Monday, April 27, 2009


I am a clinical psychologist with a coaching practice. Most young and older adults who contact me have already been diagnosed with AD(H)D. Whether or not they take stimulant medication, they seek strategies to help them in the realms that interfere with optimal functioning. But what about the ADDers who have not been tested? Do I do a screening, a short-evaluation or a complete neuropsychological evaluation? Many experts feel that a complete neuropsychological evaluation is necessary, while others indicate that a developmental history, self-report inventory, and a thorough clinical interview of the individual's work or school status, relationship issues, and social life, to name a few, is sufficient.

As for me, I take the latter approach, including the following areas: 1. developmental and school history, 2. the presence of any known learning disability,3. the coexistence of other psychological and medical issues , 4. the responses on various self-report questionnaires. If an adult has just completed high school or college and has high SAT's or GRE's, I only need to do a screening. However, recently a young man came in with a previous psychological evaluation that suggested dyslexia. I'll have to check that out, to determine if his attention problems result from that, or whether his ADD slows down his reading speed and ability to sustain attention on a reading task.

Many adult ADDers have done very well in their primary and high school years, since they were very bright and could 'wing' it. Then in later life, the demand for self-initiation of tasks and the effort involved became overwhelming. Thus, in these cases a developmental history would not reveal ADD unless there was a hyperactive component(ADHD). I therefore emphasize individualizing the assessment of ADDers, to determine how thorough the testing needs to be. Of those of you who have been diagnosed with ADD or ADHD, how was it determined?

No comments: