AdminAttention Deficit Hyper Activity Disorder according to Singh (2002) is a developmental disorder that is brain based and most often effect’s children. This developmental disorder can be characterized as a disorder in which affects one’s self control; primary aspects include difficulty with attention, impulse control, and activity levels usually diagnosed prior to the age of seven (Willoughby, 2003). It is estimated that nearly 4 to 12 percent of school age children have a type of ADHD (Pediatrics, 2000).
There are primarily three sub-types of ADHD. Inattentive sub-type 1 is ADHD which those who manifest inattention without the presence of hyperactivity and impulsivity (Barkley, 2005). There is also ADHD sub-type 2 with symptomolgy related to hyperactivity and impulsivity (Barkley, 2005). Finally, there is ADHD combined sub-type which expresses the presence of all core characteristics of inattention, hyperactivity and impulsivity. According to Pediatrics (2000) early diagnosis and management of these conditions can redirect these youth for greater educational and psychosocial outcomes.
According to Kamphaus & Campbell (2006) complexity and differences in core symptomatology regarding the nature of this disorder brings forth the logical assumption; that if a clinician is to test and evaluate an individual for ADHD, the assessment must be dynamic with the utilization of many different testing scales, different methods and information that will be collected across many different environments (p. 327). With this dynamic evaluation one must also consider the presence or absence of other disorders so common with ADHD; such as Learning Disabilities, Anxiety Disorders, Oppositional Defiant Disorder, Conduct Disorder, and Depression (Pediatrics, 2000). A clinician according to Pediatrics (2000) should realize that a thorough assessment may also occupy as many as three visits by the patient and family.
In order to effectively account for the complex and dynamic variables in regards to ADHD symptomatology, there are specific processes in which one must assess in order to gain an accurate picture for diagnosis, with special emphasis and analysis of information obtained from the child, parents and teachers if possible (Barkley, 2005).
Areas of the assessment involving multiple areas and procedures of collecting data:
1. Historical Assessment (Social, Family, Medical, Prenatal / Developmental, and Educational)
2. Use of interviews, observations and examinations
Figure 1.1
Accessing a thorough history includes multiple areas of assessment. According to Mercugliano, Power, & Blum (1999) a practitioner must first be aware that many of the problems children with ADHD confront will manifest themselves within the areas of behavior, academics and social interaction. Because of these areas of concern a clinician must assess prenatal / developmental, social, family, medical, educational histories and utilize interviews, observations and examinations as a process to collecting data (Mercugliano, et. al., 1999). Throughout data collection DSM IV criteria should be identified and compared to patterns and consistencies that have resulted through data collection (Personal Communication, Darrell Moilanen LMSW, June 21, 2007). The DSM IV criteria explicitly states that one must find 6 or more symptoms either within the areas of inattention or the areas of hyperactivity / impulsivity, and these symptoms must have been present for at least 6 months, many before the age of 7yrs, must create impairment and been observed within at least two primary systems including; work, school, or society (Quinn, 1997). The family, medical, developmental, educational and social histories are of great importance in regards to understanding if the child’s manifestation of behavioral symptomatology within multiple systems is a result of ADHD or a dysfunctional environment or health problem (Mercugliano, et. al., 1999). Assessment of the educational realm is of great importance due to the fact that many of the difficulties with behavior, learning, and performing that ADHD creates can first be identified at school (Barkley, 2005). It is usually that first transition from a child’s home to spending much of their time at school that a child is first identified as having ADHD (Barkley, 2005).
The first and primary way of collecting data during investigation of these areas includes the recommended use of a semi-structured interview (Schroeder & Gordon, 2002). When interviewing the parents and children it is important to use open ended questions and a structured fixed format (Kamphuas & Campbell, 2006). The CAIS or Comprehensive Assessment to Intervention System according to Schroeder & Gordon (2002) is an excellent format to acquiring information in a flexible semi-structured format. For the purpose of this paper, this interview is utilized as a guide to gaining relevant areas of information, and integrating proper assessment and testing processes within each primary area (Schroeder & Gordon, 2002). The CAIS has clear and specific areas of investigation. Included in the following are primary areas a clinician should consider: vyvanse 60 mg