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ADHD Test: Physical and Neurological Exam

ADHD, or attention deficit hyperactivity disorder, is nothing more than a descriptive diagnosis. The diagnosis merely describes a list of behavioral symptoms, but does nothing to explain what is causing those symptoms in the first place.  In our clinic, we perform a comprehensive physical and neurological exam designed to evaluate your child's overall physical health, and screen for other neurological problems that may be mimicking ADHD.  Our functional neurological exam allows us to understand which parts of your child's brain are strong and can be left alone and which parts are weak and need to be retrained.

Physical exam

Since hyperactivity and impulsivity manifest in the actions of the child, we usually recommend a physical exam to see the limits of his or her physical activity and to ensure the child's overall health.  The physical exam can also detect any health problems that may need to be addressed along with the disorder.

Neurological exam

Although brain scans reveal subtle differences between the brains of children with ADHD and children without, this doesn't give the complete picture of the disorder. A neurological exam is a non-invasive way to determine information about the child's nervous system and to screen for other problems like learning disabilities.  A neurological exam usually looks at several components:

  1. Mental Status.  When other neurological exams indicate no abnormalities, the results of the Mental Status Exam can make or break the conclusions. This exam is made up of a series of simple questions designed to test the patient's cognitive ability, state of consciousness, mood, content of thought, and intellectual resources.  Besides the answers to the questions, the examiner also obtains crucial information through observing the child's general behavior.
  2. Deep tendon reflexes.  Reflexes are involuntary actions performed in response to impulses sent from the nerves to the central nervous system. Any problems in deep tendon reflexes are usually the first signs of neurological dysfunction.
  3. Cranial nerves. There are 12 sets of cranial nerves in the brain that relay messages for sensory functions (including smell and vision), motor control, tongue movement, and vocal cords. The cranial nerve test involves examining the function of all 12 cranial nerves to localize any dysfunctions in the central nervous system and to aid in diagnosing systemic diseases.  Some functions that are tested in the cranial nerve test include eyelid strength, peripheral vision, visual function, tongue and lip movements, ability to identify tastes and smells, and sensations in the neck, head, and face.  
  4. Motor system. The motor system is made up of the brain, the spinal cord, and other motor nerves and muscles of the body.  Any abnormalities in the motor system are detected through examining muscle strength and tone.
  5. Sensory system.  Sensation occurs when impulses from receptors in the skin, tendons and muscles send impulses to the central nervous system. The sensory exam evaluates different types of sensation, such as pain, position, pressure, and temperature to check for sensation impairments or abnormal sensations. 
  6. The cerebellum and coordination. The cerebellum is the part of the brain responsible for controlling voluntary movement and motor coordination, such as posture.  Examining coordination gives information about conditions that may be affecting the cerebellum. 

As I have explained in other articles, the difference in how the brain of ADHD children works is not due to structural changes but to functional changes (see our free ebook "ADHD and the Brain"). This is why I recommend that you get your child evaluated by a chiropractic neurologist who will be interested in finding subtle differences in function, and not a medical neurologist who is merely interested in ruling out pathologies.