ADHD Wichita Falls Comprehensive Assessments: $149
Who typically performs ADHD assessments?
There are three contexts in which ADHD assessments are done – medical, psychological, and educational.
Medical
The family physician is most often the first person that a family approaches. The advantage of working with a physician is that he or she can rule out physical problems and prescribe stimulant medication. The disadvantage is that family physicians seldom have the time to perform comprehensive assessments and will often fall back on medication as a diagnostic tool, i.e. if the medications work, it must be ADHD. The exceptions are psychiatrists whose assessments are comprehensive but can be expensive and inaccessible to many families.
Psychological
Licensed psychologists and counselors with specialized experience and training in assessing and diagnosing ADHD provide the most comprehensive assessment including a clinical interview which is generally absent from physician’s assessments. They will commonly give their clients standardized, normed inventories of ADHD characteristics. The huge advantage of a clinical interview is that these professionals are trained to recognize co-morbid conditions. It is not unusual for this type of assessment to cost $600 – $800 or more although insurance may pay some of the cost.
Educational
Assessment and diagnosis in a school setting is only available in the context of an IEP for 504 accommodations and or assignment to special education. Diagnosticians and school counselors are trained in instrumentation and measurement but typically are not trained to perform clinical interviews nor diagnose co-morbidity. It can be difficult for parents to navigate the various governmental requirements and school personnel are frequently overworked to the point that assessments are sometimes scheduled months in the future.
What is typically included in an ADHD assessment?
Clinical Interview
In the absence of a clinical interview by an experienced licensed professional, a diagnosis of ADHD can not be considered reliable. The clinician spends at least one hour and as many as three hours investigating family history, onset of symptoms, physical or mental trauma, and other diagnoses that might explain a person’s behavior.
Standardized Inventory of Characteristics
Inventories are completed by parents and teachers as well as the students themselves if adolescents. There are specialized inventory forms for adults and college students. The inventories serve several purposes: (1) confirmation of clinical interview results; (2) recognition of symptoms across multiple contexts (i.e. home, school, and other); (3) screening for co-morbid conditions. Inventories should not be used alone. Most range from 60-80% statistical reliability.
Academic or Vocational Performance appraisal
Diagnosis of ADHD is independent of IQ. However, a great deal of information about the client’s specific symptoms can be derived from academic and/or vocational performance. Is the student behind grade level in reading or math? Is work disorganized? Does the student or adult forget things or procrastinate? Can the individual control his/her behavior in the school or work environment? Should other tests be performed such as working memory or self-esteem evaluations? ADHD symptoms can arise at times when academic workloads significantly increase – 3rd grade; 8th grade; college freshman – and during stressful periods at work.
QEEG and estimated theta/beta ratio
Quantitative Electroencephalogram (QEEG) has been shown in clinical research to have reliability greater than 90% and specificity greater than 95%. It is not in widespread use today but we expect QEEG to be the diagnostic standard within the next decade. Availability is limited and cost ranges from $500 to $1,000.
Tests of Attention
Some therapists use tests of attention. While the tests can describe inattention, the inattention can be a consequence of any number of things. In our opinion, tests of attention do not provide sufficient information to be useful in an ADHD diagnosis.