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Attention deficit hyperactivity disorder

ADHD is a Neurological condition/Disruptive Behaviour Disorder characterized by the presence of a set of chronic and impairing behavioural patterns that display abnormal levels of inattention, hyperactivity, or their combination.

Qualified professional

Professionals conducting assessments and rendering diagnoses of ADHD should have training in differential diagnosis of ADHD. The name, title, and professional credentials of the evaluator, including information about license or certification should be clearly stated in the documentation. The following professionals would generally be considered qualified to evaluate and diagnose ADHD: clinical psychologists, neuro-psychological, psychiatrists, and other relevantly trained medical doctors and professionals.

All reports should be on letterhead, typed, dated, signed, and otherwise legible. Douglas College has the responsibility to maintain the confidentiality of the individual's records.

Documentation

A diagnostic evaluation must have been completed within the past five years. Furthermore, observed changes may have occurred in the individual's performance since previous assessment of ADHD, or new medication(s) may have been prescribed or discontinued since the previous assessment was conducted. In such cases, an updated evaluation report may be required.

Evidence of current impairment

It is recommended that the following areas be covered in the report:

Statement of Presenting Problem

A history of the individual's presenting attentional symptoms should be provided, including evidence of ongoing impulsive/hyperactive or inattentive behaviours that significantly impair functioning in two or more settings.

Diagnostic interview

The information collected for the summary of the diagnostic interview should consist of more than self report, as information from third party sources is critical in the diagnosis of ADHD. The diagnostic interview with information from a variety of sources should include, but not be limited to the following:

History of presenting attentional symptoms, including evidence of ongoing impulsive/hyperactive or inattentive behaviour that has significantly impaired functioning over time

Developmental history

  • Family history for presence of ADHD.
  • Relevant medical and medication history, including the absence of a medical basis for the symptoms being evaluated.
  • Description of current functional limitations pertaining to an educational setting that are presumably a direct result of problems with attention .
  • Rule out of alternative diagnoses or explanations.

The evaluator may wish to include a discussion of the possibility of dual diagnoses, and alternative or coexisting mood, behavioural, neurological, and/or personality disorders which may confound the diagnosis of ADHD.

Relevant testing

Neuropsychological or psycho educational assessment is important in determining the current impact of the disorder on the individual's ability to function in academically related settings. The evaluator should objectively review and include with the evaluation report relevant background information to support the diagnosis. Test scores or subtest scores alone should not be used as a sole measure for the diagnostic decision regarding ADHD.

Learning, physical, or psychological difficulties deemed relevant by the examiner. Selected subtest scores from measures of intellectual ability, memory functions tests, attention, or continuous performance tests do not in and of themselves establish the presence or absence of ADHD. Checklists and/or surveys can serve to supplement the diagnostic profile but in and of themselves are not adequate for the diagnosis of ADHD.

Identification of DSM-IV criteria

A diagnostic report should include a review and discussion of the DSM-IV TR criteria for ADHD both currently and retrospectively and specify which symptoms are present.

Documentation must include a specific diagnosis

The report must include a specific diagnosis of ADHD based on the DSM-IV diagnostic criteria. The diagnostician should use direct language in the diagnosis of ADHD, avoiding the use of terms such as "suggests," "is indicative of," or "attention problems." Individuals who report only problems with organization, test anxiety, memory and concentration in selective situations do not fit the diagnostic criteria for ADHD.

Each accommodation recommended by the evaluator should include a rationale

The diagnostic report should include specific recommendations for accommodations that are realistic and that the college can reasonably provide. A detailed explanation should be provided as to why each accommodation is recommended and should be correlated with specific functional limitations determined through interview, observation, and/or testing.

A prior history of accommodations, without demonstration of a current need, does not in itself warrant the provision of a like accommodation. If no prior accommodations were provided, the qualified professional and/or the individual should include a detailed explanation as to why no accommodations were used in the past and why accommodations are needed at this time.

Because of the challenge of distinguishing normal behaviours and developmental patterns of adolescents and adults (e.g., procrastination, disorganization, distractibility, restlessness, and chronic tardiness or in attendance) from clinically significant impairment, a multifaceted evaluation should address the intensity and frequency of the symptoms and whether these behaviours constitute impairment in a major life activity.