The ADHD test: What it involves

Your child’s teacher has asked for a meeting and possibly she shares information that confirms what you may or may not have noticed at home. This usually revolves around your child’s behaviour in school and terms such as ‘distractible’, ‘disruptive’, ‘inattentive’, ‘difficulty completing tasks’, ‘daydreaming’, ‘social problems’ and more will pepper the conversation.  Often the suggestion is made that he or she be tested for ADHD.  The reason is that this might provide a diagnosis of the problem, leading to the usual medications for the mental disorder.   But what is this ‘ADHD test’?  How does one test for this condition and what procedures are followed?


The truth is that there is no test for ADHD.  There are no objective diagnostic criteria for ADHD – no physical symptoms and no neurological signs.  Neither is there a blood test that can give markers for a possible ‘chemical imbalance in the brain’ or brain scan findings.  In fact, there are no physical or psychological tests that can be done to verify that a child has ADHD. 


What is used is mere observation of behaviours in a consulting room, contents of a questionnaire filled in by teachers and parents, and perhaps a report from a psychologist noting inattentive behaviour, poor sequential memory and restlessness during an intelligence test, tests of academic standing or personality test. None of the latter test results can be used to diagnose ADHD.   In other words, it is only the presence of behavioural symptoms of ADHD that constitute the ‘test’.  One of the most popular checklists used for diagnosis is called the Revised Conners Questionnaire.


The symptoms are listed in the publication used by psychiatrists for diagnostic purposes and known as the Diagnostic and Statistical Manual of Mental Disorders – 5th edition (DSM-5).  If the child shows about 6 of the behaviours listed for either hyperactivity/impulsivity or inattentiveness and these have persisted for at least 6 months, the diagnosis of ADHD can be made.  The Conner’s Questionnaire consists basically of a variation of the traits listed in the DSM-5.


Because it is common for children to behave well in a doctor’s office, many examining doctors don’t see the signs of ADHD during the brief consultation you are given.  Instead, doctors prescribing the drugs used to treat ADHD may do so on the grounds of reports from teachers and parents.  This is startling to consider because the doctor is supposed to then treat a presumed disease or disorder with brain-altering drugs without having seen any sign of it.


Get a second opinion  


It isn’t extreme to suggest that parents seek out a second opinion regarding the reasons for a child’s behaviours and difficulties.    While drugs might provide a welcome relief for all concerned, including an extremely hyperactive child, they are only treating the symptoms.  The real, underlying reasons for the observed behaviours and the distressing symptoms suffered by the child may go unnoticed and untreated and continue to plague the child for years to come.  Indeed, many continue into adulthood with stubborn challenges that impede the realization of their potential and happiness.


Many professionals are legitimately concerned that ADHD has become a ‘catch all’ diagnosis.  Making it more difficult is the truth that there is no actual test to prove that the condition exists in a particular child.  Because of this, one can’t be surprised that the quick fix has been to rely on medications such as Ritalin and other drugs to take care of the problem.  While they may be helpful in the course of treatment of the real causes, drugs have become an overused starting place.


Professionals who take the time and trouble to explore all the possible underlying reasons for inappropriate and maladaptive behaviours usually cast their nets wide.  Amongst other possible offenders giving rise to ‘ADHD look-alike’ behaviours are:


  • Food and dietary issues, including allergies and intolerances
  • Unhealthy digestive systems, affecting brain function
  • Family dynamics, including parenting techniques
  • Delays in brain development needing correction
  • Irregular functioning of certain neurological systems needed to support behaviour and learning
  • Neurological and physiological impairment due to pollutants or toxins
  • Stress and other emotional factors
  • Academic factors, including academic deficits or extremely high intelligence


Choices available to parents


Many parents are ready to accept that their child may have ADHD but are not willing to give them drugs.  This is understandable and commendable but it doesn’t help to ignore the condition.  These days, many strides are being made in the identification and treatment of those behaviours making life difficult for families.


Integrated Learning Therapy (ILT) practitioners offer an holistic evaluation of such children (and older individuals).  Very often we do identify the real cause – and with the cooperation of the family, are able to offer substantial help through a home-based treatment plan.  This means that there aren’t weekly (and expensive) visits to a therapist but the family manages the programme in their own homes at times convenient for them.


For more information about our services and a list of practitioners available around the country, visit the website www.ilt.co.za


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