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A literature review of the diagnosis and assessment of Attention Deficit-Hyperactivity in shool-age children: A multimethod approach

27 July 1990


School-age children who evidence symptoms of Attention Deficit-Hyperactivity Disorder are typically given that diagnosis based on the subjective reports of parents or teachers, and possibly an examination by a family physician. A review of the literature suggests that a more comprehensive assessment of these children is necessary, in order to rule out a variety of other pervasive childhood
conditions. The literature on Attention Deficit-Hyperactivity Disorder has been in a state of flux, confusion, and controversy since the disorder was first identified in terms of etiology, differential diagnosis, reliability and validity of available diagnostic and assessment measures, as well as course and treatment. The
recent childhood diagnostic and assessment literature would suggest that there is no one technique or test battery that will provide all the information which might be needed to arrive at a definitive diagnosis for a specific childhood
condition. Instead, it is generally recommended that a broad-band multimethod model be utilized, within which is contained both broad and narrow-band assessment instruments. In the current literature, the most comprehensive
multimethod model is best represented by the comprehensive neuropsychological evaluation. In this review several assessment instruments are described, evaluated, and recommended for inclusion in a test battery that will not only provide information on Attention Deficit-Hyperactivity Disorder, but will also provide a holistic impression of the child's strengths and weaknesses in a variety of intra and interpersonal domains. The implications of a misdiagnosis of
ADHD has it's most profound impact on treatment selection. There can be serious consequences to the child who is misdiagnosed because the child may become a candidate for a medication trial, or his or her true condition will not
receive the appropriate intervention. The literature suggested that many children have been placed on stimulant medication by family physicians, based on the subjective impressions of parents and teachers once the child's
behavior becomes intolerable. It would seem at the very least prudent, and at most ethically and professionally responsible to conduct a comprehensive evaluation of these children prior to considering a trial of medication. It is
also clear from the literature that a misdiagnosis can impact other areas of the child's life and relationships. When considering a diagnosis of AD-HD in a school-age child the neuropsychological assessment battery can serve as an
important component in a comprehensive attempt to "rule out" a variety of possible problems or conditions of unknown etiology and course.


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