Monitoring, Evaluating & Assessment of ADHD

Despite the existence of relatively clear diagnostic guidelines (APA, 1994), establishing a diagnosis is a difficult matter (Anastopoulos & Schaffer, 2001; Neul, Applegate & Drabman, 2003). Children with Attention Deficit Hyperactivity Disorder (ADHD) are generally characterized by their inattention, impulsivity, and hyperactivity. Nevertheless, these characteristics may vary a lot, according to the child, the situation and the circumstances. They may occur in different degrees of severity, affecting students in different ways, and may be associated with other disorders. The authors conclude that any assessment of ADHD must be comprehensive and multidimensional in nature, to capture variations and differences in all situations and settings. To identify any co-morbid features and the impact on home, school and social functioning (op. cit, 2001). There is, to date, no single diagnostic test to identify ADHD. Professionals should rely on a battery of measures and data to diagnose ADHD and to organise an intervention plan. This battery varies according to different authors. Wright (2002) proposes that the battery should consist of documentation of general educational interventions, parent and teacher interviews, behaviour rating scales and classroom observations. Resnick (2005) suggests that evaluation of ADHD should be based on the following sources: (a) Psychological, developmental, and social history, including employment and educational history for adults; (b) School records, including report cards, achievement tests, teacher/school reports, and special services / special education testing along with Individual Education Plans (IEP’s); (c) Teacher ratings; (d) Parent ratings; (e) Computerized Assessment Tests, measuring inattention, distractibility, and impulsivity (ex: Conner’s Continuous Performance Test); (f) Mental Status Exam, observing the person for symptoms of ADHD while ruling out other diagnoses. We are going to review some of the data sources mentioned above, paying special attention to measures that should be obtained in school or at home, and that are particularly important to the organisation of a behavioural intervention plan. Specifically, we are going to talk about: Interviews, Behaviour Rating Scales, Clinic-based Measures and Direct Observation. We are going to pay special attention to a method called Functional Behaviour Assessment, very useful for understanding behavioural sequences that are affecting the behaviour of the child.