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ADD / ADHD Defined
Attention-Deficit / Hyperactivity Disorder, which is often referred
to as ADHD / ADD, is a developmental disorder of self-control characterized
by problems with attention span, impulse control, and activity level.
According to a leading researcher in the field, Russell
Barkley, Ph.D., ADD / ADHD is not a phase of childhood that will be
outgrown, nor is it indicative of poor parental discipline or something
inherently "bad" in a child or adult. It is not a disorder
seen only in childhood, but the current definition requires
that it must have been apparent beginning in childhood.
There are three subtypes of ADHD:
- ADHD Combined Type is perhaps the most commonly
referred to condition and it includes difficulties with both attention
and hyperactivity/impulsivity.
- ADHD - Predominantly Inattentive Type is sometimes
referred to as ADD and does not include the significant deficits
with hyperactivity/impulsivity.
- ADHD - Predominantly Hyperactive/Impulsive Type,
as the name implies, is characterized by significant problems
with hyperactivity and impulsivity but does not include significant
deficits of attention.
Difficulties that individuals with ADD / ADHD frequently demonstrate
during school-age years include:
- May seem to easily lose focus (stares into space, mind wanders,
etc.)
- May have difficulty staying seated in class
- May fidget excessively (constant knee bouncing, pencil tapping,
etc.)
- May blurt out verbal responses in class or may frequently interrupt
others' conversations
- Difficulty organizing tasks - may frequently lose homework,
messy desk/locker/backpack
- May have difficulties learning math facts
- May struggle with writing skills - particularly organizing responses
- May not be responsive to disciplinary procedures that are effective
with other children (e.g., loss of privileges does not change
behavior)
- May struggle with social interactions as they have difficulty
respecting others' space or may behave impulsively in social situations
In some bright/gifted individuals, difficulties with ADD / ADHD do
not become apparent until they are older and the rigors of the classroom
environment become more demanding. Such individuals may have been
successful when they could complete all homework in class. However,
once they have homework to do and long-term projects to complete,
they begin experiencing difficulties to an extent that affects their
grades and the amount of material they learn. Individuals with the
Predominantly Inattentive Type of ADHD can be even more difficult
to identify and may be labeled as underachievers who are simply
not performing up to their potential.
It is important to note that other psychological and medical conditions
can also result in attention difficulties. For example, individuals
who are depressed, sleep deprived, anxious, or have working memory
or processing speed deficits can all have many overlapping symptoms
with those seen in individuals with ADD / ADHD. A comprehensive assessment
for ADD / ADHD conducted by an ApaCenter psychologist allows us to
get a clear understanding of the attention-related problems that
you or your child are having. Proper diagnosis, which includes a
thorough understanding of an individual's strengths and resources,
can guide appropriate treatment recommendations.
ADD/ADHD Assessments
Attention difficulties can be the end result of many different types
of problems in your child. Primary medical concerns that should
be ruled out prior to considering a diagnosis of ADD / ADHD include
vision and hearing problems or general physical health problems
that could be screened for in a well check visit (e.g., thyroid
problems or anemia). If your child has been healthy with no significant
physical concerns other than difficulties with focus and attention
and perhaps impulsivity and hyperactivity, then a comprehensive
psychological evaluation can determine your child's strengths and
weaknesses and rule out other concerns that can contribute to attention
problems.
Reasons for a Comprehensive Psychological
Assessment
A primary care physician, a psychiatrist, or other medical professional
can diagnose your child with ADD / ADHD based on behavioral observations,
parent report, and perhaps behavior checklists completed by teacher(s)
and parent(s). While a cursory examination may result in the appropriate
diagnosis, a comprehensive psychological assessment offers the additional
benefits of more certainly ruling out other possible factors contributing
to attention/hyperactivity difficulties and determining the child's
strengths and weaknesses to better plan for effective interventions.
Further, individuals with ADD / ADHD frequently have learning disabilities
and/or co-occurring emotional difficulties that may not be readily
apparent without a thorough psychological evaluation. Perhaps most
importantly, the components of a psychological assessment are standardized
measures, which means that results from the measures given to your
child are compared to those of other children his or her age. This
helps to ensure that typical behavior is not mistaken for ADD / ADHD.
ApaCenter Assessments
ApaCenter assessments for ADD / ADHD are tailored to the individual
child but typically include the following components:
- Assessment of cognitive abilities to determine a child's strengths
and weaknesses in areas of cognitive processing including Verbal
Reasoning, Nonverbal Reasoning, Working Memory, and Processing
Speed
- Assessment of academic achievement to determine whether the
student is learning academic material in reading, writing, and
math at a level consistent with their potential
- Assessment of behavioral and emotional functioning including
behavior checklists from multiple informants, parent interview,
child interview, and more direct assessment of the child's emotional
functioning when indicated
- Assessment of attention functioning under controlled conditions
- Behavioral observations during the assessment
Once the comprehensive assessment is complete, the psychologist will
write a report detailing the findings, with recommendations provided
based on the individual's strengths and weaknesses. The goal is not
merely diagnosis, but suggestions for interventions that are tailored
to your child's individual profile. Whether or not your child receives
a diagnosis of ADD / ADHD, recommendations to address difficulties your
child may be exhibiting are an essential component of the evaluation.
The psychologist will discuss the results with you in person and answer
any questions you might have.
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