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Comprehensive Assessment of AD/HD in Children
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Establishing an AD/HD diagnosis would seem to be a relatively straightforward matter. You simply use whatever means necessary to gather information that allows you to address the DSM diagnostic criteria of AD/HD, and then decide whether AD/HD is present or not. Unfortunately, it's not quite that simple. AD/HD is a condition whose symptoms may or may not be present, depending on the situation (also known as situational variability). Therefore, it is imperative to obtain information from individuals who observe a child across different settings. At the very least, this should include input from parents and teachers. Another critical factor affecting the evaluation process is the increased likelihood that children with AD/HD will display secondary or co-occurring problems. Whether alone or in combination with various other conditions, AD/HD can also have a significant impact on family functioning.
Given that the problems of children with AD/HD very often go beyond the disorder itself, any assessment of this condition should address not only primary AD/HD symptoms, but also other aspects of the child's behavioral, emotional and social functioning. Equally important is the need for gathering information about the child's parents and siblings, which provides a context for understanding how problem behaviors manifest. This information also often serves as a basis for determining how well parents and other caretakers will be able to implement treatment strategies.
The clinical evaluations of AD/HD must be comprehensive and multidimensional in nature, so as to capture its situational variability, its associated features, and its impact on home, school, and social functioning. This multi-method assessment approach should include:
- parent and child interviews
- parent- and teacher-completed child behavior rating scales
- parent self-report measures
- clinic-based psychological tests
- review of prior school and medical records
- individually administered intelligence testing, educational achievement testing, or screening for learning disabilities (only necessary if not completed within the past year
- a standard pediatric examination or neurodevelopmental screening to rule out any unusual medical conditions that might produce AD/HD-like symptoms
- additional assessment procedures may be recommended, including vision and hearing screening, as well as formal speech and language assessment.
This article has been adapted from "The Key Components of a Comprehensive Assessment of AD/HD," by Arthur Anastopoulos, Ph.D., E. Paige Temple, M.A., and Ericka E. Kinger, M.A., which originally appeared in The CHADD Information and Resource Guide to AD/HD.