Is it hard for you to sit still? Do you act without thinking first? Do you start but not finish things? Perhaps you see these symptoms in your child? If so, they could be a signs of ADHD. Most people will show some of these behaviors at times, but ADHD is much more serious and longstanding, it causes problems at school, at home, and in social situations. ADHD is more commonly seen in boys than in girls.
A great deal of care is taken in assessing Attention Deficit Hyperactivity Disorders (ADHD), including Attention deficit Disorder (ADD). Generally there are four components of the assessment – rating scales, a clinical examination, observations, and interviews.
1. Rating Scales
If you are an adult, symptom specific rating scales will be given to you to complete, these are usually very detailed, requiring you to recall as much as you can from your earlier years, as well as your current problems. If your child is the sufferer, then you, and his or her teachers will help with the rating scales as well, or the school may provide detailed information about your child’s progress and presentation in school.
The scales used look at four basic categories – symptoms and behaviour, adverse effects, overall functioning and quality of life.
For example, a scale from the symptoms and behaviour section might ask you to rate the ADHD / ADD by assigning a number from 0 (lowest) to 3 (highest) to the following:
- Fidgeting or squirming in seat.
- Excessive talking.
- Inability to listen when spoken to directly.
- Inability to stick to instructions.
- Failure to finish tasks.
- Finds it difficult to organise tasks.
2. A Clinical Examination
Sometimes other physical conditions or illnesses can express themselves with symptoms that seem a lot like ADHD / ADD. Your clinical psychologist will take a look at other possible sources of your ADHD symptoms, given it is sometimes similar in manifestation to some other conditions, especially developmental conditions. We will want to make sure that we’re helping you work on all of your difficulties, therefore the clinical examination is comprehensive, taking into account your presentation and behaviours.
3. Observations
Sometimes family members can help assess ADHD conditions, and this is considered vital for assessments of children and teenagers. They’ll usually be asked symptom specific questions, they will be taken through a general interview based around these, and will also be asked for a history of the child’s development. As mentioned above, if the sufferer is your child then his or her teachers will also be asked to participate in the observations by providing information.
4. Interviews
As always, the most valuable measure for a clinical psychologist is the ability to talk with you, to help in confirming a diagnosis, and in identifying treatment goals. You’ll talk about your symptoms, how they make you behave and feel, and how well you’re able to function with these symptoms in your life. We’ll figure out if the symptoms are worse in specific settings. We’ll see if your childhood is having a current impact on your condition. We will explore past psychological disorders, and check to see if others in your family have had the same symptoms. We will also explore if your ADHD is paired with other disorders (which are known as “comorbidities”).
4. Diagnosis of ADHD
Finally, all that assessment information is examined and corroborated, and from that we can confirm, or exclude a diagnosis.
There are two classification systems used for ADHD. There’s the International Classification of Mental and Behavioural Disorders 10th revision (ICD-10). And there’s the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-IV).
Here are their respective definitions of ADHD:
ICD-10
Early onset; a combination of overactive, poorly modulated behaviour with marked inattention and lack of persistent task involvement, pervasiveness over situations, and persistence over time of these behavioural characteristics. Symptoms are inconsistent with developmental level and clearly interfere with functioning in at least two settings (e.g. at home and at school). At least some of the symptoms must be present before the age of 7 years.
DSM-5
Describes ADHD as a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Symptoms present in two or more settings (e.g. at home, school, or work, with friends or relatives, in other activities), and negatively impacts directly on social, academic or occupational functioning. Several symptoms must have been present before the age of 12.
Can ADHD be cured?
Unfortunately no, currently ADHD / ADD cannot be cured completely. However a sufferer’s life can be immensely improved with treatment, they can be helped to reduce the intensity of their symptoms, and increase their ability to function in their day-to-day life. For some people their symptoms appear to cahnge over time and they seem less affceted.
Medication can be used to help with problems associated with concentration as well as physical manifestations. Oddly enough, some (but not all) forms of ADHD medications are stimulants, which at first blush may seem like the medical community is trying to stop a flood with a firehose.
But stimulants work because they increase the production of norepinephrine and dopamine which are both chemicals the brain uses to help you focus and think.
Your psychologist can help you deal with your behavioural and emotional relationship with your ADHD. You can learn how to become more observant of yourself, how to feel positive when you recognise ADHD symptoms starting to take over, which in turn can lead you to understanding how you can control the symptoms to some degree, in a more efficient way, and you may also learn ways to improve your organisational skills.
Your psychologist is also there to support the family, who might be having a hard time dealing with the symptoms of ADHD. It can be disruptive and upsetting, and can create emotional difficulties, as well as a tense family environment, your psychologist may be able to help with some of these problems.