 |
||||||
|
||||||
|
 |
|
|
||||||||
 |
||||||||
|
Find out in this Q&A with the authors of ADHD Diagnosis & Management: A Practical Guide for the Clinic & the Classroom |
|
About the authors  Mark L. Wolraich, Ph.D., is chief of the Section of Developmental and Behavioral Pediatrics at the University of Oklahoma Health Sciences Center. He received his M.D. from the State University of New York Upstate Medical Center in Syracuse. Dr. Wolraich has been a major contributor to the development of guidelines for ADHD for primary care physicians by the American Academy of Pediatrics. He has spent more than 30 years in research and clinical service related to ADHD and is a 2003 inductee in the Children and Adults with ADHD (CHADD) Hall of Fame. Currently, he is investigating the prevalence and long-term outcomes of ADHD in five school districts.
Dr. DuPaul is the recipient of the Senior Scientist Award from Division 16 (School Psychology) of the American Psychological Association and was named to the Children and Adults with ADHD (CHADD) Hall of Fame in 2008. Currently, he is investigating the effects of early intervention and school-based interventions for students with ADHD as well as the assessment and treatment of college students with ADHD. Questions? Customer Service: |
Q: Is there a blood test or brain scan that can determine whether a child has ADHD?
A: No, there are no specific images or blood tests that will diagnose the condition. The diagnosis depends on observing a specific pattern of behaviors by the people closely associated with the child. Q: What does ADHD look like in the classroom? A: Students with ADHD frequently are off-task and inattentive in the classroom and can disrupt learning activities for the entire group. They may leave their seat frequently and violate classroom rules. They may have difficulties completing assignments on time or do so very inconsistently or with minimal accuracy. As a result, they fall behind their peers academically. Q: In your new book ADHD Diagnosis & Management, you note how critical it is for clinicians to have both the teacher's and the parents' perspective in determining treatment for a student with ADHD. Why is that so critical? A: Children spend their working day (6 hours) in the school setting and it is frequently the most taxing time for them so the teachers' observations are critical in making a diagnosis. The parents observe their children in multiple settings and usually have known their child longer than anybody else so they are the other critical element. Q: For a teacher in the classroom who is seeing behaviors characteristic of ADHD, how does she know when further evaluation is warranted? A: When a student appears inattentive, impulsive, or overly active on a consistent basis and to a much higher degree than classmates, teachers should discuss the possibility of an evaluation with the school psychologist, school counselor, and the student's parents. Q: Do you recommend screening for ADHD? A: Ideally, screening for ADHD is conducted as part of a broader screening of mental health and school performance. ADHD screening is typically conducted by primary care clinicians. In a school setting, universal screening for ADHD could be conducted in early elementary school by asking teachers to complete brief ratings of ADHD symptoms for all of their students. Those students receiving the highest scores could then be screened more specifically. Q: What are some cautions for teachers to understand when it comes to the less well publicized aspects of ADHD such as co-morbid conditions? A: It is the rule rather than the exception that children with ADHD will have a co-occurring or co-morbid condition. The most common are learning and language disabilities and oppositional defiant disorder, which is manifested by annoying other people and having a low tolerance of the behaviors of others as well as frequently refusing to follow rules. In the book, we have described the common co-morbid conditions to help alert teachers to be able to look for them. Other co-occurring conditions include anxiety and depression and can have a particularly deleterious effect on the social relationships that children with these conditions are able to form. Q: Considering the disruptive nature of many of the behaviors characteristic of ADHD, teachers often respond with punishment; what are some alternate interventions teachers can implement that will lead to more constructive outcomes? A: We emphasize the use of proactive, positive interventions like structuring the classroom and instruction to promote student engagement as well as providing positive reinforcement to students who are following rules and completing work. When teachers use preventive, positive strategies, they find that they do not have to use punishment as frequently (i.e., student behavior improves such that punishment is not necessary). Q: In your book, you emphasize the importance of communication among clinicians, families, and teachers. What are some common barriers to communication, and what steps do you recommend to overcome these barriers? A: Clinicians, teachers, and families all have busy schedules and have different cultural and experiential perspectives on the condition. Communication takes time to overcome the differences and neither teachers nor physicians are adequately compensated for the time it takes for them to successfully accomplish that goal. Parents frequently have to take the time out of their busy schedules to be the messenger between physicians and teachers. Utilizing electronic and fax systems can help facilitate communication, and setting up schedules and specific forms such as rating scales can be helpful. Q: AAP issued its first guidelines on clinical practice for ADHD in 2000 and is preparing to release revised guidelines. What changes have you seen since the first guidelines were issued and what changes do you hope to see over the next decade or so? A: A good deal more research has been accomplished since the previous guidelines were issued suggesting, for instance, an expansion of the age at which a child can be diagnosed and treated. We hope that physicians and teachers over the next decade will have better systems for monitoring children with ADHD and for improving their ability to adapt treatment over time to the developmental needs of the children. |
|
|
|
|
|
