yet, I also saw how impaired he was before beginning stimulant medication, repeatedly asking the same questions of the support group, always arriving very late to the meeting, and struggling through school. With medication, he became sharper, more alert, and with much improved working memory. The difference truly was night and day.
If he stopped taking medication, would being in the cockpit somehow “stimulate” him into higher functioning? I’m unlikely to bet my life—or his—on it. The much-ballyhooed “ADHD Hyperfocus” isn’t all it’s cracked up to be. Moreover, it’s certainly not reliable.
Then again, as I always say, ADHD is a highly variable syndrome. Moreover, it affects individuals. There are no cookie-cutter descriptions, answers, or strategies.
He was diagnosed as an adult, after a thorough and professional evaluation. What about potential pilots whose diagnosis as children was more informal?
As best I can make out, this is the bottom line for potential pilots with ADHD:
- ADHD itself is not a disqualifying condition.
- Yet, if you have a formal diagnosis of ADD or ADHD, you may need to undergo additional testing in order to receive a medical certificate.
- Most medications used to treat ADHD are disqualifying (stimulants and Strattera).
- A 90-day period of taking no medication is required before evaluation.
- The FAA requires its own extensive evaluation for ADHD.
Current FAA Guidelines: Summary
Here is the December 2018 information from the FAA webpage concerning ADHD (Guide for Aviation Medical Examiners: Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder)
- The FAA requires an extensive evaluation if an applicant for medical certification has been diagnosed with or is currently taking one of the medications used to treat this condition.
- If medications are being taken, they must be discontinued for at least 90 days and you will be asked to undergo a neuropsychological evaluation with a clinical psychologist or neuropsychologist
- The testing is very familiar to the psychology world and consists of a battery of different tests that measure various areas of neurocognitive functioning. The evaluation is quite comprehensive and generally takes six or more exhausting hours to perform.
- The complement of tests provides an objective way for the clinical psychologist to test for ADHD and any other underlying pathology that affects one’s short and long-term memory, ability to multitask, and to understand and comply with instructions, and many other “executive” tasks. The psychologist can compare one’s scores to “normal” functioning individuals, rather than against the applicants’ own baseline scores since there is no baseline testing to compare to! This is one of the objections that opponents have for this type of evaluation process.
- Many young folks are placed on these medications without ever being tested. They are prescribed the meds based on parental or personal concerns about attentiveness to tasks such as job or school performance or other demonstrated history. In many cases, people who are treated for apparent symptoms don’t really have ADHD, but in order to rule it out, a formal clinical evaluation should be done.
FAA Medical Examinations:
From the FAA’s Guide for Aviation Medical Examiners (AME); Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder
Q: Why is a neuropsychological evaluation required?
Attention-Deficit/Hyperactivity Disorder (ADHD), formerly called Attention Deficit Disorder (ADD), and medications used for treatment may result in cognitive deficits that would make an airman unsafe to perform pilot duties.
Q: What testing is required?
There are two test batteries:
INITIAL BATTERY – performed on everyone; and
SUPPLEMENTAL BATTERY – performed when the Initial Battery indicates a potential problem.
Q: Why is a CogScreen-Aeromedical Edition (CogScreen-AE) required?
CogScreen-AE is a neurocognitive test developed to assist the FAA in the evaluation of the domains of neurocognitive performance most important for safety of flight.
Q: Who may perform a neuropsychological evaluation?
Neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics. The following link contains a list of neuropsychologists who meet all FAA quality criteria. See FAA Neuropsychologist List (PDF).
If you have any experience or accurate on this topic, please share. Are there any workarounds to this prohibition?