I posted this blog previously on another site but I think the information is quite relevant, so I want to post here as well.
I recently completed a mental health assessment for a child that was referred by their school for an ADHD assessment due to attention difficulties. As it turned out, they demonstrated only mild ADHD. It appeared that for this particular child, the severity of the inattention was more related to depressive symptoms, anxiety and low self-esteem.
There are three types of ADHD, inattentive, hyperactive/impulsive, and combined (i.e. a combination of the previous two). Children with the hyperactive/impulsive or combined type are most often more easy to spot, particularly if they are unable to remain still and are bouncing, literally, off the walls. However, the inattentive type more often goes unnoticed, particularly as these children can be quiet and withdrawn and often do not present with externalizing behavior difficulties. It is also more difficult to diagnosis the inattentive type given that inattention can be related to many different difficulties. Therefore, I thought it might be helpful for parents who are struggling with an inattentive child to learn more about the diagnostic process.
Mental health diagnoses such as depression or ADHD due not rely solely on one symptom. In order to make a diagnosis, we look for a cluster of symptoms that occur in multiple settings and that negatively impact the child’s life. A child that is easily distracted and lacks focus could easily be diagnosed with ADHD. But further exploration is needed because the inattention could just as easily be related to depression or anxiety.
Interviews with the parents and the child, as well as behavioral observations, are primary. Is inattention a main symptom or are other symptoms more significant such as tantrums, withdrawal, poor social skills, etc? Does the child consistently demonstrate inattention across multiple settings? Children with ADHD would be expected to demonstrate differing levels of inattention across different situations depending on motivation or interest; however, within similar situations, their level of inattention would be expected to be fairly constant. If it is not, the inattention may be related more to something that changes, such as mood.
In addition to interviews, report measures such as the Conners are often used, to be completed by parents and teachers. Computerized tests such as the CPT or TOVA can also be helpful, as well as a Quantitative EEG. A child with ADHD will show attention deficits greater than the norm, based on age and gender, on these standardized tests.
In general, the symptom of inattention may be related to ADHD, depression, anxiety, or even boredom if your child is not being challenged academically. A comprehensive evaluation, including the above mentioned assessment tools and examining the multiple facets of your child’s life, is your best bet for parceling out the reason for your child’s inattention, which then guides both treatment options and goals.