We detangled the ADHD spiderweb of specialists, just for you.

Is your child struggling to focus, constantly chasing distractions like butterflies? Homework and morning routines feel like an endless marathon, don't they? Dinner turns into a circus, with your little one bouncing around, throwing out witty remarks at the worst moments. From desks to dinner tables, staying seated seems like an Olympic game! After years of watching your child juggle these challenges, it's time to face the music and seek an evaluation for attention-deficit/hyperactivity disorder (ADHD).

Yet, a quick Google search reveals a tangled web of options. How do you navigate this jungle of providers? Which specialists can truly diagnose and treat ADHD? And just like that, confusion crashes the party!

Let’s unravel ADHD: we'll explore the necessity of a comprehensive evaluation and weigh the pros and cons of different specialists in this field.

What is ADHD?

Before picking a specialist, let's understand ADHD. It's a neuro-developmental disorder. Children with ADHD struggle to pay attention and often act impulsively or hyperactively. This can affect their daily life. According to the NIH, the global prevalence of ADHD in children and adolescents was 8.0 %. Diagnoses usually start around age six or seven. Before this, symptoms can be normal. Most kids are diagnosed between 6 and 11. Symptoms must appear in different places, like home and school, and cause problems.

The term ADHD can be misleading. It suggests all kids with the diagnosis are hyperactive, which isn't true. Previously, kids without hyperactivity were called ADD. Now, we use ADHD for everyone with the diagnosis. There are three types of ADHD:

• ADHD, predominantly inattentive presentation: These kids struggle to focus, listen, or follow instructions. They might daydream or get easily distracted. (aka ADD.)

• ADHD, predominantly hyperactive/impulsive presentation: These kids often act without thinking. They might interrupt, yell out answers, or have trouble sitting still. They may run or climb excessively.

• ADHD, combined presentation: These kids show signs of both inattention and hyperactivity/impulsivity.

What does Comprehensive Evaluation of ADHD mean?

Navigating the ADHD evaluation landscape is no small feat. Often, ADHD strolls hand-in-hand with a bunch of other diagnoses. According to the CDC, nearly half of children with ADHD also sport an [additional behavioural diagnosis](https://www.cdc.gov/children-mental-health/about/about-behavior-or-conduct-problems-in-children.html#:~:text=Conduct Disorder (CD) is diagnosed,law and result in arrest.). Between 30% to 50% wrestle with learning disorders; 33% face anxiety, 17% battle depression, and 14% fit into the autism spectrum. With these statistics in mind, it’s clear that the evaluator needs to be well-versed in these overlapping conditions. After all, diagnosing ADHD is no one-test wonder.

Many specialists lean on behaviour checklists to decipher the severity of your child's symptoms. They compare these symptoms across diverse settings and against peers of similar ages. Observations made at home or in school also add valuable insights. With a variety of diagnoses lurking in the background, assessments on academic skills, intellectual functioning, memory, and even motor skills can illuminate your child’s unique profile.

As an ADHD coach with a keen focus on testing and evaluation, I often encounter families with children who received hasty diagnoses. Often, these quick evaluations hinge on just behaviour checklists filled out by parents and teachers. Unfortunately, many of these kids have untapped challenges.

Others might find themselves mislabelled, incorrectly diagnosed with ADHD when they truly align with an autism spectrum disorder. Their needs deserve tailored interventions. Additionally, some children may wrestle with co-occurring symptoms of anxiety or depression, which frequently remain in the shadows, untreated (common misconception; many parents do not accept the idea that a child can be depressed, saying “depression is for adult only”).

The crux of the matter? A comprehensive evaluation is crucial. Our children might act out, challenge authority, or express their emotions in overwhelming ways. Understanding the root causes empowers us to provide adequate interventions, guiding them towards healthier coping mechanisms. Clearly, a thorough evaluation is an invaluable tool in our quest to better understand and support our children—at home, in school, and beyond.

Who Diagnoses and Treats ADHD? Pros and Cons of Each Specialist

Now that you’re versed in ADHD diagnosis, let’s explore the specialists who can help. With a variety of options, each comes with perks and pitfalls. Below are some insights on these specialists.

1) Pediatrician

According to the CDC, around half of all children are first diagnosed by a pediatrician. Most parents enjoy a solid rapport with their trusted pediatrician, seeking guidance for their child’s developmental concerns. With training in ADHD assessment, they often provide valuable checklists for parents and teachers. Familiarity is on their side, having known your child since day one.

Pros:

• Medication? Yes, they can prescribe that, given their medical background.

• Appointments usually glide through health insurance coverage.

Cons:

• Behavioural treatments or counselling? Not in their toolkit.

• Pediatricians may struggle to evaluate conditions like autism, learning disabilities, or anxiety issues.

• Furthermore, their experience with ADHD assessment may be somewhat limited.

2) Developmental and Behavioural Pediatrician

Developmental pediatricians venture a little deeper into the realm of childhood challenges. While akin to standard paediatricians, they specialise in children with developmental variations.

Pros:

• They assess for co-occurring conditions like autism or anxiety.

• They can also prescribe medication.

Cons

• Behavioural therapies and counselling are not in their repertoire.

• Insurance may cover these appointments, though it’s not guaranteed.

• A significant pitfall lies in their limited capacity to evaluate learning disorders comprehensively.

• When it comes to complex cases of autism or learning challenges, further testing might be required outside their expertise.

3) Psychiatrists

Psychiatrists wield a wealth of knowledge about child and adolescent mental health. These experts can also evaluate for additional conditions like anxiety or depression.

Pros:

• Medication? Absolutely; they’re medical professionals able to prescribe treatments.

• Insurance may sometimes foot the bill for these appointments.

Cons:

• Behavioural therapy and counselling usually fall outside their jurisdiction.

• Many psychiatrists possess limited familiarity with autism spectrum disorders and learning challenges.

• Psychiatrists appointments tend to be brief and often rely heavily on interviews with parents and children rather than comprehensive assessments.

4) Psychologists and Neuropsychologists

When it comes to comprehensive understanding, psychologists are front-runners. They’re well-versed in most child and adolescent mental health conditions.

Pros:

• Not only do they offer behavioural therapies, but they also provide valuable parent training, family therapy, and social skills interventions.

• Testing psychologists can assess for additional issues, such as anxiety, depression, learning disorders, and autism.

• Appointments are thorough, often spanning 4-8 hours over multiple days. Families receive comprehensive reports featuring tailored recommendations for interventions. While insurance may cover this testing, it’s often not included.

Cons:

• The cost can soar due to the extensive evaluation process.

• Remember, psychologists can’t prescribe medication, so a referral back to the pediatrician or psychiatrist is essential.

5) Therapists (Counsellors, Social Workers, Family Therapists)

Pros:

• Therapists can facilitate individual and family therapy, parent training, and social skills interventions. They can usually screen for additional conditions like anxiety and depression.

Cons:

• Evaluations performed by therapists often have limitations, particularly in diagnosing autism and learning disorders.

• Assessments generally rely on behavior checklists or interviews, which can be less comprehensive.

• Therapists lack the authority to prescribe medication, requiring a referral back to the pediatrician or psychiatrist for treatment solutions.

6)Other Specialists

While they don’t hold the reins of diagnosis, their expertise shines brightly in addressing common challenges faced by children with ADHD.

Among these precious allies are speech therapists and occupational therapists, the champions of sensory support and fine motor skills, tackling handwriting hurdles encountered by children on this journey.

Next in our circle are behavior therapists. They delve deep into the specifics of behavior, crafting tailored plans to nurture positive changes both at home and in school.

Lastly but not least, we meet educational therapists, the wizards of academic intervention, providing invaluable assistance to children grappling with ADHD and their learning challenges.

The Bottom Line

In the intricate tapestry of ADHD evaluation and treatment, each specialist weave vital threads. Remember this: ADHD never travels alone and usually hang out with some other co-occuring conditions (dyslexia, autism, …). Keep also in mind that some underlying health issues (hearing issue, vision issue, gut infection) which are hard for the child to verbalize can mimic ADHD symptoms.

The contents of this site are opinions of Meru unless otherwise noted. The information on this site is not intended to diagnose, treat, or prevent any type of medical condition and is not intended as personalized medical/psychological advice. Any decision you make regarding your and your family’s health and medical treatments should be made with a qualified healthcare provider.