ADD Diagnosis: The Social History
The purpose of the social history is to look at the home and the family situation in order to obtain information that will be useful in diagnosing ADD. The social history should be taken by a social worker with an MSW (Master of Social Work) from an accredited university. The social worker should be licensed and certified. (The criteria for certification differs from state to state.)
Like all members of the multidisciplinary team, the social worker should have experience with children with ADD and their families. A child or adolescent with ADD displays behaviors associated with ADD in both the school and home. To deal with the disorder only in the school may result in a misdiagnosis. The child must function at home, as a member of a family. There is no question that at some time all members of the family are affected by the child with ADD. To ignore the family would be foolhardy. Information about the family and how they function may lead to effective interventions.
Parents and other family members may be asked to fill out a questionnaire or respond verbally to questions from a social worker. You may find that you were asked some of these questions by the physician and/or the psychologist. The point is not to "trick" you. Rather, each professional is examining responses from his or her own professional perspective. The physician may not find a particular answer important, but the social worker may find that the same answer provides very useful information. The following information is typically sought in questionnaires:
- Where do you live?
- Does anybody besides your immediate family live with you?
- Do you own your own home or rent?
- What is your age?
- What is your occupation?
- How many years did you attend school?
- How is your health and that of other family members?
- Do you and your spouse have any marital problems?
- Length of pregnancy?
- Any problem with pregnancy and/or delivery?
- How does your child get along with siblings?
- Any family history of ADD or school-related problems?
- Do both parents agree on child-rearing techniques?
- What works well with your child? What doesn't?
- Are you easily frustrated by your child's behavior?
- How do you deal with this frustration?
This information provides a sense of how the family is functioning. For example, if grandparents live with the family, do they help out with child care, or are they ill and dependent on other family members? If you live in an apartment building, do you feel pressured to control your child's behavior because the neighbors complain? If you live in a rural area, do you feel there is no one you can go to for support? Where you live and who lives there will give the social worker insight into the most effective interventions for your family.
Both parents should respond to questions on the social history, even if they don't live in the same household. Unless a parent is totally absent from the picture, the information from mother and father can provide the social worker with additional insight.
Together with the information gathered from the other evaluators, the multidisciplinary team will be able to get a picture of the total child, not just one aspect. This total view is critical, because children who have attention deficit disorders display them at school, at home, on the playground, in the library, on the beach, and on the playing field - wherever they may be. It is not simply a school-related disorder.
For a social history to be useful, it must be thorough. A quick checklist simply won't provide the team with adequate information to make an informed decision. And although some of the questions will have been asked by other members of the team, they will be viewed through the eyes of a social worker. Together, all members of the team will discuss their findings and provide parents with a picture of the "total" child.
More on: ADHD
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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