Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects children, adolescents, and adults. ADHD may present predominantly with inattentive symptoms, predominantly with hyperactive and impulsive symptoms, or with a combination of both.
Symptoms may include difficulty sustaining attention, following through with instructions, organizing tasks, remembering daily responsibilities, waiting for one’s turn, or controlling impulsive responses. Some individuals may appear excessively restless or frequently interrupt others. The nature and severity of the symptoms can vary considerably from one person to another and may change with age.
A comprehensive evaluation can help determine whether a child’s difficulties are consistent with ADHD. There is no single test that can independently diagnose ADHD. The evaluation must consider information from several sources and examine whether the symptoms occur in more than one setting and interfere with the child’s functioning.
It is equally important to consider other factors that may cause or contribute to behaviors resembling ADHD. Learning difficulties, anxiety, depression, sleep problems, medical conditions, and situational stress can affect attention, behavior, and academic performance. For example, a student with an underlying difficulty in mathematics may appear inattentive or disruptive during math class because the work is frustrating or exceeds the student’s current skill level.
A child may have ADHD along with another learning, emotional, or developmental disorder. A comprehensive assessment can identify the full range of concerns and provide information about the child’s learning profile, strengths, and needs. This information can guide treatment, educational interventions, and recommendations for accommodations.
The evaluation takes place over multiple days and begins with a detailed history and discussion of the current concerns. Dr. Elman may observe the child at school and interview the child’s teachers. Information from different settings is especially valuable because children may behave differently at home, at school, and in the examiner’s office.
Dr. Elman assesses a broad range of functioning, including intellectual ability, academic achievement across subject areas, social-emotional functioning, attention, executive functioning, auditory processing, phonological awareness, short-term and working memory, long-term retrieval, fluid and abstract reasoning, visual-spatial abilities, sensorimotor functioning, and visual-motor coordination. She may administer a computerized continuous performance test to gather additional information about the child’s sustained attention and control of impulsive responses. The results of this measure are interpreted together with the child’s history, behavioral observations, rating scales, academic performance, and information provided by parents and teachers.
After completing the evaluation, Dr. Elman prepares a comprehensive written report explaining the results and recommendations. She meets with the parents after they have reviewed the report to discuss the findings and recommendations and answer their questions.
Dr. Elman offers to consult with school personnel regarding appropriate interventions, accommodations, and services. Some schools do not permit outside evaluators to attend educational planning meetings. When participation is permitted, Dr. Elman can explain the findings and assist the school team as it considers whether the student may be eligible for an IEP, a Section 504 Plan, or other forms of support.