I write this post as a simple way to clarify for parents, laymen and concerned family any misconceptions regarding the existence of Attention Deficit Hyperactive Disordered (ADHD) and/or Attention Deficit Disorder (ADD) without the Hyperactivity noted. (Conditions noted in the DSM-5, Diagnostic Statistical Manuel-Fifth Edition). Treatment plans for these disorders vary by using behavior modification techniques, changes in living habits such as diets, time using technology, social time with others, and yes, even medication.
Also, to all parents who have not been well informed or taken advantage of with school involvement regarding your child, I am very sorry for your experience that focuses on your most treasured gift.
As students demonstrate problematic behaviors in school that are thought to interfere with social interaction, school achievement and academic progress, the schools are expected to assist the student in question by determining what can be offered to help and create student success. The process of determining causes has federal mandates to protect all involved. Best practice involves a Psychoeducational Evaluation.
Having been a School Psychologist for 35 years I have dealt with children who are suspected to be Attention Deficit Hyperactive Disordered (ADHD) and/or Attention Deficit Disordered without Hyperactivity (ADD). Walking through the process together will reveal requirements and steps to complete that lead to evaluation. This is a valid method to provide success for a student in question and is used in all the schools I have served. It is based on best practice (defined by whatever school the student is attending) and federal guidelines that protect parents and the students in question.
- Teachers, as well as the parents, express concerns regarding student functioning. These concerns include academic functioning, attention issues, as well as social functioning with others. Teachers and parents (all referring persons) become “The overall Team”.
- The school team meets with the parents to discuss all aspects of what is seen in the school and home regarding student functioning. Teachers and all who deal with the student in question are present.
- A request for a Psychoeducational evaluation is made, written consent from the parents is attained with procedural safeguards given to the parents, and the process to reveal any student observed issues can begin.
- A complete social-developmental history is taken from the parents regarding their child’s pre- and post-natal history as well as developmental milestones, health, habits at home, diet, sleep habits, and peer relations. Parent input is vital for diagnosis. Teachers present documented patterns of student functioning at school.
- Along with the above comprehensive information, the Psychologist evaluates the student using normed and age-appropriate instruments to discern ability level, social-emotional rating scales and academic prowess. Both the teacher(s) and parents are asked to respond to the social scales which give the professionals information about the student’s functioning in a variety of settings. Again, all instruments used are normed and age appropriate.
- A behavior specialist and/ or the Psychologist observes the student in question in several settings at school. (Playground, classroom, special classes-art, music, lunch, and possibly school transportation if this is provided.
- A comprehensive report is written which includes all statistical scores taken from the test results found in the evaluation. Results are then shared with the entire team.
- If suspected ADD, ADHD issues are thought to be of concern, the parents may consult a doctor with the results so a medical professional can evaluate further. Certified School Psychologists and Licensed Psychologists can legally diagnose ADD/ADHD which may lead to special education involvement thus initiating extra help for the student under the special education category of Other Health Impairment (OHI). I continue to believe a medical doctor should be consulted, too.
Parents are a vital part of the evaluation, informants of the results that are revealed. If great disparity between teacher and parent ratings exist they become suspect and should automatically be rational for further investigation.
Only suspected disabilities as revealed by the evaluation results are considered. If needed, it becomes the school’s responsibility to initiate a behavior plan to help the student attain and improve focus. Hopefully medication is a last resort as deemed appropriate by a medical professional.
Tracking behavior for any medicated child is necessary noting positive/negative changes in functioning. Finding the right medication and dosage to be used can be very challenging. However, closely tracking and charting changes in students’ success involving social, emotional and academic progress as well as attending ability will help define if what has been prescribed is working.
Taking the easy way out by automatically defaulting to a treatment program of medication is never best practice. Using appropriate medication that is given in the right amount can be a positive solution to help remediate the discussed syndromes.
As a practicing School Psychologist, I have seen many children helped using pharmacology. However, this alone is not the answer to success. It may take a number of changes at home and school to modify the involved student ‘s functioning.
It is vital that parents be involved in all aspects of the above methods to help the identified struggling student. I have always been privileged to work with dedicated parents, teachers, and other school personal. Opposing views exist at times but there have been ways to work out what is appropriate for the success of the student, our main focus!
If this best practice has not been your experience as parents, I am sorry! I am even more sorry for students who are involved with behaviors that impede attention in the classroom, at home and impact social and learning experiences. ADHD/ADD are very true disabilities, and in my opinion, those who deny this are doing a great disservice to the student. YES, there are times when medication is called for and necessary for the student’s success, socially, emotionally, and academically. However, in my opinion, medication should be considered only as a last resort after many other methods such as diet change, behavior modification at home and at school along with the review of sleeping habits and the overuse of technology by the student are explored and modified as necessary.
God bless our children, the future of America!
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I acknowledge that assessment criteria and procedures are in place to prevent (or at least minimize) false diagnosis. I also accept that a great many psychologists work diligently to benefit their patients. But when entire professions discredit themselves – as medicine and education have done – those of us not in the field no longer trust those in the field.
Is it ethical for a psychologist to diagnose someone without even meeting them? And then to publicly publish their diagnosis? I suspect not. And yet, Dr. Brandy Lee (Yale School of Medicine faculty member) and over three hundred other medical professionals did precisely that – concerning Donald Trump. Have they been disciplined in any way? Has there been an outcry from other psychologists that this was improper behavior?
Now the American Psychological Association has issued guidelines designating masculinity as harmful. Has there been an outcry from psychologists about this that I’ve missed? The non-psychologists among us are starting to suspect that psychology has become more about ideology than mental health.
My personal experience is that schools have processes which they don’t follow, and psychologists use assessment criteria which they ignore. And we non-medical professionals are expected to follow the advice of people in a profession which has thoroughly discredited itself. I don’t think so. I’m sure there are a great many people who do suffer from ADHD. But we’ll never know if the right people are being treated, until the people doing the treating clean up their act.