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How do we test for ADHD?

In another article, I spoke about the diagnostic criteria for ADHD as used by medical doctors. Generally speaking, a child is diagnosed with ADHD if he or she displays three core symptoms of inattention, impulsivity, and hyperactivity. The symptoms listed, however, do not account for individual differences and are only good for labelling the condition; the triad of inattention, impulsivity, and hyperactivity should not be the sole basis of deciding whether or not your child has ADHD.

Testing for ADHD involves more than just ensuring whether a child meet diagnostic criteria, because the condition is also triggered by factors related to the environment. For a more effective and holistic treatment approach, we need to take several steps to understand the individual child's history, environment, and behaviour.

The very first and most important step involves getting to know the individual child through an extensive interview with the parents and child. Each child displays different symptoms at different intensity levels, and we can only come up with an effective treatment plan if we uncover all of these. During the interview, we find out what is going on in the child's life, the behaviours affecting his or her social integration and schoolwork, and the child's medical history. We usually ask ten key indicator questions that help us pinpoint to some of the most common causes of ADHD that have to do with the mother's pregnancy and the child's early childhood experiences. These questions can be found in the free eBook that you receive when you sign up on our website (see resource box at the end of the article).

The second step is defining more precisely your child's behaviour. You can do that using behavioural scales. A well-known scale is called Conner's. You can find other free ones by searching on the web. In our clinic, we use a scale called the Child Behavioural Checklist . This scale is usually administered by Health Care Professionals, and cover situations at home and at school.

The third step is all about getting a better appreciation of your child's neuropsychological profile. For example, we may be testing for IQ testing or screening for Learning Disabilities or dyslexia.

The fourth step is about objectively measuring attention and impulsivity. To evaluate the child's ability to function, we use a test called the Test of Variables of Attention (TOVA), a computer test designed to measure the individual's response to visual and auditory stimuli. This test allows us to precisely measure your child's ability to concentrate and to control impulses.

The fifth step is a comprehensive physical and neurological exam. A medical neurologist is trained to recognize and diagnose gross pathologies; the subtle neurological differences present in children with ADHD are often overlooked. A chiropractor trained in functional neurology, on the other hand, will perform a complete evaluation of the nervous system that includes assessing balance with posturography, postural tone with surface electromyography, eye movement, and cerebellar testing. By performing all these tests, we will be getting the whole picture of your child's nervous system and brain functions.

There are two more sophisticated neurological tests that can map out the problems in your child's nervous system; however, these are expensive and not easily available. The Quantitative EEG test measures the brain electrical activity on the prefrontal cortex. Individuals with ADHD are found to have a more unfocused and less alert prefrontal cortex as indicated by the theta wave and beta wave activity. The other test is called SPECT. It allows to precisely measure brain function and has been made available clinically through the work of. Dr Daniel Amen.

The sixth step involves ruling out other abnormalities by performing basic lab tests such as blood tests and sometimes thyroid hormone tests. We recommend having the blood tests interpreted by a medical doctor trained in nutrition, functional medicine, or environmental medicine, or a chiropractor specializing in functional neurology. The basic blood test should include a blood cell count, iron metabolism (research in France shows that up to 75% of children with ADHD have anemia and other problems with iron metabolism), and a measure of zinc level.

The seventh and final step is advanced functional testing that measures different bodily functions. In order to take these tests, you will have to go to a holistic medical doctor or chiropractor because these are not administered by traditional medical doctors. These tests are designed to find out whether your child has any deficiencies in essential fatty acids, food allergies and intolerances, toxic elements in the system, and digestive problems, to name a few.

All these steps might seem tedious, but you must remember that there is no single test used in isolation that can do a comprehensive diagnosis of ADHD and the exact conditions affecting the individual child. Simply labelling the behaviour and treating with drugs will not work in the long-term. Your only chance to get your child back is to perform of a comprehensive exam that will pinpoint to the underlying causes of the problem.