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DIAGNOSING ADHD

A CHECKUP & CHECKLIST

Dr.Stephen Garber


WHAT IS ADHD (ADD)?

There have been many different labels used to describe children, adolescents, and even adults who are overly active, easily distracted, and have trouble sustaining attention.  While many people are familiar with ADD (Attention Deficit Disorder) the official terminology is now ADHD (Attention Deficit Hyperactivity Disorder).  There are three main types of ADHD:  1.  Inattentive, 2.  Hyperactive-Impulsive, 3.  Combined (1 & 2)

HOW MANY PEOPLE REALLY HAVE ADHD?

There has been a great deal of controversy about the over-diagnosis and treatment of ADHD.  Nationwide research estimates 1 out of every 25 school age children, which means one or two children in a class would be predicted to have ADHD.  Because ADHD often coexists with other childhood problems, the percentage of students in special education classes is often higher.  We also know that many youngsters do not simply "outgrow" this disorder.  Researchers estimate that a third to a half of ADHD youngsters will have problems related to this disorder in adulthood.

IS THERE ONE TEST THAT CAN ACCURATELY DIAGNOSE ADHD?

Even though ADHD is a biologically based disorder, there is no one test that can accurately diagnose this complex problem.  Attention and concentration can be affected by a number of other medical, psychological, and learning disorders that can either mimic ADHD or coexist with it.  In order to obtain an accurate diagnosis, other causes must be ruled out by the use of a number of different measures and assessment techniques.  The Checkup and Checklist on the next pages show steps to take. 

ADHD CHECKUP


STEP 1.  RULE OUT MEDICAL PROBLEMS

_____Vision Checked
_____Hearing Checked
_____Thyroid Function Normal
_____Neurological Problems Ruled Out
_____Physical Exam (Other Medical Problems)

STEP 2.  OBTAIN A COMPLETE HISTORY

_____Family history of others with ADHD
_____Prenatal and birth factors
_____Developmental milestones (motor, language, activity level)
_____Educational history including early teacher comments

STEP 3.  TEST FOR PSYCHOLOGICAL PROBLEMS

_____Rule out Developmental Disorders
_____Rule out Psychotic Disorders
_____Determine if an Anxiety Disorder is disrupting attention or causing fidgetiness
_____Determine if a Mood Disorder is disrupting attention, causing agitation

STEP 4.  TEST FOR LEARNING/PROCESSING PROBLEMS THAT STRAIN ATTENTION

_____Test for auditory discrimination, memory, sequencing, and language disabilities
_____Test for information processing problems that may strain academics or work
_____Determine if other academic deficits or disabilities are blocking learning

STEP 5.  GET PARENT AND TEACHER RATINGS AND USE THE ADHD CHECKLIST

 
ADHD CHECKLIST

INATTENTION

_____1.  Often fails to give close attention to details or makes careless mistakes in 
               schoolwork, the workplace, or other activities.
_____2.  Often has difficulty sustaining attention in tasks or play activities.
_____3.  Often does not seem to be listening when spoken to directly.
_____4.  Often does not follow through on instructions and fails to finish schoolwork,
               chores, or duties in the workplace.
_____5.  Often has difficulty organizing tasks and activities.
_____6.  Often avoids, dislikes, or is reluctant to engage in tasks that require sustained
               mental effort, such as schoolwork or homework.
_____7.  Often loses things that are necessary for tasks or activities, such as toys, school
               assignments, pencils, books, or tools.
_____8.  Is often easily distracted by extraneous stimuli.
_____9.  Is often forgetful in daily activities.

HYPERACTIVITY-IMPULSIVITY

_____1.  Often fidgets with hands or feet and squirms in seat.
_____2.  Often leaves seat in the classroom or in situations in which remaining seated is 
               expected.
_____3.  Often runs about or climbs excessively in situations in which it is inappropriate 
               (In adolescents or adults, may be limited to subjective feelings of restlessness).
_____4.  Often has difficulty playing or engaging in leisure activities.
_____5.  Is often "on the go" or often acts as if "driven by a motor."
_____6.  Often talks excessively.
_____7.  Often blurts out the answers before questions have been completed.
_____8.  Often has difficulty waiting my turn.
_____9.  Often interrupts or intrudes on others (e.g. butts into conversations or games).
               (DSM-IV-APA,1994)

SUMMARY

  • DID YOU CHECK SIX OR MORE CHARACTERISTICS UNDER INATTENTION AND/OR HYPERACTIVITY-IMPULSIVITY? 
  • HAVE YOU MADE SURE THESE CHARACTERISTICS ARE NOT DEVELOPMENTAL, MEDICAL, OR PSYCHOLOGICAL?
  • HAVE THESE CHARACTERISTICS EXISTED FOR THE PAST 6 MONTHS OR MORE?
  • ARE THEY MORE PRONOUNCED THAN IN SAME AGE PEERS?
  • DO THEY CAUSE SOME IMPAIRMENT IN TWO OR MORE SETTINGS?

If you answered yes to the above questions, a further diagnostic evaluation for ADHD may be warranted.  Please contact us for further information. For more information please call (404) 256-9325.



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