ADHD Awareness: Testing & Diagnosis

by Laura Malone

If you’re reading this post, chances are that last week’s post, ADHD Awareness: Signs and Symptoms, hit a little too close to home. If this is a new realization, you could be worried for your child’s future yet hesitant to take action. You might be thinking, “Maybe I should wait and see how this year goes. I don’t want them diagnosed too early. It could just be immaturity.” Or maybe you’re not sure you want them diagnosed at all. 

On the other hand, if you’ve suspected this for a while, you’re probably at your wits end with frustration. You want a quick fix and will do whatever it takes to simply have peace in your homeschool days. 

Unfortunately, there is no quick fix for ADHD and getting a diagnosis is an elaborate process. But, let’s walk through it together so you know what to expect. We’ll begin by talking a little about the importance and benefits of getting your child tested and doing it sooner rather than later. 

Should I Wait to Test?

If your child has shown signs for at least six months, is struggling in a variety of settings compared to other children their age (not their grade level), it’s time to get tested. Studies show that children who are diagnosed at younger ages, and therefore have exposure to treatments at younger ages, fair much better academically, socially and emotionally in childhood and adulthood.

While many disorders can go unnoticed by peers, ADHD is not usually one of them. It’s hard to overlook hyperactivity, social awkwardness and academic struggles. Their peers know they are different and often tease. Parents and teachers are constantly correcting and getting impatient with them. The negativity is draining to the child and with the inability to fix what they’re doing wrong, they develop negative thought patterns about themselves. 

Low self-esteem goes hand in hand with ADHD and the longer this continues unaddressed, the more ingrained these thought patterns become. Researchers say that children who have long-term struggles without some form of treatment are more likely to have negative life experiences in adolescence and adulthood. This includes frequent job changes, failed marriages, drug and alcohol abuse and lifetime battles with depression and anxiety.

I don’t say this to be dramatic or scare you. I say it because it’s true. Every child with ADHD should be understood and uplifted. They should be given the opportunity to grow into healthy, independent adults that believe in themselves. And the sooner they get help, the better.

Benefits of Getting a Diagnosis

In addition to encouraging strong self-esteem, getting a diagnosis also:

• Pinpoints specific weaknesses, so they can be strengthened by corresponding treatments;
• Gives all people involved in the child’s development (parents, teachers, doctors) a common vocabulary to use, which facilitates understanding and enables them to coordinate on defined goals;
• Increases understanding by others (family members, teachers, peers);
• Aids with getting insurance reimbursements who require an official diagnosis before making reimbursements;
• Aids in a child receiving special education services from a public school district (if you choose to use their services);
• Is required for medication prescriptions (if you choose this treatment). 

Choosing a Clinician

If you’re convinced it’s time to make the jump, walk with me through the testing and diagnosis process so you can get a game plan. There are many types of clinicians that can do an assessment and make a diagnosis. It can be overwhelming when you don’t know where to start. 

To begin the process, it’s a good idea to seek out clinicians who are ADHD specialists. If you don’t know of any off hand, it’s wise to get referrals from friends or your pediatrician.

I’ve created a chart listing the clinicians that are capable of performing an assessment and making a diagnosis. The pros and cons that come with using each of them are included. Clinicians that perform longer evaluations are more likely to make an accurate diagnosis, so it’s listed as a pro. It’s also important to note that typical methods of treatment are medication, behavioral therapy and natural remedies such as herbal supplements, dietary changes and exercise. We’ll discuss treatments in more detail next week.

Professional	Pros	Cons
Pediatrician	-could already be familiar with your child	-has limited time which translates to quick evaluations and possible inaccurate diagnosis  -quick to prescribe meds -often refers patient to a psychologist for behavior treatment so you could possibly save money and time by skipping this step
Developmental Pediatrician	-longer evaluations -specialists in assessing child’s cognitive, social, behavioral and physical development -performs physical evaluation ruling out medical causes for problem -can help monitor medication -will make referrals to other professionals if necessary	-offers medication treatment only
Psychiatrist	-longer evaluations -will monitor medication	-offers medication treatment only
Pediatric Neurologist	-longer evaluations -this is the professional you want if you suspect neurological disorders such as tics, seizures or Tourette’s syndrome	-offers medication treatment only -they can do ADHD testing, but their focus is primarily on testing for disorders of the nervous system
Clinical Psychologist	-can test, evaluate and provide treatment -uses psychotherapy treatment and behavior modification -provides parent education and training	-does not prescribe meds (except for a few states)
Pediatric Neuropsychologist	-provides detailed assessments of the child’s brain function such as memory for visual, auditory, short-term and long-term  -offers detailed treatment recommendations based on their specific findings -beneficial to use if you suspect a learning disability, processing or memory dysfunctions as well as ADHD	-does not offer treatment, but makes referrals -can be very expensive ($2000 or more)
Educational Psychologist	-useful for coming up with an educational plan to help with school work, organization, planning, studying	-does not offer treatment -can diagnose ADHD, but typically focuses on learning disabilities -the ones working through public schools do not usually provide the same comprehensive testing and recommendations as a private practice because of time and budget constraints

Diagnostic Tools & Considerations:

All clinicians will use criteria from the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), however they can use their own tools and procedures for testing. There is no single, standardized test that stands alone as a determinate of an ADHD diagnosis. 

A professional that is well-versed in assessing and diagnosing children with ADHD should not perform one test on the child and call it done.  Here are several facets of a child’s life that should be taken into consideration before making a diagnosis: 

1. Displayed symptoms.
2. History of symptoms prior to age 7.
3. Family history of similar behaviors in parents, siblings and other relatives.
4. Information regarding the child’s social history (Ex. Relationship problems).
5. Information regarding the child’s educational history (Ex. Difficulties in academic achievement).
6. The extent to which behavior affects functioning at home, school, or relationships.
7. The child’s positive character traits that can be encouraged in order to build positive self-esteem.
8. Feedback from parents as well as teachers. (Since you are homeschooling, this can come from extracurricular activities and church teachers, etc.)
9. Psychiatric history and any previous assessments that may suggest a coexisting disorder such as anxiety, mood, learning disabilities, personality or substance abuse.
10. A physical examination to rule out any possible medical problems that could be causing the symptoms, such as a head injury, seizures, thyroid disorders, diabetes, vitamin deficiencies, etc.

Closing

That’s the nuts and bolts of the testing and diagnosis process. Join me next week as we take a detailed look at treatment options including medication, behavioral therapy and natural remedies that can improve ADHD symptoms. Chin up, friend. A healthy, enjoyable and peaceful homeschool is possible. You’ve got this!

Hugs,

Laura

*Some of the information discussed in this post has been taken from “The ADD & ADHD Answer Book” by Dr Susan Ashley as well as “Non-Drug Treatments for ADHD” by Drs. Richard Brown and Patricia Gerbarg.