Many behaviors associated with ADHD—problems with taking in information, memory, processing speed, and sensory/perception—may in fact be attributable to other issues. Therefore, the only way to know if your child has ADHD is to have him undergo a thorough evaluation conducted by qualified professionals.
A complete evaluation for ADHD includes the following components:
1. Sensory evaluation
Sensory functions include hearing, seeing, and touching. An ophthalmologist or an optometrist should perform the vision test, and an audiologist should do the hearing test. (Vision and hearing tests done in the pediatrician’s office are not sensitive enough to determine sensory functioning.)
Sensitivity to touch may be obvious to you as children with tactile sensitivity typically do not like their hair brushed, seams in their clothes, and things that are too hot or too cold. A psychologist evaluates tactile sensitivity, based on parent report, during the psycho-educational portion of the assessment.
2. Psycho-Educational Evaluation
This component, conducted by a psychologist, is used to evaluate motor functions, cognition, academic functioning, and emotions. Professionals such as occupational and physical therapists, learning and reading specialists, or social workers may contribute, but the psychologist is responsible for pulling all the pieces together and providing the report.
Cognitive/intellectual functioning is estimated with a host of tests that assess knowledge, social judgment, arithmetic, visual-spatial functioning, abstract thinking, memory, and processing speed.
Neuropsychological tasks are used to assess motor function, memory, executive function (planning, organizing and motivation), visual-spatial processing, visual-motor skills, auditory processing, and speed of processing.
Academic/educational testing assesses if your child is on grade level or functioning at an age-appropriate level.
Finally, feelings and emotional functioning are evaluated by assessing how your child responds to different situations or stimuli. This information is gathered though questionnaires about development and behavior that are filled out by you, your child’s teachers, and perhaps your child.
3. Auditory Processing Evaluation
An auditory processing evaluation, which is an audiological exam, may be indicated if your child seems to hear sounds, yet does not appear to process what has been said. For example, a child may have difficulty distinguishing different sounds so he mishears or mispronounces some words. Some children have difficulty in noisy environments and others may only respond to one or two steps of a multi-step request. “Put on your shoes, get your coat and go to the door,” may leave your child looking at you as if you were speaking a foreign language.
Problems with auditory memory, speech, and reading might be due to auditory processing difficulties. As a result children may appear as if they are not paying attention or don’t have a good memory—in other words, they may look as if they have ADHD. Only an audiological exam of auditory processing can determine the type of problem that exists. Currently, these tests are most informative for children age seven and older.
After the Evaluation
Once the evaluation is completed and the report has been written, the evaluators will meet with you to discuss their report and make sure that you understand their findings. The information you receive is likely to enhance your understanding of your child and the actions you need to take next. For example, you should come away with a grasp of how your child functions relative to his peers, his strengths and weaknesses, possible areas for intervention, and what service providers might be most helpful.
If your child does have ADHD or other learning issues, identifying the problem will enable you to address it by taking the action necessary to help him achieve his potential academically and socially.
When you receive the feedback, don’t be surprised if you experience a mix of emotions such as fear, pride, relief, and sadness. It takes time to absorb the information, and you may find yourself with more questions down the road. For example, subsequent discussions may include discrepancies between the evaluation results and what you know about your child.
Jill Harkavy-Friedman is a clinical psychologist and Vice President of Research at the American Foundation for Suicide Prevention. She is also president of the Smart Kids Professional Advisory Board.