Assessment of Attention-Deficit Disorder - ADD

Attention-Deficit Disorder is a complex condition that involves impairment in focus, organization, motivation, emotional regulation, memory, and other functions of the brain’s management system.

Diagnosis of ADD

ADD affects individuals at all levels of intelligence. Diagnosis is typically made with clinical interviews, rating scales and obtaining collateral information.

A detailed clinical interview by a skilled clinical psychologist asking about the history, the nature of the patient’s current functioning and life situation, noting the presence or absence of patterns of impairment in school, work, family life, and social relationships is imperative.

Along with the above psychological assessment, rating scales such as the Connors, Copeland and SNAP are also used to make a diagnosis of ADD.

There are essentially three types of attention deficits and a skilled clinician will make the diagnosis in accordance with the diagnostic criteria as set out in the DSM-IV. Broadly, the three categories will focus on inattention, hyperactivity and/or impulsivity.

The inattentive type ADD is typically characterised by forgetfulness and failure to give close attention to details in schoolwork, work and other activities. It often seems as if these individuals do not listen when spoken to and they often lose things necessary for tasks or activities. They have difficulty in following through on instructions and often fail to finish schoolwork, chores or duties. Organisational skills are also impaired and they are often easily distracted by external stimuli.

The hyperactive type ADD is diagnosed when there are symptoms noted such as fidgeting with hands or feet, leaving the seat in the classroom or in other situations in which remaining seated is expected, running or climbing around excessively in situations in which it is deemed inappropriate, excessive talking, and difficulty engaging in leisure activities quietly.

The impulsive type ADD is characterised by blurting out answers before questions have been completed, difficulty awaiting turns, and interrupting or intruding on others e.g. butts into conversations or games.

In addition, patients with ADD may also suffer from co-morbid conditions such as depression, anxiety, oppositional-deficient disorder and/or conduct disorder.

Medical Management of ADD

The risks of using appropriate medications to treat ADD are minimal, whereas the risks of not using medication to treat ADD are significant. The medications used for ADD are among the best researched for any disorder.

Medication has been demonstrated safe and effective in alleviating symptoms of ADD syndrome in 80 to 90 percent of children, adolescents and adults who have the disorder.

However, just as glasses do not repair and cure impaired vision, medication that alleviate ADD symptoms do not cure problems with brain chemistry and the improvements last only as long as the medication is active.

Therefore, other remedial strategies such as behaviour-modification programmes, occupational therapy and psychotherapy are imperative in treating the disorder.

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