More Details on Finding an ADHD Doctor
Knowing the differences in qualifications and services can help the family choose an ADHD
doctor who can best meet their needs.
There are several types of ADHD doctors qualified to diagnose and treat ADHD. Child psychiatrists are doctors who specialize in diagnosing and treating childhood mental and behavioral disorders. A psychiatrist can provide therapy and prescribe any needed medications. Child psychologists are also qualified to diagnose and treat ADHD. They can provide therapy for the child and help the family develop ways to deal with the disorder. However, psychologists are not medical doctors and must rely on the child's physician to do medical exams and prescribe medication. Neurologists, doctors who work with disorders of the brain and nervous system, can also diagnose ADHD and prescribe medicines. Unlike psychiatrists and psychologists, however, neurologists usually do not provide therapy for the emotional aspects of the disorder.
Within each specialty, individual doctors and mental health professionals differ in their experiences with ADHD. Thus, in selecting an ADHD doctor, it's important to find someone with specific training and experience in diagnosing and treating ADHD.
What to Expect From an ADHD Doctor
Whatever the specialist's expertise, his/her first task is to gather information that will rule out other possible reasons for the child's behavior. Among possible causes of ADHD
-like behavior are the following:
- A sudden change in the child's life, such as the death of a parent or grandparent, parents' divorce, or a parent's job loss
- Undetected seizures, such as in petit mal or temporal lobe seizures
- A middle ear infection that causes intermittent hearing problems
- Medical disorders that may affect brain functioning
- Underachievement caused by a learning disability
- Anxiety or depression.
Ideally, in ruling out other causes, the ADHD doctor checks the child's school and medical records. There may be a school record of hearing or vision problems, since most schools automatically screen for these. The specialist tries to determine whether the home and classroom environments are unusually stressful or chaotic, and how the child's parents and teachers deal with the child.
Next, the ADHD doctor gathers information on the child's ongoing behavior in order to compare these behaviors to the symptoms and diagnostic criteria listed in the DSM-IV-TR. This also involves talking with the child and, if possible, observing the child in the classroom and other settings.
The child's teachers, past and present, are asked to rate their observations of the child's behavior on standardized evaluation forms, known as behavior rating scales, to compare the child's behavior to that of other children the same age. While rating scales might seem overly subjective, teachers often get to know so many children that their judgment of how a child compares to others is usually a reliable and valid measure.
The ADHD doctor interviews the child's teachers and parents, and may contact other people who know the child well, such as coaches or baby-sitters. Parents are asked to describe their child's behavior in a variety of situations. They may also fill out a rating scale to indicate how severe and frequent the behaviors seem to be.
In most cases, the child will be evaluated for social adjustment and mental health. Tests of intelligence and learning achievement may be given to see if the child has a learning disability and whether the disability is in one or more subjects.
In looking at the results of these various sources of information, the ADHD doctor pays special attention to the child's behavior during situations that are the most demanding of self-control, as well as noisy or unstructured situations such as parties, or during tasks that require sustained attention, like:
- Working math problems
- Playing a board game.
Behavior of the child during free play or while getting individual attention is given less importance in the evaluation. In such situations, most children with ADHD are able to control their behavior and perform better than in more restrictive situations.
The ADHD doctor then pieces together a profile of the child's behavior. Common considerations include:
- Which ADHD-like behaviors listed in the most recent DSM does the child show?
- How often are these behaviors displayed?
- In what situations?
- How long has the child been doing them?
- How old was the child when the problem started?
- Are the behavior problems relatively chronic and enduring, or are they periodic in nature?
- Are the behaviors seriously interfering with the child's friendships, school activities, home life, or participation in community activities?
- Does the child have any other related problems?
The answers to these questions help identify whether the child's hyperactivity, impulsivity, and inattention are significant and long-standing. If so, the child may be diagnosed with ADHD.
A correct diagnosis of ADHD often resolves confusion about the reasons for the child's problems that lets parents and child move forward in their lives with more accurate information on what is wrong and what can be done to help. Once ADHD is diagnosed, the child and family can begin to receive whatever combination of educational, medical, and emotional help they need. This may include:
- Providing recommendations to school staff
- Seeking out a more appropriate classroom setting
- Selecting the right medication
- Helping parents to manage their child's behavior.