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Identifying Inattentive ADHD-1

01/12/09
by Pam Wright

I am an elementary school special education teacher and I’m concerned that one of my students is being overlooked. I work with a 4th grade student we believe has ADHD-I (Inattentive) and a learning disability.

Several Connors forms have been filled out on him. The inattentive scores were high, activity level scores were low, overall scores were not significant. I believe that his learning disability may have much to do with his inability to pay attention and remember things.

Is the Connors form my only option to use for identification of ADHD-1? I feel that it may be outdated for this type of attention problem, especially since ADHD-I is only beginning to be researched.

I believe your concerns about the Connors surveys are justified.

As a psychotherapist with a Masters degree in Clinical Psychology and another Masters in Clinical Social Work, I have many years of experience working with children and adults with ADD/ADHD. For most of 30 years, I worked in mental health settings. I did a one year internship in school social work.

I agree with your concerns about the Connors forms. They are not objective evaluations. They are simple surveys of parent and teachers’ observations. They are not sufficient to diagnose an individual with ADD/ADHD. At a minimum, the child should receive a comprehensive psycho-educational evaluation.

In some cases, neuropsych testing is needed to pinpoint the specific problem areas and strengths. In most cases, individuals who have ADD or ADHD also have learning disabilities. The learning disabilities may be subtle but do create additional problems in the school setting.

The following information is from the web site of a psychologist who evaluates children – although she focuses on ADHD, the same requirements exist for a child who has the inattentive type of ADD:

Although pediatricians generally have experience treating children with ADD/ADHD and can describe the disorder’s core symptoms, a “snapshot” of a child’s behavior in a brief pediatric office visit is unlikely to provide a sufficient basis for assessing the presence or absence of the disorder.

  • The optimal assessment battery for identifying ADD/ADHD includes data that are gathered from multiple sources and across situations.
  • Assessment with parents should include a comprehensive developmental history, a diagnostic interview following DSM-IV criteria & norm-referenced behavior checklists.
  • School information should include direct observations and behavior checklists completed by teachers.
  • The child component of a comprehensive assessment should entail testing of academic achievement, cognitive capabilities, executive function, information processing characteristics and attentional factors.

This page has links to several fact sheets that may be helpful:
http://www.margaretkay.com/ADHD.htm

Thanks for your concerns about your student.

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8 responses so far ↓

  • 1 JRoberts 01/27/10 at 8:57 pm

    There is a new test for ADHD on the market that may help you with your concerns. It is called The Quotient and you can learn more on the website: http://www.biobdx.com. I have heard great things about this product both on news clips and from friends. It is an actual computer-based test, rather than a checklist format.

  • 2 Tess 01/15/10 at 10:58 am

    I had primarily inattentive add as a child. My symptoms are now greately reduced (or I have managed to adjust for them). I have an 11 year old son who is ADHD-I. I have answered some of these questions at http://primarilyinattentiveadd.blogspot.com.

  • 3 Sue 12/18/09 at 11:55 am

    How can I help my daughter if she diagnosis inattentive ADHD?

    Thanks

  • 4 Sheryl 10/09/09 at 3:53 pm

    Can a school Psychologist remove an ADHD diagnosis based on their testing? My child has been under the care of a childrens hospital specialtiy unit for 5 years for ADHD so we have long term documentation of diagnosis and treatment. So would the school be permitted by law to say that she does not have ADHD?

  • 5 O’tue 01/27/09 at 10:41 pm

    ADHD is a medical diagnosis and if a parent or physician is not willing to supply information to the school district to help with the assessement the inattentive side can be a moot point. I agree that this can be a child that can fall between the cracks but they are also children that respond well to behavior plans, mandatorial tutorials, and counseling.

    It can be difficult to associate all characteristics to ADHD; there can be many reasons for in-attentive or avoidant behaviors. Sometimes there are other emotional or psychological problems that parents do not want divulged. Kids today are under extraordinary pressure at home and school.They still want to be kids and just play vid. games. It is so hard to sort out. If you can get everyone on the same page, be open and honest, and allow the school to investigate beh’r, you may get it.

  • 6 Roy 01/18/09 at 4:42 pm

    I recommend you find a ADHD doctor that can monitors the individual closely. We were fortunate to find a great local doctor. With his help our child is doing much better. The Dallas ADHD Treatment Center is wonderful if you are in the Dallas area.

    - Roy

  • 7 Debbie 01/12/09 at 4:58 pm

    This teacher can also refer the child to the Special Education team. They can perform some of the needed tests without cost to the parents. Additionally, with her suspicion that the learning disability may be contributing to the ADD symptoms, providing supports to address the LD may make the ADD diagnosis less important. If this neurological condition exists, it will still exist after LD supports are in place. Identifying AD/HD too frequently puts pressure on parents to medicate. Some doctors will prescribe stimulant medications based solely on a teacher’s concerns, without really developing a differential diagnosis.

    The Special Ed referral is something the teacher can do. Please do not surprise the parents. Bring them in, explain how the testing around the LD can be done by the school at no cost and get their approval.

  • 8 Mindy 01/12/09 at 12:14 pm

    I have a similar questions. I am unfamiliar with the tests that may be done as part of the CST evaluation. I have an Auditory Processing Evaluation which was done privately one year ago (no need to do that). However, I am uncertain as to which tests I should request besides the Woodcock Johnson. This is the first time my 14 year old daughter will be evaluated by the CST. She will be entering high school in September. She is treated for OCD (anxiety), ADHD, and mood disorder.
    Could someone please steer me in the right direction? Thanks