The Building Blocks of a Good ADHD Diagnosis
Clinical interviews. Physical exams. Rating scales and teacher input. Learn how to get diagnosed with ADHD — and what options don't reliably help, like SPECT scans and genetic tests.
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3 Comments: The Building Blocks of a Good ADHD Diagnosis
I have to take issue with the statement that a neuropsychological evaluation is not an appropriate tool in the evaluative process for suspected ADHD! For a myriad of reasons, and because this type of evaluation covers much ground, it should be included in the evaluation process as it includes screening for LD’s, anxiety, executive functioning, depression and other comorbid conditions, as well as screening and evaluation for ADHD. This magazine itself has frequently cited neuropsychological testing as a necessity in getting a full and comprehensive picture of what is happening within the child’s brain and it’s various functions. And as we know, ADHD frequently travels with other comorbid conditions that may masquerade as ADHD or exist side by side with it, and other dysfunctions within the brain. Not an appropriate statement to be included in this article, by this author, as it is both misinformed and misleading.
As a MFT and 51 year old female with moderate to severe ADHD that was not diagnosed (officially) until well into my adult hood, it really bothers me that counselors with experience and expertise in treating clients with ADHD are not included in the diagnostic process above. We have the time and training to do the type of in depth sessions necessary to rule in and/or out ADHD, and work with clients do uncover other possible causes of symptoms that may come from PTSD, sleep problems, trauma, mood disorders, etc. Although I would never give a definitive diagnosis of ADHD (or sleep disorders), by working in tandem with a treating physician and completing an assessment such as this, then communicating with the psychiatrist or physician who will do the medical side of the diagnosis the results, patients could begin receiving treatment sooner. I know I am not qualified to do many of the other tests necessary for these diagnoses, i.e. blood work to check thyroid levels and other possible issues, sleep studies, ensure pre-existing conditions that would rule out the use of stimulant medications, etc., so I am not advocating for counselors to make an ADD/ADHD final diagnosis, but to exclude us from a vital role in the diagnostic and treatment process does a dis-service to both patients and treating physicians. We have the time (covered by insurance) to do much of the leg work that, unfortunately, insurance won’t allow most physicians. I realize many therapists may not have the expertise needed, but I would strongly encourage physicians treating patients with ADHD to work with us who do have the needed qualification in this process.
I appreciated this article but did NOT appreciate negating the utility of neuropsychological assessment. This is often warranted as part of a larger battery of psychodiagnostic and achievement testing. And, I’ve never heard of a neuropsych test being 20 minutes. If you’re freferrkng to a screener the MDs use to identify who needs further neuropsych assessment, these screeners are not neuropsych measures. Would appreciate more accuracy on how neuropsych is useful in diagnosing ADHD (and other LDs), In addition to medical neuropsych referrals. Thanks.