The Role of Accurate Diagnosis in Treatment of ADHD
Heather A. Heinrich, Ph.D.
Licensed Clinical Psychologist
Emily’s parents are at their wits’ end. They have gotten their third call this week from her
classroom teacher, telling how Emily has been spending her time drawing on her worksheets, rather
than completing the actual items that need to be done. She is not disruptive in class, but just seems to
not follow through with instructions and to become bored easily. When Emily works with her parents
one-on-one at homework time, she seems to know the information that she is supposed to be learning
and is able to complete her homework with encouragement and prompting.
Michael’s parents have also been facing some challenges. From first grade, Michael has had
difficulty sitting still during class time and with losing his assignments. This has seemed to increase over
time and has become even more problematic since entering high school, where teachers expect him to
be more independent. Michael started out strong this semester, vowing to do all of his homework and
to stay organized, but started having some difficulties with turning in his work and has seemingly given
up on it. He has developed an attitude that he knows he is not able to do the work, so why bother
trying. His parents have tried taking some things away as a consequence for not completing his work,
but that has not helped with the situation. Michael’s parents worry about his future and how he will
function independently.
Both of these children, while presenting with different concerns, may meet criteria for diagnosis
of Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is a neurological disorder that impacts frontal
lobe or executive functioning. Individuals diagnosed with ADHD may have difficulties with paying
attention for sustained periods of time, increased distractibility, impulse control, inconsistency in school
and/or work performance, and excessive activity. Based upon an individual’s symptom profile, diagnosis
may be ADHD – Predominately Inattentive Type (commonly referred to as ADD), ADHD – Hyperactive
Impulsive Type, or ADHD – Combined Type. The subtype of ADHD is important in developing supports
and interventions to assist individuals in meeting their full potential.
Because the symptoms that both children are experiencing may be related to a number of
different diagnostic categories, having competent diagnosis is essential in developing a treatment plan.
Psychologists and pediatricians or primary care physicians, are often consulted for diagnosis of ADHD. It
is important to choose a provider who has training and expertise in the diagnosis and treatment of
ADHD. When a psychologist is completing the evaluation, it will typically include a clinical interview with
the parents and child, completion of behavior rating scales, tests of baseline cognitive functioning, and
other assessments as needed to rule out other clinical concerns. The exact tests chosen depend upon
the presenting concerns. Since other factors, such as depression, anxiety, and learning disabilities, may
impact a child’s attentional resources, it is very important to rule out difficulties in these areas prior to
formally diagnosing ADHD.
After a formal diagnosis has been made, specific recommendations for treatment may be
developed. Interventions may include a medication consultation with the pediatrician or primary care
physician, using incentives to encourage appropriate behavior, extended test time, implementation of
organizational systems, skill building for underlying processing, and many other strategies tailored to
meet an individual’s needs. The parents may also initiate a request for services at the child’s school, if
recommended as a result of the evaluation process. Individuals with ADHD may present with very
different symptoms, despite having the same diagnosis, and thus the interventions need to be tailored
to address each individual’s specific needs.
Competent diagnosis of ADHD is the essential first step in treatment of ADHD. By seeking
appropriate diagnosis, Emily and Michael’s parents can begin the process of finding some solutions for
their child’s academic concerns. After a diagnosis is obtained, customized treatment plans may be
developed to address the difficulties. Accurate diagnosis and appropriate treatment can help to improve
children’s school performance.
The Child and Family Wellness Institute is a division of Psychology Specialists. We are a group of doctors
and counselors with a broad range of specialties. In addition to diagnosing and treating ADHD, we help
people with all types of physical and emotional pain. For more information, contact us at 217-520-1047
or visit www.psychologyspecialists.com.