Competing medical and biological explanations for ADHD must first be ruled out. Although genetic and neuroimaging studies are able to discriminate between subjects with ADHD and normal subjects, these findings apply to differences among groups and are not sufficiently precise to identify single individuals with ADHD. Nonetheless, there are a variety of well-established behavior rating scales that reliably discriminate between children with ADHD and controls as well as between ADHD and other childhood psychiatric disorders ( APA, 2013).Ĭurrently, there are no laboratory tests available to identify ADHD in children. Behavior rating scales are useful in establishing the magnitude and pervasiveness of the symptoms but are not sufficient by themselves to make a diagnosis of ADHD. In addition to performing a clinical interview, health care providers should assess the number and severity of ADHD symptoms within the home and school settings, using parent and teacher behavior checklists. Finally, a family history of first-degree relatives with ADHD, mood or anxiety disorders, learning disability, antisocial disorder, or alcohol or substance abuse may indicate an increased risk for ADHD and comorbid conditions ( Larsson et al., 2013). Disruptive social factors, such as family discord, situational stresses, abuse, or neglect may result in hyperactive or anxious behaviors. Moreover, an interview should emphasize factors that might affect the development or integrity of the central nervous system or reveal the presence of chronic illness, sensory impairments, or medication use that might affect the child's functioning. During an interview, information pertaining to the child's history of the presenting problems, overall health and development, and social and family history should be gathered. Though the evaluation of impairment in ADHD is thought to be more subjective than in that of intellectual disability, there are objective measures of impairments that are increasingly used in ADHD ( Gordon et al., 2006), such as the measures of adaptive functioning in general and specific ADHD impairment measures ( Biederman et al., 1993 Fabiano et al., 2006).Ĭlinical interviews allow for a comprehensive analysis of whether or not the symptoms meet the diagnostic criteria for ADHD. It is important to systematically gather and evaluate information from a variety of sources, including the child, parents, teachers, physicians, and, when appropriate, other caretakers ( APA, 2013). ADHD is often difficult to diagnose in preschoolers as distractibility and inattention are within the range of developmental norms during this period ( APA, 2013).Ī diagnosis of ADHD is made primarily in clinical settings after a thorough evaluation which includes a careful history and clinical interview to rule in or to identify other causes and contributing factors, behavior rating scales, a physical exam, and any necessary or indicated laboratory examinations. Symptoms may vary from motor restlessness and aggressive, disruptive behavior, which is common in preschool-aged children, to disorganized, distractible, and inattentive symptoms, which are more typical in older adolescents and adults. The first is ADHD, predominantly inattentive the second is ADHD, predominantly hyperactive-impulsive and the third is ADHD, combined. There are three different presentations of ADHD that are identified in the DSM-5. The current diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) require that a child's behavior be developmentally inappropriate (i.e., the child's behavior is substantially different from other children of the same age and developmental level) and that the symptoms must begin before age 12 and be present for at least 6 months must be present in two or more settings must cause significant impairments in home, school, occupational, or peer settings and must not be secondary to another disorder ( APA, 2013). A number of organizations have developed diagnostic and treatment guidelines, including the American Academy of Pediatrics ( AAP, 2011) and the American Psychiatric Association ( APA, 2011), but adherence to guidelines is inconsistent, particularly for uncomplicated cases ( Garner et al., 2013). Diagnoses are made by a range of health professionals, including primary care physicians, psychologists, and child psychiatrists. Most diagnoses are made in school-aged children and often based on teacher and parent concerns about school and home performance and behaviors. Attention deficit hyperactivity disorder (ADHD) has been diagnosed with increasing frequency over the past several decades (see Chapter 12 for an in-depth review).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |