Child ADHD Assessment
Our child ADHD assessments involve the following stages:
This is an interview conducted by telephone by one of our intake officers who will go through your child’s background, previously conducted assessments, and current symptoms of concern. This way we will be able to determine what type of assessment will be required and whether an ADHD assessment is appropriate. At this stage, we will send you and your child's teacher out standardised questionnaires. Please note: To make an appointment for an assessment, a deposit of $180. This deposit pays for the standardised questionnaires (purchased on your behalf from MHS), as well as secures a morning set aside with one of our clinicians. We usually set aside a 4 hours slot, which includes up to 3 hours of assessment and a feedback session. It is however noted that for younger children or more severe issues we may need to break up this session.
Prior to attending the initial ADHD consultation with one of our clinicians, we request that you complete 3 questionnaires (1) Background history questionnaire (2) ADHD symptomatology questionnaire (including 12 other developmental disorders as well as social, emotional, behavioural and academic concerns), (3) an executive functioning questionnaire. To confirm a diagnosis of ADHD, it must be shown that these symptoms occur in two or more areas in their life, hence another rating is required in another setting. We therefore usually ask one of your child’s teachers to also complete some of these questionnaires (2 & 3) in order to understand how your child is affected in the main environment where they are expected to sit and focus for extended periods. Often ratings can differ between home and school and it is important to understand what issues present in different settings in order to guide appropriate recommendations for intervention. For parents who are reluctant to involve the school we ask for another person to also rate.
STAGE 3: Parent initial consultation:
Prior to us actually formally meeting your child we require an initial consultation with one or both parents in order for the clinician to review your background questionnaires and discuss current concerns with the family. At this stage, depending on the background, the actual tests to be conducted will be planned. Other issues at this stage may also need to be ruled out, and it may be recommended that you also concurrently seek out other assessments (visual, auditory, sleep) if it is felt that issues are present. Please note: We ask for you not to bring your child to this initial consultation so that you can speak freely with us, without risking any self-esteem issues with your child. It is not necessarily recommended to let children know about a potential ADHD diagnosis unless they have raised this themselves. For child who has specifically requested an ADHD assessment (often seen in teenage children), they can attend the initial consultation, however we ask for you to request to speak to us alone about any information you do not think your child will be able to cope well with emotionally (ie. negative comments about mood or behaviour).
STAGE 4: Formal neuropsychological/cognitive assessment with your child:
Children will undergo the core neuropsychological module (see below). Feedback will then be given about the individuals results so far, and we may then recommend having further testing done in a specific area of difficulty. Sometimes the initial testing may suggest additional areas of difficulty that may need further exploration. Following each assessment feedback will be given regarding all the results to the child’s parents.
Core Neuropsychological Module: Approximately 3 hours
This includes the assessment of:
- General intellectual functioning (IQ test): Verbal comprehension, perceptual reasoning, working memory, processing speed
- Attention: Visual attention span, visual selective attention, visual sustained attention, divided attention (visual & auditory), auditory attention span, auditory sustained attention and switching attention.
- Executive functioning: planning, problem solving, utilising feedback, self-monitoring, task scheduling (8 years+ formal assessment)
- Academic achievement : word reading, spelling, mathematics screening
Extension Modules: We may then recommend that additional testing is conducted due to indications from the core module that there may be either (1) some non-attention based processing deficits masking themselves as an attention deficit or (2) some processing weaknesses that are co-occurring with the attention problems that need further examination (and possible additional treatment). We may assess in more depth any of the following:
- Academic achievement- Extensive: reading comprehension, written expression, phonological processing (segmentation, blending), listening comprehension, oral expression (this can be used to diagnose comorbid learning disabilities)
- Memory: in depth verbal and nonverbal short-term & long-term memory
- Visual perception: visual discrimination, visual spatial skills, figure-ground relationships, form constancy, visuomotor integration
- Auditory processing screener
- Language and language-related processes: expressive and receptive language skills
- Motor skills: fine motor coordination, motor speed, visuomotor integration
STAGE 5: Feedback Session:
Following the assessment (either on the same day or at a time convenient to the family) we will then go through all the results, the diagnosis (where appropriate) and recommendations for intervention.
STAGE 6: Comprehensive Report:
We will provide the family with two reports: One for the family with recommendations appropriate to the home environment and one for the school with recommendations appropriate to the classroom environment.
STAGE 7: Follow-up treatment program:
As discussed at the time of the feedback as well as in the report, we will put together a comprehensive treatment program (as required) to address all of the issues your child is presenting with. We have an extensive list of treatment programs available to address not only ADHD symptomatology but also other common social, emotional and behavioural issues. We are also happy to liaise with the school and any other health professionals working with your child.
Diagnosing ADHD in Children
Neuropsychologists have a very different way of diagnosing ADHD compared to other clinicians due to their different type of expertise. Neuropsychologists are experts within the field of psychology in cognitive-based assessments. A neuropsychologist will typical take 3 hours to formally assess the child and get objective tests of their cognitive, learning, attention and executive skills, as well as look at the diagnostic criteria according to standardised parent and teacher ratings. Formal and objective testing of attention skills is conducted in order to get an unbiased measure of what attention problem/s the child is experiencing, as this is an important baseline to guide therapy and judge its success. A neuropsychologist is also trained in looking at other cognitive, psychological and behavioural issues that often can present as attention problems, to make sure that the issue is a genuine attention issue, rather than a different issue that needs an alternative form of treatment.
Why have an ADHD Assessment at The Sydney Cognitive Development Centre?
During the assessment we aim to not only look at the attention issues your child is experiencing but also any comorbid issues, including social, emotional and behavioural issues both at home and at school. It is possible that emotional or behavioural factors may be creating symptoms of inattention, rather than a true attention problem, and this will need to be ruled out so that your child is not inaccurately misdiagnosed with ADHD. For example, children with anxiety and depression often fulfil many of the diagnostic criteria for ADHD, so it is important to pinpoint the causes of the attention weaknesses as obviously the therapies differ greatly. At the Sydney Cognitive Development Centre we pride ourselves on accurate and precise diagnosis as this leads to correct and targeted treatment, which leads to better outcomes and long-term prognosis.
During the parent interview we also look at developmental history and other possible issues that may underlie attention problems either at school or at home (eg. visual and hearing issues, head injury, sleep problems, sleep aponea, etc). As we only have trained neuropsychologists conduct our testing our assessments are extremely thorough. We have outlined below the tests that we include. Obviously, we tailor the testing to the child based on initial interview and standardised questionnaires as we will not put your child through unnecessary assessment. If no issues are reported in a certain area we will not test this area unless we see additional signs of issues on other testing completed. Often families are referred to paediatricians for ADHD assessment, however often these paediatricians will need to refer out for formal testing to obtain the following vital information for diagnosis (see below). Even a psychologist cannot conduct the tests below as they should only be conducted by someone with qualified neuropsychological training. Make sure that any person you choose to do your assessment can formally assess the skills below.
It is felt that many people misunderstand what attention is. Attention is an umbrella term for many different skills and without formally assessing each aspect of attention, and truly understand what aspect of attention is affected, recommendations for remediation will unhelpful and often inappropriate. Attention testing is also the only objective way of assessing a child's attention skills rather than just getting the opinion of a parent or teacher. Attention testing will show a parent how their child performs compared to other children their age on a range of tests and allows for the parent to understand the severity of the problem rather than being given a one-size-fits-all label of ADHD based solely upon the diagnostic criteria.