02 Apr ADHD: Assessment and Diagnosis
It will likely not come as a surprise to anyone to hear that there has been a significant increase in the percentage of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) in recent years. From 2003 to 2007 rates of ADHD diagnoses in children ages 4 to 7 increased by 22 percent according to the CDC and in 2011, 11 percent of school-age children had received a diagnosis of ADHD. This is despite the fact that current estimates from the National Institute of Mental Health indicate that approximately 3 to 5 percent of school-age children meet the criteria for ADHD. While there is certainly more awareness of ADHD and the impairments it causes in children and adults in our culture currently, there is also evidence to suggest that ADHD is being diagnosed in situations in which such a diagnosis is not warranted.
ADHD, in brief, is a disorder which impacts the ability to filter information, and individuals with ADHD may have difficulties with attention, such as getting distracted easily, being forgetful and having trouble listening, among other symptoms, and/or may demonstrate hyperactive and impulsive behaviors, such as being fidgety, running around excessively, interrupting frequently, etc. Evidence suggests that ADHD has strong connections to genetics and heredity and also may be related to environmental influences such as significant exposure to lead.
Despite concerns about the possible over-diagnosis of ADHD, there is considerable evidence and research to support the existence of this disorder and the significant impairment caused for some individuals throughout childhood and adolescence, and in some cases into adulthood. Thus, if you have concerns about your child’s ability to regulate their attention and/or activity level, or a teacher or doctor has mentioned such concerns, or if you are concerned about possible ADHD symptoms as an adult, the most important step for you is seek out a thorough evaluation. Such an evaluation can be completed by a psychologist, psychiatrist, clinical social worker or counselor/therapist with experience in this area. While neuropsychological testing may be helpful in certain situations, particularly where there is concern about making the distinction between ADHD and other possible impairments, such as learning disorders or speech and language disorders, such testing is not always needed in order for a diagnosis of ADHD to be given.
Although the value of an assessment cannot be measured in time alone, it is important to consider that an appropriate evaluation of possible ADHD symptoms, whether in a child or an adult, should take an hour or several hours and the necessary information required for a diagnosis of ADHD cannot be adequately obtained in a matter of minutes. An assessment of ADHD in children should include normed ratings from parents, often through the completion of a rating scale, and should include information from the school in the form of a school observation of the child and/or the completion of a rating scale by teachers. Such an evaluation will also include a discussion of developmental history and will insure that behaviors present are not better explained by another psychiatric diagnosis or stressor and will also assess whether any other disorders or impairments may be present. In adults, assessment of ADHD should also include normed ratings whenever possible and will carefully consider developmental history and relative impairment across several settings and the evaluator may wish to speak to other individuals who are familiar with the history and current functioning of the adult being assessed, such as parents or partners.
If a diagnosis of ADHD is warranted after a thorough evaluation, the excellent news is that there are very effective treatments for ADHD and this topic will be addressed in a future blog post.
For more information, you can reference:
The American Academy of Child and Adolescent Psychiatry’s ADHD Resource Center http://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/ADHD_Resource_Center/Home.aspx
Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) : www.chadd.org