When a parent has concerns about inattention or hyperactivity, they may seek an ADHD evaluation. The first question they might have is “Who is the best person to complete this evaluation?” There are different schools of thought on this, but in my opinion, the most important question is not “What type of professional should complete the evaluation?” Instead of looking at the title of the person, consider looking at the thoroughness of the evaluation they would complete. Medical doctors, School Psychologists, Clinical Psychologists, and Psychiatrists are all qualified to diagnose Attention Deficit Hyperactivity Disorders. It is my opinion that one group is not better than another. It’s the methods of the individual evaluator that is most important to consider.
With that being said, some will say that a medical doctor should diagnose ADHD, because it is a medical condition. The medical doctor can rule out other medical conditions. However, I can give you a list of doctors that I personally know will give an ADHD diagnosis after a 15 minute interview with the parent. I know a doctor who will give medication to a child and if it works, then give a diagnosis and if it does not work, say “it must not be ADHD.” I also know of a practice that works collaboratively with the school and a Clinical Psychologist in their office as part of the process of the evaluation. Within the medical profession, as any profession, there is a large spectrum in the quality of the type of evaluation completed.
Another school of thought is that the schools should complete the evaluation as it relates to school difficulties. This can be done effectively when a school uses a multidisciplinary approach. When looking at special education services, the student’s disability must cause academic impairment. However, a student can have a diagnosis of ADHD and not be eligible for special education. Schools often approach evaluations as whether they would meet special education criteria. Some schools will do an excellent job of completing an evaluation for Attention Deficit Hyperactivity Disorders, while others do not. In fact some schools will not evaluate for ADHD and require a medical diagnosis instead.
According to the Diagnostic Criteria in the DSM-IV-R, there must be an impairment in two or more settings, not just school or home. Whoever is conducting the evaluation must consider both settings. Doctors can send rating scales to teachers and review previous records. Schools can interview parents and send rating scales home. As a parent, if your child is being evaluated for ADHD, carefully consider whether the evaluator will be looking into all perspectives.
Questions to ask an evaluator prior to agreeing to an evaluation:
1. Will you use multiple sources as informants (teacher, parents, observations)
2. How will you be ruling out medical conditions and other learning disabilities?
3. What types of assessment procedures will you be using?