How To Be An Elementary Maths Teacher Without A Degree What Are the Factors That Can Rule Out the Presence of ADHD?

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What Are the Factors That Can Rule Out the Presence of ADHD?

According to the American Psychiatric Association’s DSM-IV, ADHD is a childhood-onset disorder that is usually seen before the age of seven in a child. It is characterized by inadequate developmental levels of inattention, distraction, impulsivity and/or hyperactivity. Impairment occurs in one or more major areas of life, usually at home, in the classroom, in social interactions, in occupational settings, or in other areas of adaptive functioning. The list of symptoms goes on to describe a variety of interferences that can occur with ADHD that can easily disrupt any child’s performance, learning, and behavior. Interestingly, the symptom description does not specify the amount or severity of the symptoms except that the interference must exceed the normal developmental levels evident in children. As a result, parents and professionals are left with the challenge of distinguishing excessive ADHD symptoms from those that are normal for a child’s specific level of development.

Best practice calls for an ADHD assessment to include the collection of multiple types of information from multiple sources. A simultaneous effort should be made to rule out as many alternative disorders that may present with similar attention and performance difficulties. This could include but not be limited to impairments seen in learning disabilities, developmental delays in younger children, sensory regulation dysfunction, mood difficulties and depression, anxiety, as well as a low basic motivational effort. These alternative disruptions will easily and predictably interfere with a child’s optimal performance and learning in the classroom. However, distinguishing these interferences in the classroom remains a challenge for teachers and practitioners, especially when attention deficits are characteristic of a variety of interfering disorders.

As a child psychologist, I realize this professional challenge every time I begin a new ADHD evaluation for a presenting child. I will then lament the absence of an accurate and objective assessment of ADHD that can effectively distinguish inattention from alternative interference conditions. Sometimes, I’ll be lucky enough to learn crucial information about the presenting child that I’ve come to recognize as an ADHD “rule-out.” Although these ruling-out factors are not necessarily absolute in their ability to distinguish, they tend to increase my potential to accurately diagnose ADHD.

Age of onset is one of these differential diagnostic factors. The presence of ADHD can be recognized at least at the age of seven in a child. Generally, by this age, a child has developed in multiple areas including cognitive, social, emotional, behavioral, and physical to enable them to meet most of the routine expectations of that student in the classroom. The same cannot be said for five-year-olds who may still be developing their ability to self-regulate attention and activity levels to facilitate learning in the preschool classroom. My comfort level in trying to assess ADHD improves substantially when the identified child is at least six years of age. At this chronological age, I can more accurately use my clinical experience and judgment to determine when activity and inattention are observed beyond expected developmental levels.

I use a related exclusion factor whenever I assess students who are slightly older. I recently evaluated a fifth grade girl referred because of her poor academic performance and difficulty attending specifically in the area of ​​Mathematics. His absence of symptoms or concerns of inattention during the early elementary years raised doubts about a possible diagnosis of ADHD. Not only was there an absence of previous ADHD concerns, but this student enjoyed excellent academic results and performance in all previous elementary school years. Unfortunately, his performance in mathematics began to show a degradation as he progressed through the curriculum that involved greater abstraction in concepts and problem solving. In my opinion, increased academic challenge will predictably lead to higher levels of inattention and poor engagement in tasks in students and cannot be recognized as the neurological impairment of ADHD.

Ruling factors are critical when considering any child for ADHD. Specifically, children should show evidence of ADHD by the age of seven and the symptoms cannot be mistaken for a developmental delay in the child. The interference of ADHD symptoms must be recognized by teachers in every primary grade without fail, and the interference must be evidenced in every academic area. This suggests that a student with ADHD will show some amount of impaired attention in all subjects and activities. And finally, the interference of ADHD will not suddenly appear in the fourth or fifth grade correspondent with the increasing demands of the curriculum in elementary school. In the current example, a student who demonstrates a developmentally appropriate ability to maintain participation in tasks from elementary school will not lose that ability in later grades. More accurately, learning disabilities or motivational problems are common in students who struggle with progressive academic demands in the classroom. These students will almost certainly have trouble staying focused and attentive to their assigned work.

These factors to rule out are certainly helpful in arriving at an accurate diagnosis of ADHD in any child or student. Although these exclusion factors may reasonably rule out the diagnosis of ADHD, these factors are largely suggestive rather than absolute in making such a diagnostic determination. The non-specific descriptive criteria for ADHD (DSM-IV) in combination with the lack of objective evidence for ADHD will continue to set the stage for meaningful clinical judgment to contribute to its final diagnosis. Although there are numerous factors and indicators that will support an accurate diagnosis of ADHD, there are numerous variant presentations of this disorder that must be considered in order to diagnose or rule out this disorder.

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