To Assess or Not to Assess: Unraveling the ADHD Evaluation Puzzle
As families begin to engage in our school placement services, we spend our time over the summer getting acquainted with each student, their family and the student’s profile. One of the questions that has been popping up this summer from parents is whether or not their student should have neuropsych testing if their only diagnosis is attention deficit hyperactivity disorder (ADHD), and more specifically, if that diagnosis was given by a pediatrician or a therapist?
Yes, ADHD is a diagnosis that can be given and treated by a pediatrician or therapist. With that being said, a pediatrician or therapist does not usually assess for weaknesses in higher-level executive functioning skills as a neuropsychologist would. In our experience, we’ve seen how these areas of weakness can increasingly have an impact as a child progresses in school and the demands increase.
Rather than identifying a set of symptoms and then providing patchwork recommendations, we love how a comprehensive neuropsych evaluation sheds light on the entire cognitive and learning profile, outlining which specific accommodations and supports would be most beneficial. It offers a complete picture and detailed roadmap for what a child needs for the next 2-3 years. For example, the standard accommodation of extended time (e.g., time and a half or double time) can be extremely beneficial for some students but might not be particularly meaningful if the child tends to rush and has issues with planning/organization. We find that it also can be incredibly valuable when considering different school placements, as it helps guide our thinking regarding the type and frequency of learning support a student may benefit from.
Deciding whether a comprehensive neuropsychological assessment is necessary for a student with ADHD depends on several factors. While it is not a requirement for every student with ADHD, a comprehensive assessment can provide valuable insights and support for the student's academic, emotional, and behavioral needs. Here are some considerations:
Impact on Functioning: If the student's ADHD significantly impacts their daily functioning, including academic performance, social interactions, or emotional well-being, a comprehensive assessment can help identify the specific challenges they face. It can provide a deeper understanding of their cognitive strengths and weaknesses, and offer recommendations for appropriate interventions, accommodations, and support strategies.
Differential Diagnosis: A comprehensive neuropsychological assessment can help differentiate between ADHD and other conditions that may present with similar symptoms. It can rule out other underlying conditions that might be contributing to the student's difficulties or identify comorbid conditions that may require additional interventions.
Treatment Planning: The assessment results can guide the development of a tailored treatment plan. It can inform decisions about medication management, behavioral interventions, therapy approaches, and educational accommodations. For example, many doctors will require a comprehensive neuropsych evaluation prior to trialing a student on any medication. Understanding the individual profile of strengths and weaknesses can help professionals and parents make informed choices about interventions that will best support a student's needs.
Educational Support: A comprehensive assessment can assist in obtaining appropriate educational support and accommodations. It can provide documentation needed for eligibility for Individualized Education Programs (IEPs), or Section 504 plans. As we mentioned above, the assessment results can inform decisions regarding the provision of extended time on exams, preferential seating, note-taking assistance, or other accommodations that can optimize the student's learning experience. And fun fact: Did you know that in some states, a student can maintain eligibility for an IEP or 504 Plan even if enrolled at an independent school?
Self-awareness and Advocacy: As students “age up” the notion of self-advocacy is critical and we can’t emphasize it enough! The middle school and high school years are a great time for students to start embracing how they learn best and what they need to find success! A comprehensive assessment can help the student develop a better understanding of their strengths and challenges. It can enhance their self-awareness and empower them to advocate for themselves. With a clearer understanding of their unique profile, the student can communicate their needs effectively, seek appropriate resources, and develop effective strategies to manage their symptoms and succeed academically.
All this being said, if the student doesn't have any potential learning challenges and the impact of their ADHD symptoms are being treated with medication or is rather minimal in the school setting, a neuropsych evaluation may not be needed or particularly helpful (e.g., if a child is already getting organizational supports as well and therapeutic interventions, etc). It also depends on the extent to which the pediatrician and/or therapist communicates what the student needs and the receptiveness of the school team to a more targeted assessment/treatment plan.
Ultimately, the decision to pursue a comprehensive neuropsychological assessment should be made in consultation with parents, educators, and relevant professionals, such as neurologists, psychologists or psychiatrists specializing in ADHD. They can assess the student's specific needs, consider their functioning, and determine whether a comprehensive evaluation would provide valuable information and support for the student's academic and personal development. As we always tell the parents we work with: “You know your student best!” Knowledge is power and learning how your student learns best, including their strengths and areas for growth, will help your student thrive and reach their potential!