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Re: Noa and JohnL... & 'how much is Dexedrine worth?'

Posted by Noa on February 2, 2000, at 21:30:19

In reply to Noa and JohnL... & 'how much is Dexedrine worth?', posted by Janice on February 2, 2000, at 20:34:18

It is unusual to do psychological testing to dx ADHD. It can be helpful, when there is a question of a possible learning disability or to identify particular processing problems. But--I agree with both of you--if a person has been dxed by psychiatric interview and had been taking a medication with good results, what exactly IS the point of psychological testing?

The "standard" for DXing kids with ADHD is to use a normed checklist, completed by two separate observers of the child in two separate environments(parents and teachers, for example), to get a complete developmental history, do a good interview, and have direct observation. I don't think this standard is met most of the time. A lot of pediatricians make decisions based upon parent report alone, which can be correct, but sometimes is insufficient, and doesn't meet the criterion of observed problems in two settings. Some doctors even go so far as to base their decision on simple parent report in a typical 10 minute HMO office visit, without using a checklist. This, in addition to the issue that sometimes depression and/or anxiety can present like ADHD in kids.

Even if a doctor is 100% sure of the dx, he or she should ALWAYS gather the data, because baseline data is necessary to properly track response to the medication.

In any event, all of this is relatively cheap--a couple of questionnaires, some telephone time to touch base with school personnel, time for a good history. It is nothing compared to the cost of a complete battery of psychological tests. BUT, there ARE learning problems and processing deficits that present in similar ways to ADHD, so sometimes the testing is really useful.


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