Distinguishing Attention Deficit Hyperactivity Disorder
(ADHD) from other childhood behavioral and emotional disorders is a very
important yet challenging task. Correctly diagnosing this complex disorder
reduces the risk of implementing medical or psychological treatment which
may be inappropriate, overlook other disorders, and/or delay more effective
treatment. A careful and systematic approach by a trained and experienced
diagnostician is essential. Researchers are currently in consensus that
only three to five percent of children qualify for the ADHD diagnosis
and that the prevalence of boys to girls is approximately three to one.
Because ADHD has from time to time received much media attention, many
parents and teachers have been provided with "lists" of signs
and symptoms to look for in identifying this disorder. While these articles
and programs are valuable in bringing to light ADHD, a listing of behaviors
characteristic of the disorder is likely to incorrectly identify large
numbers of fairly normal youngsters. Providing the usual ADHD medical
and psychological treatments for all children who show only some of the
symptoms of this disorder would clearly be inappropriate. Therefore, it
is very important for parents, teachers and others who work with children
to have access to professionals and procedures for identifying only those
youngsters who are actually in need of the usually prescribed ADHD treatments.
The Counseling and Assessment Service, P.C. provides services to ADHD
children and their parents through Dr. George Harper, Licensed Psychologist.
In his 26 years of experience in evaluating and treating children, Dr.
Harper has worked with numerous physicians, parents, teachers and others
in attempting to understand the behavioral and emotional problems of children.
Dr. Harper emphasizes not only the assessment of the signs of ADHD but
also the severity of each of the identifying characteristics. Additionally,
Dr. Harper is well aware of the difficulties in evaluating youngsters
whose behavior may change from one setting to the next, and of the importance
of sorting out other emotional and behavioral problems which often mimic
ADHD but may lead to inappropriate diagnoses and treatment.
The diagnostic procedure consists of parent and child interviews, behavioral
observations, parent and teacher rating scales, carefully selected psychological
tests, and a sophisticated computer measure of attention, impulsivity
and reaction time. (The computerized measure can be readministered to
assist the collaborating physician in verifying the actual benefit of
prescribed psychoactive medication). Available developmental, medical
and educational background information is quite significant and is reviewed
and considered. The length and scope of the assessment procedure varies
depending upon initial findings. Typically the assessment requires about
two to three hours with the parents and the child. Additional time is
required for scoring and interpreting tests and, when requested, for the
preparation of a formal and comprehensive written report.
The written report is usually in the format of a letter to the parents
in which the results of the evaluation are carefully explained and specific
recommendations are made for treatment, follow-up and further evaluation,
if necessary. Every effort is made to produce a report which is understandable
to all parties involved with the child, with the dissemination of this
report to be at the discretion of the parents via their personal distribution
or signed authorization for release. Authorization for release to the
referring professional is very strongly encouraged.
Individual counseling for the child with ADHD can be effective under some
circumstances. If this child also functions with another disorder, such
as depression or post traumatic stress disorder, counseling for these
other problems may be effective and, in some cases, may even diminish
the severity of the ADHD symptoms. However, counseling specifically for
impulsivity and attention span difficulties is usually not effective.
On the other hand, short term counseling for the parents of the ADHD child
is often indicated to assist them in understanding the disorder, structuring
the environment, and in effectively parenting. Dr. Harper offers this
service as well as consultation and/or workshops to school personnel.
Many insurance carriers cover the initial assessment of ADHD as well as
indicated and reasonable treatment. Ironically, some third party payers
will cover individual counseling with the ADHD child but not professional
consultation to the parents. Parents who are concerned about third party
reimbursement are encouraged to contact the Counseling and Assessment
Service, P.C. regarding its experience with their payer.
The Counseling and Assessment Service
, P.C. welcomes the opportunity to collaborate with referring physicians
as well as other involved professionals in the diagnosis and treatment
of its clientele.
*Fees for school consultations and/or workshops must be
negotiated individually with Dr. Harper or with Dr. Rick Jennings, Director
of the Counseling and Assessment Service.