What is ADHD (ADD)?

Attention Deficit/Hyperactivity Disorder is a challenging condition experienced by a number of children, adolescents, and adults. Core symptoms include problematic levels of impulsivity, inattention, and hyperactivity. It is a biologically based disorder that when diagnosed properly and managed effectively, one can lead a full and productive life. The American Academy of Pediatrics (AAP) recommends screening children for ADHD as early as four years of age.

Symptoms found in childhood that suggest the disorder include inattentiveness, distractibility, impulsivity and for some individuals hyperactivity.

More specifically one might find a child:

  • Failing to give close attention to details and making careless mistakes
  • Having difficulty sustaining attention
  • Not appearing to listen
  • Struggling to follow through with instructions
  • Having difficulty with organizing tasks
  • Avoiding or disliking tasks that require sustained mental effort
  • Being forgetful in daily activities

One may also find the child:

  • To be excessively restless
  • To fidget with hands or feet or squirm in the chair
  • To have difficulty remaining seated when expected
  • To run about or climb excessively
  • To talk excessively
  • To create disruption in activities in which he/she is expected to do quietly
  • To have difficulty waiting one’s turn
  • To interrupt or intrude upon others

A word about adolescent and adult ADHD

While ADHD is often first diagnosed in childhood, an understanding of ADHD in adolescents and adults is also very important both for diagnostic and treatment concerns. Research has suggested that a number approaching 70% of the children properly diagnosed with ADHD continue to experience symptoms in adolescence. Furthermore some 50% of those individuals continue to be challenged by ADHD into adulthood. In addition, with the adult population, ADHD may have previously gone undiagnosed or overlooked as our understanding and awareness of the nature of the disorder is greater than in the past and is continuing to develop each year.

In adolescence the symptom presentation generally shifts from the prominent impulsivity and hyperactivity of childhood to a correspondingly greater experience of challenges with poor organization, forgetfulness, excessive daydreaming, poor follow through on tasks, the needing of excessive direction, and engaging in risky behavior. In adults, undiagnosed and unmanaged symptoms can lead to underachievement in work and social relationships. In addition, difficulty associated with organization, procrastination, inattention when receiving or processing information, compromised tolerance for frustration, displays of irritability, and forgetfulness are but some of the experiences of adults with ADHD.

Why is a comprehensive multimodal method necessary for diagnosis and for guiding treatment?

First, there is no single definitive test for ADHD. Secondly, many of the symptoms for ADHD are displayed by all children, adolescents, and adults on occasion or to some degree. Third, some of the same or similar symptoms are found in other disorders as well as ADHD. Fourth, other conditions such as: mood disorders, anxiety disorders, and disorders of childhood, are found to frequently co-exist with ADHD in many children. The co-existing of other concerns is also at issue in adolescents and adults with ADHD. Learning disabilities experienced by many children with ADHD further complicate the task of identifying the scope of the difficulty and in providing the most effective treatment. Finally, treatment of ADHD, as well as for other disorders, often includes the use of medication. Such an important choice should only be made with a thorough understanding of the range of the problems experienced by the individual child, adolescent, or adult and with the need for such a serious intervention being well established. A comprehensive assessment provides information addressing these concerns.

What is involved in a comprehensive assessment?

A thorough assessment should include gathering information from individuals familiar with the child, adolescent, or adult in more than one setting, i.e., school, home, place of employment or in the community, both in structured (rating scales) and semi-structured (interviews and narratives) ways. It should include consideration of other diagnostic possibilities and may include intelligence testing, achievement testing, and/or consideration of the child’s, adolescent’s, or adult’s emotional functioning. A continuous performance test to provide further evidence of impulsivity and/or inattentiveness may also be included; not as a definitive means of diagnosis, but to help support or dispute evidence found elsewhere. In adult and adolescent assessment, there is a particularly strong need for the accurate and thorough gathering of historical data.

How do I go about arranging for such an evaluation?

If you believe you or your child has ADHD contact our office to arrange an assessment. Bruce and Patricia Feltrup-Exum have extensive experience in working with children, adolescents, and adults in the diagnosis of ADHD. In addition, because a diagnostic evaluation and assessment is an important part of the management of ADHD, we have the knowledge and experience in understanding the diagnosis and treatment of other challenges or disorders of childhood, adolescence, and adulthood that may co-exist with ADHD or which may account for symptoms or behaviors thought to be associated with ADHD.