Should I do an ADHD evaluation for my child?

We all want our children to live life feeling happy, successful, and confident. The truth is when a child is feeling incapable, constantly in trouble, or otherwise unsuccessful at home or at school, this begins to affect how they feel about themselves overall. It can be a scary process for parents to seek an ADHD evaluation for their child who is displaying symptoms of ADHD. Fears of a label or fears of what this will mean for the future of their child can be overwhelming. Dealing with these struggles on their own can be a tempting option for parents.

Unfortunately, children with Attention Deficit Hyperactivity Disorder (ADHD), begin to feel ‘bad,’ ‘stupid,’ and different from those around them. At school, they often find themselves getting in trouble for blurting out comments, not following directions, getting out of their seat in class, or engaging in inappropriate behaviors. Children experiencing these symptoms  can start to fall behind in school, feel school work is too hard, and have difficulty completing academic tasks. 

While these issues are almost always separate from a child’s actual intelligence, children often report feeling ‘stupid.’ Between frequently getting in trouble and struggling with learning, these kids often start feeling different, and “less than,” compared to their peers. Unfortunately, these kids often get labeled as simply ‘misbehaved’, especially when their symptoms get mis-identified as laziness, low-motivation, or defiance.

Not only do these difficulties affect children at school, but the issues continue at home. At home, parents of children with ADHD (especially before a diagnosis) report a wide range of difficulties. Common issues include frequent arguments, perceived disrespectful behaviors, and emotional outbursts. Parents often report their child has emotional difficulty stopping what they’re doing, completing basic tasks, or following directions. 

Since they have usually received negative feedback about their child’s behavior at school, these parents can start to feel pressure to “fix” these behaviors in their child. Before long, the child can start internalizing the “bad kid,” label at home too, feeling as though they can’t do anything right. Parents often have similar thoughts, feeling “I’m trying so hard, but nothing is working.”

All too often, when left unaddressed, children showing difficulties with impulsivity, trouble focusing, and learning difficulties, have these issues added with emotional struggles such as feelings of guilt, lowered self-esteem, and frequent episodes of anger. Parents may “clamp down” harder on problem behaviors, usually with little success, leading both child and parent to feel unsuccessful, emotionally tired, and losing hope that things can change.

Perhaps for you it play out like this:

As you pick up Jimmy from school one Thursday, the teacher asks for a word with you. “Jimmy was being disruptive when I was trying to teach today. He kept getting up and trying to talk to kids, and wouldn’t listen when I told him to stop. Please talk to him about being respectful.” ‘I talk to him about respect all the time,’ you think to yourself as you nod to the teacher. This is far from the first time you’ve gotten this feedback. In fact, a part of you is glad the teacher didn’t say he pushed somebody again or that he has more missing work to make up.  

You make it home and after Jimmy finishes his snack, you hand him his backpack and ask him to get out his homework as you go put his little sister down for a nap. 10 minutes later you come down to find Jimmy’s backpack untouched and that he has dumped out a huge box of blocks and is playing with them. A familiar argument breaks out and eventually Jimmy begrudgingly goes to the table and begins his homework. The blocks stay on the floor. The next hour is filled with you trying to stay calm as you repeatedly remind Jimmy to keep working, sit back down, and stop fidgeting with things around him. Eventually, you sit down next to him and walk him through the seemingly ‘easy’ math assignment. You’re not sure if he understands it any better by the end, but at least it’s done. Hopefully he remembers to actually turn it in tomorrow.

You remind yourself that the weekend is almost here. You wish you could fully look forward to it, but find yourself trying to think of how you’re going to fill the time. You’d like Jimmy to be able to spend at least a few minutes playing quietly, but you know unless he’s in front of the TV or playing video games, he will be complaining of boredom, creating a mess he’s unwilling to clean up, or even worse, breaking something. You try to make sure Jimmy has a fun, relaxing weekend to gear up for the next week of school, but you worry the weekend will be filled with needing to ‘correct’ him constantly and figuring out a way to have him make up his missing work. You feel like you’re chasing your son more than getting to enjoy the fun, sweet boy he is.

Eventually, you wind up feeling there has to be some more support for your child. You start thinking, ‘shouldn’t the school be doing more to help my child feel successful? What else can I be doing at home?’ You see your child struggling to feel accepted and valued. You know there may be something not quite right with how your child is developing. It’s not as simple as “he just doesn’t listen.”

It can certainly be overwhelming to parent a child struggling with these symptoms without support or without knowing what is really going on. However, if we can learn more about how your child’s mind is working, it can result in increased understanding of what your child is experiencing, and more importantly, give a positive direction regarding how you can help. When we have a more complete picture of a child’s neuropsychological functioning, we can tailor supports to fit their individual needs, and ultimately, promote confidence in both child and parent.

Keep reading to learn more about the value of ADHD evaluations.

Without learning more about what is really going on for your child, life continues to be a struggle. You try to do your best to advocate for your child, address teachers’ concerns, and manage your child’s emotions. Your child may feel there is something wrong, and continues to lose self-esteem. You are all doing your best, but it feels like you are just treading water.

When you get a neuropsychological evaluation, we learn more about why and how your child’s mind is working. There are certainly strengths just as there are likely areas of weakness. By having a more complete picture, we achieve a different level of understanding about what’s going on for the child, and can start tailoring supports to fit the true needs rather than just delivering consequences.

Over time, with a clearer picture of how your child’s mind works, his strengths can be highlighted and interfering behaviors more effectively addressed. As proper support is put in place, your child can begin to thrive. Strategies can be implemented to help prevent hyperactivity, promote focus, and target your child’s motivation.

Take a look at what an ADHD evaluation entails

At Simi Psychological Group, a neuropsychological evaluation assessing for ADHD (and other learning issues) consists of several components:

Step 1: Clinical Interviews and Questionnaires

The first step is administering a developmental interview with you, the child’s parent(s). By learning more about your child’s early development as well as current concerns, a clearer picture emerges of how symptoms have developed over time. Learning more about school history and how current concerns are showing in your child’s life can help determine the course of the assessment. As part of the assessment process, you will also complete important questionnaires related to your child’s behavior, social skills, and/or independence.

Another part of this step is contacting your child’s teacher (with your permission) to obtain a better picture of what is occurring at school. Through questionnaires and/or an interview, a description of your child’s difficulties at school, as well as their strengths, can effectively be obtained.

Step 2:  Cognitive Assessment

A cognitive assessment (IQ test) is conducted. This test serves as a starting point for your child’s cognitive ‘potential.’ Usually, a simple IQ score is not the most representative piece of information obtained on the cognitive assessment. Instead, it involves information about several areas of intelligence including verbal skills, visual-spatial skills (e.g. puzzles, patterns, etc.), reasoning ability, short-term memory, and efficient processing of information. By looking at these different areas, we can start to get a more complete picture of your child’s strengths and weaknesses. Certain combinations of strengths and weaknesses may indicate an issue such as ADHD, or potentially other issues. For example, many children with ADHD perform noticeably more poorly on short-term memory tasks or tests of processing speed (which looks at being able to do ‘easy’ tasks quickly without making simple mistakes). 

Step 3: Academic Testing

An academic evaluation is included as an important component of an overall neuropsychological evaluation. By looking at your child’s academic knowledge and skills, we can screen for potential learning disabilities. Often times, a child’s struggles in school are related to an underlying difficulty in a specific area of learning such as reading, mathematics, writing, processing verbal information, or processing visual information. An academic evaluation again provides a clearer picture of your child’s strengths/weaknesses while looking for any potential learning problems.

Step 4: Attention and Executive Functioning Assessments

You may have heard the term ‘executive functioning.’ What this term refers to is the set of processes involved in important aspects of our lives including planning, shifting our attention, controlling impulses, and managing our attention. Being able to control attention is an important part of what a child is asked to do both at school and at home. This is different than just “paying attention,” and instead often involves not paying attention to sounds, smells, and other distractions around us, as well as being able to shift our attention from something interesting when necessary. For example, parents often report feeling their child with ADHD can really focus on enjoyable tasks (e.g. video games, building, drawing, etc.). On less interesting tasks, distractions such as different sounds, smells, or small objects around them tend to easily interrupt their focus. Tests of attention and executive functioning help describe specific areas that may be underdeveloped in a child and that may be contributing to issues with attention and impulsivity.

Step 5: Careful Interpretation of Results with Individually Tailored Recommendations

After the evaluation is complete, a detailed report is created with a clear interpretation of the results. Describing your child’s functioning in the different areas assessed helps paint a picture of his/her overall strengths and difficulties. A child’s results on a neuropsychological evaluation can warrant a diagnosis such as ADHD, a specific learning disorder, etc. On some occasions, the evaluation does not result in a diagnosis if the child’s scores are consistently within the expected range. Regardless of a diagnosis, recommendations are provided for both home and school to ensure the child is receiving supportive interventions to help address their symptoms. Parents are connected with resources that can help their child and help them feel more confident managing their child’s symptoms.

WHAT YOU CAN EXPECT DURING AN ADHD EVALUATION PROCESS

The assessment process usually takes about 5-6 in-person sessions. Typically, the first session is with just the parent(s) and designed to help you feel comfortable with the examiner and the testing process, as well as to obtain information about concerns. Your child will typically come into the office 3-4 times for about 2 hours. During these sessions, they are doing several various tasks that are each relatively short (usually 5-10 minutes each). Because each individual activity is relatively short, children are usually able to keep giving good effort. Also, many of the activities are presented as ‘brain games’ and kids often report feeling they are fun. During the session, children are also provided brief breaks to encourage motivation and make sure they are able to give their best effort. At the end of each session, parents are given a brief update about what tests were given that day and how their child responded. The final session is again with the child’s parent(s) and involves going over the report with the results, describing the findings in a meaningful way, providing clear recommendations for the future, and answering your questions. 

It can be a scary decision to seek an evaluation for your child. However, you will find that learning about your child’s strengths and weaknesses, and having a clearer picture about his/her needs can be an empowering process. After completing an evaluation, parents often report feeling they have a sense of direction on concrete and practical ways they can help their child succeed. Better understanding why your child may be showing certain behaviors can help these difficulties feel less personal to both you and your child. Parents often report feeling they are better able to advocate for their child’s needs at school and elsewhere, as they have a better understanding of what those needs are. As a parent, these changes can help ease the feeling of overwhelm you may be experiencing, and help provide an opportunity to better connect with your child. As your child also begins to learn about his/her strengths, while also receiving the right types of support for areas of struggle,  they can begin to feel understood, supported, and confident. 

While the idea of starting a neuropsychological evaluation for your child may be a stressful one, at the end of the process, you will be armed with information critical to understanding what is happening for your child. By the end of the process, you will feel you have a plan for supporting your child’s needs moving forward. One of the biggest benefits to the process is no longer feeling you have to do this alone. Feeling connected and supported can encourage the change you would like to see for your child, yourself, and your family. 

At Simi Psychological Group, we are here to guide through the assessment evaluation process. Call now to schedule a free consultation 805-842-1994. 

Written by,

John Danial, Ph.D.

I’m a licensed psychologist who encourages children, teens, and families to take the steps and make the changes they need to see real, lasting change in their lives.

I specialize in working with Autism Spectrum Disorder, Anxiety, Defiant behaviors, and Attention Deficit Hyperactive Disorder (ADHD) and in helping children and adolescents build confidence and strength to live their lives to their true potential. I believe that each child is unique and has the inner strength to fight through their obstacles with the support of their loved ones. So they never have to experience feeling “less than” or being labeled as “different” or “difficult.” Read more

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