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• W10543319 abstract "While it is acknowledged that there is no flawless measure of attention deficit/hyperactivity disorder (ADHD) in childhood, a review of the literature reveals significant agreement in recommended assessment procedures. An overview of these procedures is presented in this paper. It begins with the diagnostic criteria for ADHD, such as symptom duration, inattention, hyperactivity, impulsivity, developmental level, symptom onset, symptoms appearing in multiple settings, clinical significance, and the ruling out of other disorders that might cause the symptoms. paper then discusses procedures recommended in a sample of the literature that discuss ADHD diagnosis, including diagnostic procedures, rating scales, interviews, parent interviews, direct observation, laboratory and psycho-educational tests, medical evaluation, a review of school records, and peer assessments. It was found that rating scales, interviews, observations, and laboratory/psycho-educational testing were the most frequently recommended diagnostic techniques, although the efficacy of some of these techniques is questionable. It is emphasized that the diagnosis of ADHD is a matter of an educated opinion and that no single psychological or medical test is recommended for use in diagnosing ADHD. Furthermore, a number of other factors or conditions can create ADHD-like symptoms. Contains 48 references. (RJM) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. ******************************************************************************** Diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in Childhood: A Review of the Literature. Stephen E. Brock Lodi Unified School District, Lodi, California PERMISSION TO REPRODUCE THIS U.S. DEPARTMENT OF EDUCATION MATERIAL HAS BEEN GRANTED BY Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION S CENTER (ERIC) 0 document has been reproduced as received Iron, the person or organization originating It O Minor changes been made to improve Cif) TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC). BEST COPY AMIABLE 2 reproduction Quallty Points of new or opinions stated in the document do not necessarily represent official OE RI position or policy Diagnosis of Attention Deficit /Hyperactivity Disorder (ADHD) in Childhood: A Review of the Literature Stephen E. Brock' Lodi Unified School District, Lodi, California Abstract From a review of the recent literature this article discusses the process of diagnosing Attention-deficit/Hyperactivity Disorder (ADHD) in children. First, the article discusses diagnostic issues generated by the Diagnostic and Statistical Manual of Mental (American Psychiatric Association, 1994). Then it presents procedures recommended in a sample of publications that discuss ADHD diagnosis. Results of this literature review found rating scales, interviews, observations and laboratory/psychoeducational testing to be the most frequently recommended diagnostic techniques. Other less frequently recommended procedures were medical evaluations, peer assessments, and reviews of school records.From a review of the recent literature this article discusses the process of diagnosing Attention-deficit/Hyperactivity Disorder (ADHD) in children. First, the article discusses diagnostic issues generated by the Diagnostic and Statistical Manual of Mental (American Psychiatric Association, 1994). Then it presents procedures recommended in a sample of publications that discuss ADHD diagnosis. Results of this literature review found rating scales, interviews, observations and laboratory/psychoeducational testing to be the most frequently recommended diagnostic techniques. Other less frequently recommended procedures were medical evaluations, peer assessments, and reviews of school records. Because there is no single procedure that will reliably diagnose ADHD (Lin-Dyken & Wolraich, 1991; Morriss, 1992, March/April), diagnosis is a complex process (Anastopoulos & Barkley, 1992). Further complicating matters are the variety of other disorders that can co-exist with and/or cause ADHDlike symptoms (Barkley, 1990; Schaughency & Rothlind, 1991; Swanson, 1992). As a result, this diagnosis is a time consuming process ideally invoNing multiple diagnostic procedures (Anastopoulos & Barkley, 1992; Atkins & Pelham, 1991; Barkley, 1990, 1991; Guevremont, Du Paul, & Barkley, 1990; Landau & Burcham, 1996; Schaughency & Rothlind, 1991), conducted by several different specialists (Swanson, 1992), obtaining information from multiple sources (Barkley, 1991; Guevremont, Du Paul, & Barkley, 1990; Landau & Burcham, 1996; Schaughency & Rothlind, 1991). While it is acknowledged that there is no flawless measure of ADHD (Atkins & Pelham, 1991) a review of the literature has found significant agreement in recommended assessment procedures. This article will review these procedures. Before doing so, however, it begins with a discussion of the American Psychiatric Association's (1994) ADHD diagnostic criteria. ADHD Diagnostic Criteria ADHD is a diagnostic category found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) published by the American Psychiatric Association (1994). In DSM IV ADHD is placed within the subclass of Usually First Diagnosed in Infancy, Childhood, or Adolescence (pp. 37-121) known as Attention-Deficit and Disruptive Behavior Disorders (pp. 78-94). Along with ADHD, this subclass includes Conduct Disorder and Oppositional Defiant Disorder. According to DSM IV, the primary symptoms of ADHD are developmentally inappropriate degrees of inattention, impulsiveness, and hyperactivity. Using DSM IV criteria (Table 1) a child can be diagnosed as Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive, Predominantly Hyperactive-Impulsive or Combined types. Diagnostic criteria for the Predominantly Inattentive Type require that six or more of the nine symptoms of inattention be present. Criteria for the Predominantly Hyperactive-Impulsive Type require that four or more of the six symptoms of hyperactivity and impulsivity be present. Criteria for the Combined Type require that both Inattentive and HyperactiveImpulsive criteria be mete. Although the specific behavioral symptoms presented by DSM IV are self explanatory, other diagnostic requirements deserve further elaboration. Symptom duration. First, the criterion behaviors must have persisted for at least 6 months . (American Psychiatric Association, 1994, p. 84). It has been suggested that strict adherence to this requirement is especially critical when assessing preschoolers. Up to 40% of this population is rated as inattentive and overactive by their parents. However, in the majority of these cases concerns remit within three to six months. In other words, significant inattention and hyperactivity in the three to four-year-old is not necessarily indicative of a persistent pattern of ADHD (Barkley, 1990). author would like to thank Carolyn Fisher and Bev Gabrielson for their helpful comments on earlier drafts of this paper. The use of these fixed cut-off scores, generates a diagnostic issue that needs to be mentioned. It has been argued that a fixed score fails to take into account developmental differences. As younger children are frequently viewed as having short attention spans and as being hyperactive, use of the single criterion scores for all age groups may tend to over identify young children. Conversely, it may be too exclusive when applied to older age groups (Barkley, 1990)." @default.
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• W10543319 title "Diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in Childhood: A Review of the Literature." @default.
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