Evaluation Process to Diagnose Learning & Behavioral Issues
I have talked about why kids should be evaluated if they have learning or behavioral issues and who is involved in this evaluation in the past few posts. Today I want to talk about what to expect during an evaluation. Not all kids need every test available. It depends on what their specific concerns are as to what will be tested, but a proper diagnosis can't be made without standardized testing and a complete evaluation.
What types of things are evaluated?
The evaluation includes several types of assessments because there are many things that can cause learning or behavioral issues. There are no specific laboratory or imaging tests available to determine a diagnosis on a routine basis. It's important to do a thorough standardized evaluation to get the right diagnosis. Contributing issues include but are not limited to: ADHD, anemia, anxiety, bullying or abuse, chronic illness, depression, hearing or vision problems, learning disabilities, malnutrition, oppositional defiant disorder, sensory integration disorder, and sleep deprivation.
Symptom overlap
Having one diagnosis does not mean you can't have a second. Actually many of these issues go hand-in-hand and co-exist.
There is a lot of overlap of symptoms of many similar conditions.
Standardized questions
A big part of the diagnosis lays in the symptoms noted at home and school, so there are a lot of questions about how your child fares at each. Both parents and teachers and any other significant adults should fill out standardized questionnaires as recommended by the clinician doing the evaluation for many behavioral issues. Older kids (and adults) can do self assessments. It's important to answer each question as honestly as possible to avoid misrepresentation of symptoms, which can lead to an improper diagnosis.
History
Reviewing the child's story can give clues. This includes the current concerns of parents and teachers in addition to historical facts and events. If there were developmental delays in motor skills or language development, further evaluation in those areas might be insightful. It's important to review the family history, since many of these issues run in families. Sleep patterns are often insightful since sleep deprivation can decrease executive functioning and mimic many conditions. Other issues, like a history of anemia or elevated lead levels should be discussed.
Exam findings
A physical exam should be done to help identify any physical symptoms that can contribute to learning or behavioral problems, such as large tonsils leading to sleep apnea.
Behavior evaluation
Some clinicians will go to your child's classroom to observe behaviors. This is sometimes provided through the school district but might also involve a private therapist.
Neuropsychological testing
Neuropsychological testing might be recommended. It can assess learning disorders and attention issues, identify strengths and weaknesses, and help determine what interventions will work best for your student. Understood.org has information about neuropsychological testing.
Vision and Hearing
If your child has not had a vision and hearing screen done previously or there are concerns, it is recommended to do those screens. When a child cannot see the white board or hear the instructions, learning and behavior are both impacted.
Evaluation Process
As you can see, there are many things to consider when evaluating learning and behavioral concerns. A proper diagnosis usually takes more than one visit. More than one person should be involved in the screenings in many cases. Do not attempt to shortchange this process. Without a proper assessment, the wrong treatment might be advised, leading to poor outcome.
More on ADHD
The next few blogs will discuss treatment options for ADHD, including dietary changes, supplements, alternative and additional treatments and medications and more medications.
Looking for more?
Many parents benefit from support groups to learn from others who have gone through or are currently going through similar situations, fears, failures, and successes. Find one in your area that might help you go through the process with others who share your concerns. If you know of a support group that deserves mention, please share!
ADHD
CHADD is the nationwide support group that offers a lot online and has many local chapters, such as ADHDKC. I am a volunteer board member of ADHDKC and have been impressed with the impact they have made in our community in the short time they have existed (established in 2012). I encourage parents to attend their free informational meetings. The speakers have all been fantastic and there are many more great topics coming up!
Anxiety
Many parents are surprised to learn how much anxiety can affect behavior and learning. To look for local support groups, check out the tool on Psychology Today.
Autism
The Autism Society has an extensive list of resources.
Dyslexia
Dyslexia Help is designed to help dyslexics, parents, and professionals find the resources they need, from scholarly articles and reviewed books to online forums and support groups.
Learning Disabilities
Learning Disabilities Association of America offers support groups as well as information to help understand learning disabilities, negotiating the special education process, and helping your child and yourself.
Tourette’s Syndrome and Tic Disorders
Tourette’s Syndrome Association is a great resource for people with tic disorders.
General Support Group List
For a list of many support groups in Kansas: Support Groups in Kansas .
School information
Choosing schools for kids with ADHD and learning differences isn’t always possible, but look to the linked articles on ways to decide what might work best for your child. When choosing colleges, look specifically for programs they offer for students who learn differently and plan ahead to get your teen ready for this challenge.
Midwest ADHD Conference - April 2018
Check out the Midwest ADHD Conference coming to the KC area in April, 2018. I’m involved in the planning stages and it will be a FANTASTIC conference for parents, adults with ADHD, and educators/teachers.
The Midwest ADHD Conference will be held in April 2018, in Overland Park, Kansas.