| Frequently Asked Questions about ADHD Assessments For Children and Adults Are the Psychologists at the Learning & Behavior Evaluation Center familiar with this diagnosis? The assessment techniques used by the professionals at the Learning & Behavior Evaluation Center take into consideration the best practice guidelines established for the assessment of Attention-Deficit/Hyperactivity Disorder and are closely related to the assessment guidelines set forth by a number of professional organizations. The expertise of the staff is second to none. The Psychologists at the evaluation center have had advanced training related to the disorder and are well-versed in both the assessment and treatment of the disorder. Additionally, the ADHD assessment staff have participated in the re-norming and item selection on motable assessment measures (e.g., the forthcoming Conners' Rating Scales) and have participated in ADHD education and training all across the country. Some Common Symptoms of ADHD Include: Inattention: (Common to Both Children & Adults) -Makes careless mistakes -Has a difficult time sustaining attention -Does not seem to listen when spoken to directly -Fails to follow through on instructions, schoolwork, chores, etc. -Often loses things -Is easily distracted -Is often forgetful Hyperactivity: (Primarily In Younger Children) -Often fidgets or squirms in seat -Often leaves seat -Runs about excessively -Has difficulty playing quietly -Is often “on the go” -Often talks excessively Impulsivity: (More Common In Adults) -Often blurts out answers -Often has difficulty waiting turn -Often interrupts or intrudes on others conversations -Often makes decisions impulsively -Cannot delay gratification -Has difficulty with organization -Has difficulty with planning How do I know if my child’s behaviors are normal or if it is ADHD? Most children exhibit the symptoms of ADHD at some point in their life. The difference, however, is that the ADHD child will have these symptoms to excess, thus causing both frustration and impairment in their everyday functioning.
If it isn’t ADHD, then what else could it be? Many different problems “look like” ADHD. In fact, this is the reason why ADHD is so frequently misdiagnosed by other professionals. The Psychologists at the Learning & Behavior Evaluation Center are specially-trained to conduct high-quality, comprehensive evaluations designed to determine whether or not your child has ADHD. Other potential problems are also considered and “ruled out”. A few of the areas assessed include depressive disorders, anxiety disorders, learning disabilities, normal development, substance abuse, cognitive deficits, lead exposure, head injury, and adjustment to stress in the child’s life. What is a “psychoeducational assessment”, is it similar to your ADHD evaluation, and does my child really need it? The first major component of a psychoeducational assessment involves measurement of cognitive functioning. This means that your child’s IQ will be measured and compared to other children their age. This is helpful for determining giftedness, mental retardation, and assisting with the determination of whether or not your child has a learning disability. The second major component of this type of assessment is achievement testing. This assesses material learned in school. Areas assessed include: Reading Comprehension, Word Reading, Spelling, Numerical Operations, and Math Reasoning. Other school-related areas of functioning (e.g., Written Expression) are often included in this assessment. This type of evaluation is embedded within the ADHD evaluation. Ruling out academic concerns, giftedness, learning disabilites, cognitive deficits, etc. is an essential part of an ADHD assessment. Without this information, it would be impossible to determine whether one of these issues or attention problems was the primary difficulty. Don't people with ADHD just outgrow it? Assessment for ADHD in adulthood is extremely important. Many individuals with ADHD will learn to cope with some of the symptoms as they mature. They will often choose jobs that avoid their areas of difficulty and will often choose spouses whose organizational abilities can help compensate for their areas of difficulty. In general, however, 71% of children do not outgrow ADHD symptoms when they enter adolescence. Similarly, 66% still demonstrate "at least one major disabling symptom of ADHD" into adulthood. Why is accurate identification and treatment of ADHD such a big deal? Few people are doing an adequate job identifying and treating this disorder, you will see some of the negative outcomes associated with not appropriately identifying and treating the disorder listed below.
Below are some comparisons of ADHD Children (who are untreated) to “Normal” or “Control” children:
Accidents: ADHD children experience higher rates of accidental injuries than do comparison children. These include such things as accidental poisonings, broken limbs, head injuries, hospitalizations, and sports-related injuries.
Driving: Children with untreated ADHD have more car accidents, more “at fault” accidents, more accidents with injuries, more traffic citations, worse accidents (financial cost), more suspensions and license revocations, are rated by themselves/others/driving instructors as using fewer safe-driving habits, exhibit poorer steering (on controlled tests), and slower measured reaction times to significant events.
Educational Attainment: Educationally these individuals are more likely to be placed in Special Education, are more likely to be suspended from school, are more likely to be expelled, have a higher drop-out rate (despite receiving Special Education services), are retained more often, finish less formal schooling, and have lower college graduation rates.
Employment: In the workforce, these individuals generally enter at an unskilled or semi-skilled level. They are more likely to be fired, change jobs more often, are more likely to get laid off, have more oppositional and disruptive symptoms on the job (as rated by supervisors), have lower work performance ratings (as reported by current supervisors), and generally end up in a lower social class based on socio-economic status.
Smoking: Children with ADHD smoke more and start at an earlier age than controls. Adult patients with ADHD smoke more and have more difficulty quitting.
Reproductive Issues: ADHD individuals begin sexual activity earlier than same-age peers, have more sexual partners, spend less time with each partner, are less likely to employ contraception, have a greater risk for teen pregnancy, and have a higher rate of sexually-transmitted diseases. Additionally, over half (54%) of a recent sample, do not have custody of their offspring.
Cost to Society: It is impossible to measure this. However, some studies have found that ADHD children followed to young adulthood are more than twice as likely to be arrested as control children. Mean judicial costs have been estimated to be $8,814 per ADHD person vs. $341 per control.
Problems Into Adulthood: Young adults with ADHD in a longitudinal research study complained more of sexual, neurotic, and interpersonal problems, and reported more suicide attempts than did controls. Nearly 2/3rd of adults with a history of ADHD developed major depression; 2/3rd had a history of substance abuse or dependence; and nearly 1/5th had a history of anxiety problems. Nearly ½ of the ADHD individuals studies appeared to develop a rather pessimistic, helpless, and/or disorganized personality style. Finally, families of children with ADHD have greater levels of marital discord, separation, and divorce.
| | The Learning & Behavior Evaluation Center Approach How long does an evaluation take? How many times do I need to come in? The length of an evaluation will vary based on the needs and individual characteristics of your child as well as what testing has been done in the recent past (last 3 years). In general, however, an ADHD assessment for a child is conducted as follows: Session #1: The first session involves reviewing the reasons for concern, conducting an interview, and discussion of rating scales. The rating scales are not brief screeners, but rather thorough, research-tested tools designed to elicit the necessary information. Rating scales are generally completed by someone who knows the person who is being assessed very well. If the assessment is for a child, we will often need rating scales from their teachers. If the assessment is for an adult, we generally request that a spouse, parent, or close friend complete the measures. Session #2: This session is focused on both testing and completion of a diagnostic interview. Objective computer-based assessment tools are utilized during this session. Cognitive/ intellectual assessment, academic screenings, and child self-report scales are initiated during this session. Session #3: Assessment measures outlined in Session #2 are continued during this session. Session #4: Assessment measures outlined in Session #2 are completed during this session. Session #5: The final session is generally the feedback session where results and recommendations are reviewed and a copy of the final report is furnished. It is important to note that, while this is the typical pattern, it is not uncommon for the assessor to need an additional session to gather the information described above. While Session #1 is generally slightly longer than the others, the remaining sessions will all generally be approximately 50-60 minutes in length. What is the format of the ADHD assessment for Adults? Assessment for adults is similar in structure to the format described above. The assessment will also take approximately 5 sessions. If psychoeducational testing data (i.e. IQ and Achievement scores) from the past 2-3 years is available, then the number of sessions will generally be reduced. Evaluations of Adults for ADHD Assessing an adult for ADHD presents a number of unique challenges. The Psychologists at the Learning & Behavior Evaluation Center are aware of these challenges and have experience with assessing for ADHD in adulthood. The goal of the assessment is to determine whether or not the difficulties described by the client are due to ADHD, or if there is another possible explanation. Specialized assessment tools are often used and may include: adult ADHD scales (ratings by themselves and significant persons in their life), semi-structured diagnostic interview, an objective computer-based assessment, and a thorough review of academic and vocational history. This assessment battery varies considerably based on individual characteristics. The general assessment outlined above will often serve as the foundation for the assessment. For assessment of adults, the literature states that it is extremely helpful if a “paper trail” can be produced by the client that outlines the history of problems (e.g., grades from school, performance evaluations, etc.). Additionally, it is also very helpful if a spouse or loved one is involved in part of the assessment to provide additional information from another point of view. Documentation of how the symptoms affect ones functioning is extremely important in the diagnosis of Attention-Deficit/Hyperactivity Disorder with adults. My physician told me that he loves your reports, but mentioned something about a picture. What is he talking about? Each ADHD assessment conducted at the Learning & Behavior Evaluation Center meets the highest standards of quality available. As such, our reports are well-known for being easy-to-read, concise, clear, and well-organized. One “signature” element of our reports is the inclusion of a digital photo in the demographics section of the cover page. While you have the right to decline to have the photo taken, it is generally quite helpful for individuals who will read the report to have the additional reference. In addition to helping the recollection of physicians, teachers, and others; the picture also provides a visual age reference, and added document security (similar to having your photo on your credit card). The Learning & Behavior Evaluation Center would like to assure you that the photo will not be used for any other purposes.
More information on ADHD is located under the "ADHD Resources" tab on this website. These include slides from the world's foremost authority on ADHD, usable rating scales, and a variety of other useful tools and resources.
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