What is Attention Deficit Disorder and
How is it Diagnosed?

 

Attention Deficit Disorder (AD/HD) is mostly an organic problem which tends to run in families. It is characterized by the inability to sustain focused attention, (distractibility or inattention). To diagnose ADHD, mental health professionals ask parents and teachers to observe children and rate their behavior using specific questionnaires or checklists. These checklists rate the following behaviors which are present in most people with ADHD:

        • Distractibility
        • Inattention
        • Free flight of ideas (free associations to any other idea)
        • Impulsivity - Moodiness
        • Insatiability
        • Bursts of hot temper
        • Hyperactivity

In most cases, these behaviors were noticed before the child was seven years old. Since the ADHD person's ability to stay focused gets worse when the environment is noisy or full of distractions, teachers often are the first ones to notice when a child is having trouble paying attention.

There are two major subtypes, ADHD (with hyperactivity) and ADHD without hyperactivity (impulsive and inattentive form).

ADHD, Attention Deficit Disorder with Hyperactivity is often easier to diagnose as these children move continuously, have trouble sitting still, have poor impulse control, and may have temper outbursts more frequently than their peers.

ADHD, Inattentive type is often misdiagnosed. These children:

        • may be withdrawn or “spaced-out” (may be more prevalent in girls)
        • may be poor academic achievers
        • may occur concurrently with Learning Disabilities
        • may demonstrate excessive anxiety or shyness

We now know that ADHD can be concurrent with Learning Disabilities. Current research suggests anywhere from 25 to 50 percent of the people diagnosed with ADHD also have Learning Disabilities.

Is ADHD a Learning Disability?

It is clear that having ADHD can affect your ability to learn in a highly stimulating environment such as a noisy classroom due to the amount of auditory and visual distractions. However, ADHD is not a learning disability per se. If your child functions at least one a half to two years below grade level as the result of ADHD, the same criteria for services for children with learning disabilities can apply to your child as well (meaning they are eligible for special services under IDEA). One reason why people think that ADHD is a learning disability is because so many children and adults have a learning disability along with their ADHD. We don't know exactly how many people have both, but various studies indicate that twenty-five to fifty percent of people with ADHD also have Learning Disabilities.

Evaluation for ADHD

1. History: A health professional should take a comprehensive family history. It needs to include when you first noticed your child had a problem. Since assessment is based on the presence of these symptoms before the age of seven, particular attention needs to be paid to your child's pre-school and early grammar school experiences.

2. Identifying other family members with ADHD. Does anyone else in your family have ADHD? We frequently find parents can identify another family member who has ADHD. Does a parent, sibling, or an aunt, uncle, cousin or grandparent suffer from undiagnosed ADHD? One way of recognizing undiagnosed ADHD is to look at the behavior patterns. Did this relative have an inconsistent job history? Did they have problems with their temper or were they dependent on drugs or alcohol? Many adults who have untreated ADHD, have suffered with these problems.

3. Behavior Checklists. After consulting a medical doctor or psychologist, the parents and classroom teachers are asked to fill-out behavior checklists. These are standardized lists that look for typical ADHD behaviors. Sometimes, achievement tests are used in addition to checklists.

4. Psychological tests are sometimes used to define the scope of the problem. Because they can be costly, they are not always used.

5. Medication trials. One way of defining the presence of ADHD is to see if a trial of medication gets rid of the major symptoms. Many parents and adults have noticed an immediate change in concentration or mood from medications. Medication trails are regulated by medical doctors.

6. Continuous Performance Tests: IVA, TOVA, and CPT Continuous performance tests are a popular means of assessment. Although the creators of the tests say that they aren't to be used by themselves to assess for ADHD, many clinicians are using them in this way.

The major problem with these tests is that they don't take into account that the person taking the test may have Learning Disabilities which frequently affect eye-hand coordination. So, when they push a button slowly in response to a letter which has flashed on the computer screen or a sound you have heard, are they really inattentive? Maybe they have trouble responding and evaluating what they have seen or heard or just have difficulty with their finger responding to their brain's command. To accurately assess ADHD, the makers of these continuous performance tests would have to create a database of Learning Disabled children and adults. Until they do, these are not valid assessment tools for anyone who has ADHD and Learning Disabilities (which maybe 30-50% of the ADHD population).

A positive use for these tests is to demonstrate increased attention or shorter response time. In other words, you take the test before starting a treatment regime and then you take it after your treatments and you compare the results. The effects of any treatment can be measured in this way such as medication trials, training in EEG biofeedback, or sensory-motor integration therapy.

Warning

Do not diagnose yourself. See a competent medical doctor, psychologist, school psychologist or psychotherapist who is familiar with ADHD. CHADD, the support group for children and adults with ADHD, has a list of all of its active, clinical members. For more information, go to CHADD.

<< back to top