Evaluations for Attention Deficit Disorder
It is important to understand that there is no test for Attention Deficit Disorder (ADD/ADHD). The diagnosis is made based on the history and current behaviors or symptoms comprising this syndrome. Other factors which could cause these symptoms (e.g., a learning disability, lack of motivation, depression) also must be ruled out in the diagnostic process.
The evaluation consists of an extensive behavioral history given by parents or an adult and completion of behavior rating scales. Scores on these scales compare an individual’s behavior to norms for other same-age individuals with and without AD(H)D. Rating scales are completed by parents, significant others and/or teachers.
Another important fact about AD(H)D is that there are several types. ADHD, Combined Presentation is an impulse control disorder that causes acting and speaking without thinking, fidgetiness, hyperactivity, and problems sustaining attention to tasks that are not interesting. ADD, Inattentive Presentation does not include impulsive/hyperactive behavior. This type of ADD creates problems with starting and finishing tasks, memory and concentration, organization, and usually reading comprehension. ADHD, Predominantly Hyperactive/Impulsive Presentation occurs mostly in young children who aren’t yet required to pay attention very long to anything so they won’t manifest problems with attention. These youngsters exhibit excessive impulsivity, hyperactivity and sometimes aggression.
A learning disability is not the same as AD(H)D. A learning disability involves a signficant difficulty with mastering an academic subject (reading, math, or written language). If you’re unsure whether you or your child has a learning disability or AD(H)D or both, you can schedule an initial consultation with me where we’ll discuss the child’s difficulties. After I’ve learned more about the problem, I’ll will advise you about the type of evaluation that seems appropriate.
An AD(HD) evaluation for a child usually requires at least two appointments. The child accompanies the parent(s) for the first appointment but the child spends a good deal of time in the reception area while I obtain a description of behavioral concerns and a history from parents. I’ll usually not speak with young children because they do not have much awareness how their behavior differs from other children. I will be observing the child’s behavior as he interacts with parents and behaves in the reception room. I will interview older children and adolescents who have more insight into their behavior. If I suspect that a learning disability or other problem may be contributing to the presenting problem, additional evaluation beyond two consultations will be recommended. At the conclusion of the initial consultation, parents are usually given behavior rating scales to email or fax back. If no further evaluation is recommended, the second appointment will be scheduled to discuss my findings and recommendations. If no further assessment is necessary, the fee is approximately $400. If additional testing is necessary for a possible learning disability, the fee for an evaluation of both disorders may be $1000 – $1200.
Adult Evaluation for AD(H)D
An evaluation for adult AD(H)D also usually involves two consultations. There is much more behavioral history to obtain dating back to childhood. Information is gathered from multiple areas of functioning including academic, social, family, and occupational. In addition to the adult being evaluated, a significant other (e.g. spouse, parent) is usually asked to complete rating scales. The fee is approximately at least $375.
Evaluations Based on AD(H)D for Educational Accommodations in high school, college & professional school
An evaluation for these purposes must be more extensive according to guidelines established by the Association on Higher Education & Disability. These evaluations are extensive and more expensive.
Results of the Evaluation
Depending on my diagnosis and the age of the patient, various recommendations for interventions will be offered to address the problem. I can provide some of these interventions (e.g., consultation for parents regarding behavior management, strategy instruction for adolescents and adults, memory training) and I’ll make referrals to other resources in the community for other necessary interventions. If AD(H)D is diagnosed, educational accommodations may be recommended. Although schools will consider a psychologist’s recommendations, they make their own decisions in compliance with various laws and guidelines regarding services they offer students.
Public School Evaluations for Students with AD(H)D
School psychologists working in school districts are not qualified to diagnose AD(H)D. Schools may have parents and teachers complete checklists and have parents bring the child with the checklists to “a doctor” for a diagnosis.