“The Diagnosis and Treatment of Attention Deficit Disorders”
by Licensed School Psychologist, Clarice L. Honeywell, M.S., N.C.S.P.
When a student is not doing well in school, especially if teachers also report that the student doesn’t seem to concentrate in class and complete assignments, the parents may wonder if the student has an Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). It is important for parents to recognize the symptoms of an Attention Deficit Hyperactivity Disorder (ADHD) and then work with the proper professionals in making this diagnosis.
ADHD is a disruptive behavior disorder characterized by levels of inattention, impulsivity, and overactivity that are well beyond what is expected and appropriate for a student’s sex and age. Students with ADHD may have difficulty concentrating on schoolwork, frequently interrupt conversations or activities, and have difficulty remaining seated when required to do so. Approximately 3%-7% of school-age children in the United States have this disorder. Children with ADHD typically first exhibit symptoms of this disorder during their preschool or early elementary school years, and it is likely that these symptoms will continue throughout their lives. Boys are three times more likely to be diagnosed with ADHD than girls.
Characteristics of ADHD or ADD:
Students who have ADD or ADHD may display a variety of characteristics, but some of the most common are impulsiveness, inattention, disorganization and distractibility. These children are often described as:
not thinking before they act
having difficulty following complex directions
unable to wait
having difficulty maintaining attention to tasks that are not basically interesting, such as school work or chores (but they may be able to watch TV or play computer games for hours!)
unable to comply with a schedule
frequently losing things
Parents often will say, “Even when I see him complete his homework, it never seems to get turned in.” It is as if a “black hole” follows some of these children and swallows their homework and supplies. Some children get into fights often and are avoided or rejected by their peers. Others are very likeable and have many friends, although their friendships usually are not deep and lasting. They may get into trouble in school and in the community for doing things they know they should not do, and they may relate a feeling of being out of control or not being able to stop an activity. Parents may ask, “I know he knows better, and I know he’s a good kid; why is he always in trouble?”
Many of the symptoms associated with ADD also may be symptoms of other childhood problems such as depression, anxiety or conduct disorders. Another problem with the diagnosis is that there is no blood test or other specific medical test for ADD. Physicians and psychologists who diagnose ADD use observation, behavior reports from people who know the child well and a careful history. Sometimes there is a family history of ADD. In addition, the child’s personal history is important because symptoms of true ADD will be present in a child before age seven and will be persistent over the years. If a child suddenly begins to exhibit these symptoms, especially if the child is older than seven, the behavior usually is a temporary response to something that is troubling him or her; however, it also may the beginning of a deeper emotional problem.
What if I Suspect that an Individual has ADD?
If you suspect that an individual has ADD, it is best to seek the assistance of a physician or psychologist who is knowledgeable about ADD. The appropriate diagnosis of ADD/ADHD requires a collaborative effort using multiple sources of information, regardless of the training or credential of the professional(s) involved. It is essential to obtain multiple perspectives regarding symptoms in order to assess their pervasiveness and severity. Input from family, teachers and other school personnel who have the opportunity to observe and interact with the student over time in many different situations is therefore critical. Educational, mental health and medical personnel with appropriate training can effectively use systematic methods of assessing inattention, activity level, and factors that may contribute to attention difficulties. Such methods might include:
formal observation in multiple settings
interviews with the student and relevant adults
rating scales completed by family, teachers, and the student
developmental, school, and medical histories
formal tests to measure attention, persistence, and related characteristics
Most of these measures are not medical procedures. However, it is important that a physician knowledgeable about attention problems participate in a comprehensive evaluation to rule out other medical problems that can interfere with attention and activity level and to further determine if a medical condition exists.
Portions of this article were reprinted with permission from Helping Children at Home and School: Handouts from Your School Psychologist, provided by the National Association of School Psychologists.
Clarice L. Honeywell, M.S.,N.C.S.P. is a nationally certified and licensed school psychologist in independent practice with The Psychology and Counseling Group in Orlando, Florida. She has over 20 years of experience in the private sector and specializes in the assessment of characteristics of Attention Deficit Disorders. She is available to conduct ADHD screenings and evaluations as well as providing evaluations for learning disabilities, educational screenings and gifted assessments.