Neuropsychological assessment for attention deficit disorder (ADHD and ADD)

Last year an article in the Boston Globe caught my eye.  It described a new test for ADHD, which involved hooking children up to a motion sensor.  This was hailed as the first “objective” test for ADHD.  Children are complex creatures, and this article struck me as very misleading to parents, educators, and other doctors.  In response, I wrote a letter to the editor, which the paper kindly published titled, “ADHD diagnosis made easy?  Think again.”  

Before diagnosing a child (or adult) with attention deficit hyperactivity disorder, we need to first objectively identify the presence of an attention problem. We also need to understand the “so what?” of the problem. Is it affecting the child at school, at home, on the ball field? Are the expectations in all of these settings reasonable? Other factors can mimic the symptoms of ADHD, and identifying whether those factors are present is critical in making an accurate diagnosis. Is the child getting enough sleep, are there stressors at home, is the child dyslexic or anxious?  

In isolation, a single “test” of ADHD can be misleading and result in a treatment path that isn’t effective.   This is the benefit of a thorough neuropsychological assessment.  Objective measurement of attention, identification of other learning disabilities or emotional issues, and a clear description of children’s thinking strengths gives us the most accurate diagnosis of the problem, and also a clear understanding of how best to address the problem.