Attention Deficiency Hyperactivity Disorder History, Diagnosis and Assessment
The following information will be specific to ADHD, to help parents understand what it is, and the barriers it poses to students in achieving their potential. References have been included at the bottom of the page.
ADHD’s History
ADHD was first introduced by Sir Alexander Crichton, where he wrote a chapter on “Attention and its Diseases”, in 1798! It was first treated by Charles Bradley in 1937. Up until the 1960s, it was believed that “brain damage” was the cause of hyperkinetic behaviour. This was viewed on a continuum from Cerebral Palsy to “Minimal Brain Damage”. It was believed that ADHD itself was evidence of brain damage. The 1963 Oxford International Study Group found that the brains of children with impulsivity were normal, and there was no history of trauma or infection. Thus, ADHD became viewed as a functional disorder. The DSM V (2013) thinks of ADHD as being a disorder that starts in childhood, up to the age of 12; it recognise a number of subtypes of ADHD. There is more evidence emerging that specific areas of the brain have structural changes (not related to trauma as mentioned before), which point to a biological basis for ADHD. These areas include reduced volume in the caudate Nucleus, Basal Ganglia and Putamen. It is a complex system where there is overlap between genetics, environment and biology.
The American Psychological Association stated, “the disorder is characterised by overactivity, restlessness, distractibility and short attention span, especially in young children”.
There are three types of ADHD:
Inattention only: ADHD Predominatelyn Inattentive
Impulsivity/Hyperactivity: ADHD Predominately Impulsivity/Hyperactivity
Combined: ADHD Combined Presentation
ADHD occurs in 5 to 7% of school-aged children in Australia. It is a chronic condition that can seriously disrupt the lives of children, and significantly impact their education outcomes.
Diagnosis of ADHD
If you suspect your child displays the characteristics of ADHD, having a professional health practitioners make an assessment is the next step. This assessment can be done by a paediatrician, psychiatrist, clinical psychologist and registered psychologist. These health professionals will use clinical judgment and protocols to diagnose ADHD.
ADHD will often present with behavioural difficulties that are progressively unable to be controlled between the ages 5-7. If a child’s IQ is normal, these learning difficulties at school are often not apparent until grade 1 or 2. Children with short attention spans can get through prep,. but as the demands at school increase, symptoms begin to manifest.
According to the Therapeutic Guidelines, a diagnosis of ADHD requires a comprehensive assessment (including medical, developmental and psychosocial assessments). Shield Health Support conducts comprehensive assessments to diagnose ADHD.
Comprehensive Psychological Assessment
Our psychologist will conduct a comprehensive assessments to evaluate the child’s presentation.
This will involve:
Intake forms, case formulation
ADHD Screening Tools
IQ Testing
ADHD Rating Scales: parent, teacher, student.
Educational Testing
Interpretation and Report Writing
Feedback Session with Recommendations
Parents will be given specific recommendations on how to best support their child in light of any diagnosis, tools to assist at school and psycho-education about the results and what they mean, and the report in full. These reports help schools put necessary supports in place: extra time on exams and teacher aides for example.
Here is a helpful resources for parents:
https://www.rch.org.au/kidsinfo/fact_sheets/Attention_deficit_hyperactivity_disorder_ADHD/
References
Canadian ADHD Resource Alliance (CADDRA). Canadian ADHD practice guidelines. 4th ed. Toronto, ON: CADDRA; 2018. http://www.caddra.ca/canadian-adhd-practice-guidelines/
National Institute for Health and Clinical Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management (NG87). London: NICE; 2018. https://www.nice.org.uk/guidance/NG87
Taylor E, Dopfner M, Sergeant J, Asherson P, Banaschewski T, Buitelaar J, et al. European clinical guidelines for hyperkinetic disorder -- first upgrade. Eur Child Adolesc Psychiatry 2004;13 Suppl 1:I7–30. https://www.ncbi.nlm.nih.gov/pubmed/15322953
Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2019;144(4). https://www.ncbi.nlm.nih.gov/pubmed/31570648
Canadian ADHD Resource Alliance (CADDRA). Canadian ADHD practice guidelines. 4th ed. Toronto, ON: CADDRA; 2018. http://www.caddra.ca/canadian-adhd-practice-guidelines/
National Institute for Health and Clinical Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management (NG87). London: NICE; 2018. https://www.nice.org.uk/guidance/NG87
Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2019;144(4). https://www.ncbi.nlm.nih.gov/pubmed/31570648
