diagnosis

Attention Deficit Disorder Diagnosis

Testing for ADD

Many times in talking with adults concerning Attention Deficit Disorder I have heard:

"Oh our son used to have ADD, and was on medication for a while but we think he has grown out of it."

Based on my experiences, and those of the many ADD adults I interact with, very few of us have ever "grown out of it". This quote about sums it up:

"Earlier researchers (e.g., Laufer & Denhoff, 1957) viewed ADHD as limited to childhood, with the symptoms partially disappearing by adolescence. This developmental lag view of learning has repeatedly been shown to be incorrect; the same is true of ADHD. There have since been both retrospective and prospective studies of outcome into adolescence and adulthood, and the general conclusion is that problems such as impulsivity, restlessness, poor self-esteem, and poor social skill are found in a majority of ADHD children on follow-up into adolescence and adulthood."1

If we are in agreement that ADD does exist in adults them we can look at the requirements involving in testing. The four elements of testing for Attention Deficit Disorder are:

• the referring symptoms
• the behavioral and clinical history
• the observable behaviors
• and the test themselves2

In clinical testing many things need to be considered. Testing for Attention Deficit is no simple matter. I have mentioned the importance of your history of ADD type behaviors, as well as those behaviors which are currently observable. The first mistake we may make is going to see the doctor and trying to be on our best behavior. We all know that controlling yourself for a short period of time in the doctors office, does not mean that we can control our ADD behaviors the rest of the time.

With this in mind, It is important to be honest and up front with the doctor when you see him or her. Don't hesitate to tell the doctor what problems you have been having and be specific. Let them know how you heard about ADD, and what makes you think you have it. It you have a history of failed relationships and lost jobs let them know. If you don't take on new challenges like college or a job advancement because of your fears of not being able to handle it, tell them about it. Make some notes before you go to see the doctor to help you stay on track in the interview, so you can contribute to your own accurate diagnosis.

Being depressed does not mean you have Attention Deficit Disorder! Having difficulty remembering dates, times, directions and conversations is a type of ADD related behavior. Getting into trouble, interrupting conversations, getting into lots of fights, saying things you regret later and failing to complete projects and keep agreements are types of ADD related behaviors. Let the doctor or psychologist know about these types of behaviors.

If you have adjusted to certain behaviors to compensate for your ADD behaviors, then use them in the office during the interview. If you take notes to help you carry on your conversation and not loose your place, then do that during the interview. If you need to review the information presented, or paraphrase what was said to be certain you have it right, then do that as well. Don't try to pretend that you are less ADD then you believe yourself to be!

Your Physician may require initial testing to rule out other conditions that may present behaviors similar to Attention Deficit Disorder, but not be caused by ADD, or to rule out potential biological problems with medications often used for treatment of ADD. It is important to rule out thyroid problems, low blood sugar, dyslexia, anxiety, Tourette's syndrome and other related conditions to obtain an accurate diagnosis.

In addition to the developmental history, and the observable behaviors, the person doing the testing can employ a variety of tests to help them make the diagnosis. These include but are not limited to:

1. The WISC-R achievement and visuo-motor tests *the third component of this test primarily called the "Freedom from Distractibility" or "FD"
2. The Wisconsin Card Sorting Test
3. The Continuous Performance Test
4. The Contingency Naming Test
5. The MMPI test
6. Additional behavioral scoring sheets such as Dr. Copland test.

Other parent-report symptom inventories maybe included from childhood such as:

1.  Diagnostic Interview for Children and Adolescents (DICA)3
2. Barkley's inventory of problem situations4
3. Achenbach's childhood Behavior Checklist (CBCL)5

I will not go into details here about the nature of the testing or what to expect. These tests provide a combination of detailed information relating to your ability to process information, listening and concentration, math and other skills. They help to measure your ability to stay in focus and on track. When you take these tests do your best, but do not try to conceal your difficulties with any portion of the test. Ask the health care provider giving you the testing if you don't understand. Remember this test is for your benefit, not for someone else's'.

1Diagnosing Learning Disorders" A Neuropsychological Framework, by Bruce F Pennington, p97

2"Diagnosing Learning Disorders" A neuropsychological Framework, by Bruce F Pennington, p36

3Herjanic, Campbell, & Reich, 1982

4Barkley, R.A. (19810 "Hyperactive children; a handbook for diagnosis and treatment. New York: Guilford.

5Achenbach, T.M.. (1982). Developmental psychopathology. New York; Wiley.

6Douglas, Ball, O'Neil & Britton, 1986; Pelham, 1988, p. 79

7"Diagnosing Learning Disorders" A neuropsychological Framework, by Bruce F Pennington, p36

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