I THINK MY CHILD MIGHT HAVE ADHD (PART 2) - ADHD EVALUATIONS
The previous article in this blog series, I Think My Child Might Have ADHD (Part 1), discussed initial steps to take to determine the relative severity of any behavior concerns you are seeing from your child and how working with your child’s school can help support your child at home and at school. This blog post will discuss specific symptoms of ADHD, how to seek out an ADHD evaluation for your child, and what these evaluations look like.
ADHD Symptoms
ADHD stands for Attention-Deficit/Hyperactivity Disorder. There are three presentations of the disorder that include inattentive, hyperactive/impulsive, and combined. Whereas the term “ADD” was previously used to refer to the inattentive presentation and is still commonly used by the community as well as by professionals, the current official diagnosis is ADHD-Predominantly Inattentive Presentation. Symptoms of the inattentive presentation include impairments with focus, disorganization, difficulty sticking with and completing tasks, losing things, poor time management, forgetfulness, and poor attention to detail. The hyperactive/impulsive presentation includes symptoms of restlessness, acting without thinking, difficulty remaining seated, fidgeting/tapping, interrupting others, and talking excessively. Finally, the combined presentation includes characteristics of both the inattentive and hyperactive/impulsive presentations.
School Supports for ADHD
As discussed in I Think My Child Might Have ADHD (Part 1), schools have systems in place for supporting students that range from your child’s teacher providing accommodations in their classroom to working with your child’s teacher to implement targeted interventions at school and at home. Your child may also be referred to a Muti-tiered Systems of Support (MTSS) team that implements and tracks targeted interventions, or be referred to work with behavior support staff such as the school psychologist, school social worker, or school counselor. If the concerns are persistent and more severe, special education supports may also be considered by initiating a special education evaluation.
At any point in the above process, it may be beneficial to talk with a pediatrician or seek out a clinic that specializes in psychological or neuropsychological evaluations that assess cognition, behavior, learning, and mental health. These evaluations provide in-depth information about strengths, weaknesses, and areas to focus on for supporting your child. They are also able to identify and diagnose developmental and mental disorders such as ADHD, autism, specific learning disorders, anxiety, and depressive disorders. Accurate diagnoses are important for developing specific treatment plans to support your child at home, at school, and in the community.
Components of an ADHD Evaluation
If you decide to pursue an ADHD evaluation, there are certain components that are critical to be able to determine if your child has ADHD. One of the most important components is a comprehensive developmental interview to gather specific information about the presence of ADHD symptoms, how the symptoms and behaviors have changed over your child’s development, and how the symptoms present in different contexts and settings. Often children with ADHD are able to focus very well during high interest activities, when there is a strong motivator, or when they are getting immediate feedback. However, significant issues with inattention and distractibility show up when attempting to complete tasks where these factors are not present.
Differential diagnosis and comorbidity of ADHD
Along with getting detailed information about the specific symptoms of ADHD, it is also important for the clinician to gather information about other factors that may be contributing to the symptoms of ADHD. For example, if during reading tasks your child becomes easily distracted and engages in more hyperactive behaviors, these concerns my be the result of reading impairments and not the result of ADHD. Similarly, other factors such as trauma, anxiety, and depression can mimic the symptoms of ADHD. To complicate things further, ADHD is often comorbid with other disorders such as learning disabilities, anxiety, and depressive disorders. Therefore, gathering a highly detailed and thorough developmental history is extremely important when considering an ADHD diagnosis.
ADHD normative rating scales
Another important component of an ADHD evaluation is a normative rating scale. Whereas open ended interviews with parents, teachers, and others who know the child well can provide important and specific details of what the child’s behaviors look like, normative rating scales can quantify how severe the behavior concerns are compared to other children their same age. These rating scales are completed by parents, teachers, and sometimes the child and ask questions about how often the child is engaging in behaviors that are characteristic of ADHD. Their answers are then compared to answers from parents, teachers, and children from the normative sample group to determine the relative severity of your child’s behaviors.
Other Components of an ADHD Evaluation
Other components of the evaluation may include cognitive or intellectual assessments, academic assessments, tests of executive functioning, adaptive functioning measures, and assessments of anxiety or mood disorders that can provide more information to get a better understanding of how other factors might be impacting your child.
Next Steps if ADHD is Suspected
Given the complexity of these factors in determining an ADHD diagnosis, it is imperative to find a clinic that specializes in comprehensive ADHD testing. For more information about St. Paul, Minnesota comprehensive neuropsychological testing, including ADHD and other learning disorders, go to White Bear Psychological Services or contact us to schedule a phone call with our client care specialist. Part 3 of this blog series will focus on School Special Education Evaluations for ADHD.
