Some clinicians misusing ADHD diagnosis tools, report says

Clinicians diagnose attention-deficit hyperactivity disorder (ADHD) inconsistently, according to a draft consensus report from the National Institutes of Health (NIH). But the lack of consistency isn't because there aren't good diagnostic tools. Rather, it's because some diagnosticians either don't use the tools or use them improperly, said the panel preparing the NIH report after three days of examining the ADHD research.

Among the report's conclusions is that the diagnosis of ADHD should be team-based, including input from parents, teachers, psychologists and other health and mental health specialists. Such an approach could improve diagnosis since the behaviors associated with the condition--such as poor attention and concentration, distractibility and impulsivity--can be difficult to evaluate quickly.

Psychologists are uniquely trained to make such a complex behavioral diagnosis, say APA officials. In fact, that was one of the main points of APA testimony presented to the NIH consensus panel by psychologist George DuPaul, PhD, of Lehigh University.

"Psychologists' unique training in evaluation, diagnosis and treatment of complex mental disorders prepares them to integrate their expertise...to diagnose and treat ADHD," said DuPaul.

Still of concern to psychologists, however, was a call by the report for more research to validate the diagnosis of ADHD because there's no biological test for the condition.

"It's not troubling that we don't have a biological test," says Benjamin Lahey, PhD, professor of psychiatry and chief of psychology at the University of Chicago. "There is clearly a syndrome of behaviors associated with impairment."

"What we have right now works quite well when clinicians...collect information in the manner it's supposed to be done," says Howard Abikoff, PhD, professor of clinical psychiatry and director of research at New York University Child Study Center. "When they do that...the diagnostic process is reliable and valid."

In addition to addressing diagnosis, the draft report also concluded that short-term use of stimulants, such as Ritalin, is effective in treating the core symptoms of ADHD. However, stimulants do not appear to improve academic achievement or social skills. Instead, combined therapy that includes medication and behavioral treatments may help to improve not only core symptoms but also social skills.

Overall, the draft report presents a real opportunity for psychologists to use their unique assessment and treatment skills in collaboration with parents, educators and other health care providers to better diagnose and treat children with ADHD, says David Nickelson, PsyD, JD, special assistant to the executive director of APA's Practice Directorate.

A final version of the report is expected out soon. To view the most current draft and abstracts from the consensus conference visit the NIH consensus conference web page at consensus.nih.gov.
--B. Azar



Read our privacy statement and Terms of Use

Cover Page for this Issue

PsychNET®
© 1999 American Psychological Association

APA Home Page . Search . Site Map