Today, the Centers for Disease and Control (CDC) report that 11 percent of American children, ages 4-17 have Attention Deficit Hyperactivity Disorder (ADHD). ADHD is a mental disorder that most often occurs in children. 6.4 million American children ages 4-17 have been diagnosed with ADHD. Males are almost three times more likely to be diagnosed with ADHD than females. The average age of ADHD diagnosis is 7 years old, however symptoms of ADHD typically begin to surface between the ages of 3 and 6. Roughly 6 percent of American children are being treated for ADHD with medication. Over the past 8 years there has been a 42 percent increase in ADHD diagnoses. Of all these numbers, it is the last number that we find most interesting. That increase means more and more children are being diagnosed with this condition each year. How do you know what a good evaluation is?
When looking at the characteristics of ADHD, it doesn’t take long to recognize how many of the behaviors could be a manifestation of another condition. For example, children with anxiety disorders often share many of the characteristics of children with ADHD. Simply looking at the behavior on the surface could likely lead to an incorrect diagnosis. To make a diagnosis the clinical should first determine that the diagnostic criteria have been met based on the Diagnostic and Satistical Manual of Mental Disorders-Fifth Edition (DSM-5). Making this diagnosis includes documenting that the child has the difficulties in more than one major setting, which is an important aspect of a proper diagnosis. Both clinical interviewing and behavior rating scales should be used together to ensure that, in fact, the behavior are observed in more than one setting. There are many statistically sound ratings scales that are appropriate for helping the clinician gather the correct information. Rating scales that we recommend include the following: Connors Rating Scales, Behavior Assessment Scales for Children, Achenbach Child Behavior Checklist, and the Vanderbilt ADHD diagnostic Teacher Rating Scale. These rating scales compare the child’s ratings with other children’s ratings to help the clinician determine if the behavioral challenges are significant and meet criteria for ADHD.As mentioned before good clinical interviewing techniques should be used to help assess whether other conditions are present that might coexist with ADHD. Conditions that can look like or coexist with ADHD include; anxiety, depression, oppositional defiant disorder, and conduct disorder. Additionally, the clinician should also consider whether the behaviors might coexist with a learning disability. Often children with learning disabilities demonstrate behaviors associated with ADHD. Essentially the process for making an accurate diagnosis takes time and careful considerations of all the variables mentioned above.Russell Barkley is an international expert on ADHD. His theories to the neuropsychological underpinnings of ADHD have been widely accepted and practiced today. Dr. Barkley has studied the important role of executive functions and self-regulation in children with ADHD. Dr. Barkley has stated that the etiology of ADHD is complex and can involve multiple causes. To date, “all of the major causes fall in the realm of neurology and genetics. Despite what some might speculate, Dr. Barkley has stated that there is no evidence that social factors alone can cause ADHD. Cognitive testing should also be used to help make an accurate diagnosis. Neuropsychological constructs such as attention and executive functions should be evaluated to help ensure a diagnosis is proper.The diagnosis of ADHD requires a comprehensive assessment of symptoms by professionals with training in the diagnosis and management of ADHD. The observations of third parties should be taken into consideration, which for many children include parents/careers and educational professionals. A comprehensive evaluation should include ratings scales to multiple raters, including when appropriate the student. Neuropsychological or cognitive screening tools should also be used as part of the evaluation to help rule out or detect comorbid conditions. A strong clinical interview which includes behavior learning, and social characteristics of this child should be taken.
When time is taken to ensure that a diagnosis is correct, parents and clinicians can begin the long journey to management and treatment.
