ADHD Awareness Month #ADHD #ADHDawareness #Seekahealthymind
So my previous blog brought awareness to the symptoms of
ADHD, but how does a person get diagnosed with the disorder? Well, I’m here to
tell ya!
Making the diagnosis
of ADD/ADHD:
One of the most important steps in getting a proper
diagnosis of ADHD is selection of a healthcare provider. Who can diagnose ADHD?
Well, family doctors, pediatricians, psychiatrists, psychologists, and
neurologists are all licensed to diagnose. However, when it comes to a neurodevelopmental
disorder, such as ADHD, seeking evaluation by a psychiatrist and/or neurologist
is often your best bet. These specialized healthcare providers are trained in
diagnosing and treating this disorder, whereas many family doctors and
pediatricians are not.
Diagnosing ADHD is done according to the criteria set forth
in the Diagnostic and Statistical Manual
of Mental Disorders or DSM-V. This book provides diagnostic criteria for
mental disorders. The criteria for
diagnosing according to the DSM is that the patient has to show six of nine symptoms of inattention
and/or hyperactivity/impulsivity before the age of seven. I had listed those
symptoms in my last blog, so refer back if you need to. The symptoms should have persisted for at
least 6 months, and must impair the person’s functioning in settings such as
the home, school, and work.
A clinical interview
utilizing a standardized ADHD rating scale should be used in the diagnostic
process. This scale rates the symptoms into classifications of inattention,
impulsivity and hyperactivity. The ADHD
rating scale can be found at: http://www.fmpe.org/en/documents/appendix/appendix%201%20-%20adhd%20rating%20scale.pdf
There are common mistakes that occur in the diagnostic
process. These mistakes may occur when seeking a diagnosis from a family or
pediatric doctor. I’m not downing these types of providers, they are generally
highly educated and experienced in general or pediatric practice. But many have
limited knowledge in diagnosing and treating ADHD. Diagnosing is best
accomplished by a neurologist or psychiatrist. Common mistakes include:
·
Length of time
of an exam: A diagnosis of ADHD should not be done in a 15 minute office
visit with a family/pediatric doctor. This is a complex disorder and a thorough
evaluation is essential.
·
Diagnosing
secondary symptoms as the primary problem. Many of those with ADHD have
coexisting conditions of anxiety, depression, or other mood disorders. These
may be secondary symptoms caused by the primary diagnosis of ADHD/ADD.
·
Academic
success: Just because a person isn’t failing or doing poorly in school
doesn’t mean they don’t have ADHD. Some kids with ADHD may do very well in
school.
·
The child has a high IQ, therefore they can’t have ADHD. Many of those with ADHD
have an average or higher than average IQ score.
Finding the right clinician is important. If I had listened
to the first pediatrician who told me Nevia doesn’t have ADHD, we would have
never received a proper diagnosis or treatment. This can really make a kid
suffer unnecessarily. Of the three pediatricians Nevia has been to, none of
them utilized the ADHD rating scale to evaluate for this diagnosis. She
received a diagnosis of ADHD from doctor #2, and #3 carried on treatment after
we switched providers for insurance purposes. While prescription of the
medication to treat ADHD was not an issue, neither of the pediatricians
referred us to a psychiatrist or psychologist for counseling or behavior
therapy.
A
friend of mine told me a story of a coworker who asked another coworker who has
ADHD what symptoms she has with this disorder. She mentioned that she wants to
get a prescription for ADHD because she heard it acts as an appetite
suppressant. So this young lady went to her primary care doctor complaining of
inattention & difficulty focusing. She even acted the part by staring out
the window & losing her attention when the doctor was talking. After her 15
minute encounter with her primary care provider, she walked out of the office
with a prescription for a Schedule II narcotic, Focalin. This medication is
commonly prescribed to treat ADHD. It is a HIGHLY abused medication by those
who don't actually have ADHD, but somehow managed to get diagnosed with it. A
more socially acceptable form of drug
abuse, I suppose.
Many of those with ADHD/ADD have coexisting learning
disabilities, as well. While ADHD is not considered a learning disability, it
is important to evaluate for learning disabilities in those diagnosed with
ADHD. Some disabilities that may coexist include; dyslexia, dyscalculia,
dysgraphia, dyspraxia, and executive functioning. By the way, I dislike the
term ‘disability’. I really wish they would change the wording to Learning
Differences. Those with learning disabilities have the capacity to learn. They
just learn differently. Additionally, other screening tests may be conducted in
those with ADHD to assess for coexisting conditions, such as anxiety,
depression, and other mood disorders. This particular testing can take about 4
hours for a psychologist to complete. Yes, my daughter Nevia sat through FOUR
hours of testing. Quite an accomplishment for an ADHDer!
So in some circumstances, getting a diagnosis of ADHD may be
quite simple. However, it is a complex disorder with many variables and the potential for coexisting conditions. This is why a thorough evaluation by a
licensed psychiatrist and/or psychologist is important.
Mental health does not receive the attention that it should.
We have a tendency to undervalue the importance of a healthy mind. With ADHD Awareness Month, hopefully more
focus will be shed on this mental disorder that over 15 million Americans have
been diagnosed with and many others live with without a proper diagnosis.
Dr. Donna Poma Fife, DNP, ARNP
Disclaimer: This blog is meant for informational purposes only and does
not constitute or substitute medical care. If you think you or your child may
have ADHD please see a healthcare provider, preferably a psychiatrist or a
neurologist, as they are best equipped to make a proper diagnosis.
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