ADD Diagnosis: The Multidisciplinary Approach
ADD is a complex disorder. In order to insure a proper diagnosis, information must be gathered from a variety of sources. The evaluation should be undertaken by a group of professionals, referred to as a multidisciplinary team. This team consists of a physician (neurologist), a psychologist, a special educator, and a social worker. They work together in making a diagnosis that will provide you with a total picture. Without a multidisciplinary approach, an important part may be missing. And without that part, an erroneous diagnosis may be made.
The neurologist, preferably a developmental or pediatric neurologist, will evaluate the functioning of the central nervous system. This is not an invasive examination. Depending upon the nature of the concern, certain laboratory tests may be desirable. For example, if there is a suggestion that there is a seizure disorder, the neurologist may ask for an electroencephalogram (EEG), which measures brain wave activity. This is also a painless, noninvasive test.
A psychologist will evaluate the intellectual and social-emotional functioning of the child. The psychologist will look for disorders such as learning disabilities, emotional disturbances, or other psychological or psychiatric disorders that may exist with ADD or may be the main problem.
A special educator, thoroughly trained in psychoeducational assessment procedures, will administer a battery of tests to explore the existence of a learning disability or other school related disorders. The student will be assessed in basic psychological processes (attention, memory, perception) and basic skill subjects (reading, math, and so on) in order to determine specific strengths and weaknesses. In some parts of the country, a school psychologist will administer these tests.
The social worker will meet with the family to obtain information about the child's social history, including birth information, developmental milestones, family dynamics, medical information, and school placement. The social worker will also explore the behavior of the child at home and at school in order to acquire information that would help determine the cause of ADD.
The need for such a multidisciplinary evaluation cannot be minimized. By accumulating information from a variety of professionals, the true nature and needs of the child can be determined. For example, a child may be referred for an evaluation because of excessive motion in the classroom. Upon evaluation, the neurologist may not find a satisfactory explanation for the behavior, but the special educator may note the school problem as does the psychologist. The social worker would request a home visit and the mother may confide in her that there are marital difficulties and she has been under a great deal of stress. In such a case there does not appear to be a neurological basis to ADD. Rather, the child's anxiety about her parents is causing her to act in a disruptive manner in the classroom. The treatment would be markedly different for this child than for a child who appears to function in a hyperactive fashion because of a central nervous system dysfunction.
When all professionals have accumulated their findings, they generally meet to discuss their results, to determine the existence or absence of ADD, and to develop a treatment plan and ways to monitor progress.
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From Keys to Parenting a Child with Attention Deficit Disorders by Barry E. McNamara, Ed.D. & Francine J. McNamara, M.S.W., C.S.W. Copyright © 2000 by Barron's Educational Series, Inc. All rights reserved. Used by arrangement with Barrons Educational Series, Inc.
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