ADHD Diagnosis

Attention-deficit hyperactivity disorder(ADHD) is much more prevalent in todays society
compared to previous generations. More and more people are being diagnosed at an alarming
rate. To our surprise, I learned this disorder does not only affect children. There are many adults
who suffer from it also. ADHD characteristics are neuro-biologically based, and they often
change as the individual gets older. One does not out-grow ADHD even though the behaviors, or
symptoms may not be exhibited in the same manner or with the same intensity. After learning
this fact, I thought it would be very interesting to see how this disorder affects both children and
college students. Therefore, I choose one journal article which relates ADHD to children, and the
other which deals with the effects of ADHD on college students.

The first journal article I researched, An Intervention Approach for Children with
Teacher and Parent Identified Attentional Difficulties, explained that inattention, impulsivity,
distractibility, and restlessness are all signs of a child with an attention-deficit hyperactivity
disorder. There are three subtypes of ADHD which have been defined by the Diagnostic and
Statistical Manual of Mental Disorders as: predominantly inattentive, predominately hyperactive
impulsive, and combined (Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor,
1999). Usually children who exhibit these subtypes have difficulty completing assignments,
displaying high qualities of work, and maintaining good behaviors. Children with the
hyperactivity-impulsivity subtype do not display significant attentional problems, though they are
identified as young as pre-schoolers. However, symptoms of inattention dont typically emerge
until the later ages, which must be why the predominately inattentive and combined subtypes of
ADHD have been found in older school-age children.

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These children who have been identified as having ADHD, show an inability to
use effective problem solving over a period of time. When researchers looked at their brain
structures, they found that the frontal-striatal regions are involved with the childs ability to
inhibit, focus, and shift attention.

Researchers have formed interventions involving the behavioral or cognitive
management of children with ADHD. Attention-training strategies, classroom-based
contingency systems, home-school contingencies, and peer-mediated contingencies are examples
of these interventions. In an effort to measure students with ADHD, in addition to medication
and intervention strategies, researchers conducted two types of tests.

The first test, the visual attention task, required the child to scan fourteen rows of
ds, each d had one to three marks around it. The child was instructed to select the ds with two
marks around them. The children were also told to move down to the next row every twenty
seconds. The score is calculated by subtracting the errors from the total amount correct. It was
suggested that this task assesses the capacity for sustained attention as well as accurate visual
scanning and inhibition of rapid responses(Semrud-Clekeman, Nielsen, Clinton, Sylvester,
Parle, and Connor, 1999, p. 585).

The second test, the auditory attention task, required the child to listen to random
letters and numbers. Afterwards, they were asked to remember how many letters or numbers they
heard. The child must keep in mind the letters and numbers they heard for each stimulus at the
same time. The test starts out with four stimuli and finishes with twelve. This task has been
hypothesized to be a measure of auditory divided attention as well as sustained
attention(Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999, p. 585).

The results of this study confirmed that children with ADHD who had help
through the intervention programs showed an increase in their performance on visual and
auditory attention tasks, while the other children without the help of intervention programs did
not show any improvement. These children most likely represent a continuum of attention and
activity / impulsivity problems and may describe the population of children with significant
attention problems who are infrequently referred for an assessment beyond the
pediatrician(Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999, p. 587). It
seems very probable that children with attention and work completion difficulties without
significant behavioral and learning problems often go unaided in classrooms today.

The second journal article I selected is titled Psychological Functioning
Differences Among College Students With Confirmed ADHD, ADHD by Self-Report Only, and
Without ADHD. In an attempt to understand attention- deficit hyperactivity disorder, professor
Lee A. Rosen, psychologist Cori Ann Ramirez, and doctoral student Tracy L. Richards have
researched the effects this disorder has had on college students. College students were researched
based on three categories: those with confirmed ADHD, those with self-reported, and students
without ADHD. The team of researchers had difficulty in diagnosing students with ADHD
because of three factors: establishing a childhood history of ADHD, conducting careful
differential diagnoses, and assessing for comorbid diagnoses (Ramirez, Richards & Rosen,
1999, p.299) Researchers also found that the abuse of drugs and/or alcohol, as well as various
other diagnoses are usually associated with ADHD.

As I learned from the first research article, symptoms of this disorder include
inattention, hyperactivity, and impulsivity. When researchers noted the symptoms in college
students, they found many of these students exhibiting restlessness, impulsivity, distraction, poor
performance in academic settings that require sustained attention and behavior regulation. To
measure students for ADHD, researchers used several tests: the Brief Symptom Screening
Form(BSSF), a self- report measure of ADHD, a Background Questionnaire, which involves
information of ethnicity and medical history, and the ADHD Behavior Checklist for Adults was
used to measure the symptoms of ADHD over the past six months of the persons life as well as
their childhood. The other tests used were the Wender Utah Rating Scale(WURS), which helped
to measure an adults assessment of their own childhood, the Symptom Checklist-90-R
(SCL-90-R), that consists of ninety items to assess psychological symptoms of psychiatric and
medical patients, and the last analysis used was The Conduct Disorder Scale, which instructed
students to admit to any delinquent activities they took part in within the past twelve months.

After researchers measured the scores from the aforementioned tests, they found
that ADHD students and self-reported ADHD students scored very similar. Although the results
between the two groups showed similarities, there were many problems in assessing the scores.

Self-reported students and their parents did not agree on their condition. The article states, that
parental recall of childhood behavior is more valid than patient recall because often times
students may forget, exaggerate, or underestimate their own childhood behavior (Ramirez,
Richards & Rosen, 1999, p. 304) Also, students of the self-reports could have been lying when
answering the questionnaires. As one can see, this study may not be the most accurate way to
determine if someone truly does have ADHD.

Overall, researchers agree that attention- deficit hyperactivity disorder is a
common issue amongst college students, especially those who do not know why they are
experiencing certain inabilities. Researchers feel that without proper measurements, many
students who suffer from ADHD will not receive the appropriate assistance deemed necessary,
and they will continue to have attentional problems that will interfere with their academic
performance.

The popular media article found in U.S. News and World Report , Taking a
Picture of a Mind Gone Awhirl, focuses on a new imaging method used to diagnose ADHD. It
is said to be the first definitive test for ADHD. The new diagnostic exam, developed by
psychiatrists at McLean Hospital in Belmont, Mass., uses an infrared tracking device to measure
difficult-to-detect movements of children as they attempt a tough but boring attention test,
pressing the space bar each time a particular kind of star appears for a brief moment somewhere
on the computer screen (Schrof Fischer, 2000). Researchers began a study on eleven boys who
had previously been diagnosed with ADHD and six boys who do not have this disorder. If the
boys pressed the space bar too quickly, it demonstrated how impulsive they were. If they did not
notice one of the stars on the screen, it determined how much their attention wandered. Using
this rigorous screening, only six of the eleven boys were confirmed to fit a strict definition of
ADHD (Schrof Fischer, 2000). This in turn means that five of the boys did not fit the strict
definition of ADHD. Therefore they must have been misdiagnosed at some point. The article also
discusses a part of the brain called the putamen and how it is different in an ADHD child.

It seems as if this new test could be a much better way of diagnosing someone
with ADHD compared to the methods used in the two journal articles. I feel the research
presented in the journal articles does support the report in our popular media article by
illustrating that there is continuous research taking place that just seems to be getting better as
time goes by. All three articles also helped confirm my awareness of the fact that ADHD is
presently such a widespread problem. The articles also helped me to realize how many
individuals are misdiagnosed. All types of disorders, from anxiety to manic-depression to
conduct disorders, are now mistaken for ADHD, and everyone suffers for that diagnostic
sloppiness (Schrof Fischer, 2000). It comes as a relief to know that with modern technology,
comes more accurate ways a determining whether an individual is suffering from ADHD. If this
new test is confirmed to be reliable, it could help correct both the overuse of Ritalin and the
undertreatment of kids whose ADHD is missed by the naked eye (Schrof Fischer, 2000). All in
all, Ive learned a great deal about attention deficit hyperactivity disorder, and I am glad to now know that there is hope for our future generation to be prepared with more improved methods to accurately diagnose people with ADHD.

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