The Diagnosis of ADHD

99 Pages·2006·0.92 MB·English

by  Stephen E. Brock

The Etiology and Diagnosis of AD/HD
Amanda Clinton, Ph.D.,
Stephen E. Brock, Ph.D.,
Doris Pachenar, B.A.
California State University Sacramento
Introduction to AD/HD
A neurobiological disorder that affects 3 to 7 percent of
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the general population (2.5 million school-age children).
The exact cause of AD/HD is not known.
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Genetic, environmental, and neurological factors likely
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play a primary causal role.
No single procedure will reliably diagnosis AD/HD.
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A variety of conditions may co-exist with and/or cause
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AD/HD symptoms.
Diagnosis is time consuming.
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Multi-procedure.
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Multi-source.
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Multi-disciplinary.
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Workshop Outline
Introduction to AD/HD
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AD/HD Symptoms and Associated Features
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Prevalence
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Legal Issues
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Etiology of AD/HD
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AD/HD Diagnostic Criteria
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“AD/HD-like” Behaviors
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Diagnostic Procedures
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Rating Scales Laboratory & Psycho-educational Testing
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Interviews Medical Examinations
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Observations Review of School Records
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AD/HD Symptoms
Diagnosis requires…
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Six or more of nine symptoms of inattention.
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Six or more of nine symptom of hyperactivity and
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impulsivity
Symptoms of Inattention
Fails to give close attention to details/make careless
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mistakes.
Difficulty sustaining attention.
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Does not seem to listen.
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Lack of follow through.
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Difficulty organizing tasks and activities.
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Avoids/dislikes tasks requiring sustained mental effort.
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Loses things.
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Easily distracted.
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Forgetful.
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Symptoms of Hyperactivity/Impulsivity
Fidgets with hands or feet.
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Difficulty remaining seated.
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Runs about/climbs excessively.
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Difficulty playing quietly.
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On the go. “Driven by a motor.”
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Talks excessively.
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Blurts out answers before questions are asked.
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Difficulty awaiting turn.
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Interrupts or intrudes on others.
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Associated Features
Vary according to age and development, but may
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include…
Low frustration tolerance
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Temper outbursts
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Bossiness
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Stubbornness
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Excessive and frequent insistence that request be met
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Mood lability
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Demoralization
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Dysphoria
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Rejection by peers
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Poor self esteem
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Source: DMS IV-TR (APA, 2000)
Associated Features
May also include
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Impaired academic achievement (especially
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among the predominantly inattentive type)
Peer rejection (especially among the
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hyperactive/impulsive type)
Poor achievement motivation
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Family discord
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Negative parent-child interactions
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Source: DMS IV-TR (APA, 2000)
Associated Features
“There are no laboratory tests, neurological
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assessments, or attentional assessments that have
been established as diagnostic in the clinical
assessment of AD/HD” (pp. 88-89).
“There are no specific physical features associated
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with AD/HD, although minor physical anomalies
(e.g., hypertelorism, highly arched palate, low-set
ears) may occur at a higher rate than in the general
population” (p. 89).
Source: DMS IV-TR (APA, 2000)
Prevalence of AD/HD in the USA