Does my child have ADHD?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR), a diagnosis of ADHD entails the following:
It is always important to remember that, for a diagnosis of ADHD, there needs to be a set of symptoms negatively affecting functioning – not just one or two. For example, because a child is able to hyperfocus (which, actually, is not a part of the diagnostic criteria), it does not necessarily mean that the child has ADHD, or is gifted. What is troublesome for a child with ADHD is controlling attention, particularly in situations that are not necessarily rewarding or require substantial effort. Hyperfocus can be a positive thing when it corresponds with task motivation, but it is troublesome when a child needs to shift his/her attention or focus on activities that are socially required (e.g., sitting at one’s seat completing schoolwork). Often, when people describe hyperfocus in children with ADHD, they are referring to the child who watches television or plays video games for hours. This typically is not the same way that hyperfocus is described in gifted children, where a child works on a Lego set or reads about space for hours.
While ADHD is considered to be a pervasive difficulty, the outcome varies depending on several issues, like intensity of the disorder, co-morbidity with other disorders, positive family environment, etc.
There are many reasons why a person is inattentive or forgetful, such as depression, stress, or anxiety. Therefore, a comprehensive evaluation is needed to definitively diagnose ADHD. One needs to know what is “causing” the difficulty to effectively “treat” the difficulty.
In our practice at the Assessment and Counseling Clinic, the assessment battery varies depending on (1) the referral question and (2) how the testing data unfolds. All scores from psychological tests should be interpreted within a context. For example, there are a multitude of reasons why a student would demonstrate slower than expected processing. Therefore, when I see a difference in IQ scores such that the verbal and nonverbal scores are far superior to the processing speed score, I try to discern what could be causing the discrepancy. If I think that the difference is related to attention, I would look at scores on measures of executive functioning, continuous performance tests, and behavioral rating scales and see if there is a pattern.
Typically, an ADHD assessment in our clinic consists of the following tests:
In general, researchers have found that psychopharmacological treatments for ADHD reduce the core symptoms of ADHD (inattention, hyperactivity, and impulsivity), and improve the child’s general ability to handle task demands and academic productivity. They have not been shown to help with learning and applying knowledge to various situations. Researchers have also found that behavioral treatments are helpful, but not as helpful as medications in reducing the core symptoms of ADHD. They are, however, just as effective at reducing oppositional and defiant behavior and improving parent-child relationships.
Not everyone with a diagnosis of ADHD responds well to a psychostimulant medication treatment regimen. In fact, about 20% of individuals with ADHD/ADD do not respond positively to stimulants. However, one positive aspect to considering a trial of stimulant medication is that they are quick in / quick out. Sometimes, it takes various trials before one finds a medication that works with minimal side-effects. Some children will need to take medications as they get older, but others will not.
Behavioral and educational interventions to consider:
This article is provided as a service of the Davidson Institute for Talent Development, a 501(c)3 nonprofit dedicated to supporting profoundly gifted young people 18 and under. To learn more about the Davidson Institute’s programs, please visit www.DavidsonGifted.org.
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