Assessment for ADHD


Traditionally, the diagnosis for ADHD has rested on a Clinical Psychologist, Psychiatrist or Paediatrician doing a thorough history of the individual and their family. However a thorough evaluation for this condition involves a great deal more.

Research has indicated (*Behavioural and Brain Functions, 2018) the combination of objective and subjective test materials provides a more accurate assessment of the condition than subjective measures alone. Also important to the assessment of the diagnosis is the elimination of other disorders that can be wrongly diagnosed as ADHD. Anxiety and Depression in children can in some ways look very much like ADHD and are mistakenly treated for anxiety or depression, however the treatment for ADHD would have little impact on the symptoms of these other disorders. Therefore tests measure for ADHD must also include the assessment of the presence of these other conditions so that they can be ruled out. Getting an accurate diagnosis is crucial in providing the correct treatment approach.

Subjective measures are comprised of paper and pencil tests (like the Behavioural Assessment for Children -2- BASC2), usually having multiple choice answers, that are given to the individuals (and sometimes the individual being assessed depending on age) who best know the individual under going the evaluation.  In the case of children, these individuals would be the parents or caregivers and a teacher. In the case of adults it might be a spouse, close friend or sports coach. The crucial element is that they have known the individual for some period of time (years versus months would be preferable).

Subjective measures have their problems. Because the assessment is being left to the observations of individuals other factors have an influence on the outcome. For example teachers. Teachers are experts in the education of children, but in the case of a new teacher, there experience of behaviours of children and therefore their understanding of the cause of these behaviours may reflect their inexperience. Therefore any child who presents as unruly, disruptive or not paying attention maybe seen as displaying ADHD symptoms. In the case of an experienced teacher, who has seen lots of unruly, disruptive children over the years may look at this same child and just see another high spirited child in need of a little guidance. Subjective measures are open to a number of different bias effects.

Objective measures are primarily computer based assessment tools like the Test of Visual Attention (T.O.V.A) or other Continuous Performance Tests (CPT) or Computerised Neurofeedback (uses the assessment of brainwaves to evaluate the presence of the condition based on a data base of individuals of the same age as the individual being tested. The databases are mostly used in the assessment of children). These tests have the advantage of the diagnosis not being effected by individual bias.

In a thorough assessment of ADHD all three (including observation of the individual by the examiner) are considered in the findings of the report.

At IPS the report will identify the strengths and weaknesses of the child in terms of the specific symptoms as identified by the Diagnostic Statistical Manual (DSM) for the condition of ADHD.  The DSM is the universally accepted means for mental health professionals to make a diagnosis.

An evaluation of ADHD can take a few visits and last for a total of 3-4 hours. The cost for such an evaluation with IPS is approximately (other factors like school visits to do classroom observation or consultation with the individuals teacher would need to be factored in to the fee) $750.

If you are interested in finding out more about this assessment process, please call.