ADHD
ADHD can be diagnosed in the course of an ASD or Psychoeducational assessment, but it is not the main focus of either of these assessments. Studies show that there is a high concurrence of ADHD in ASD patients.
Attention
Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition
characterized by difficulties with attention (e.g.: difficulties
staying on task, remembering instructions, keeping organized, and
completing work) and hyperactivity/impulsivity (e.g.: difficulties
keeping still, acting without thinking, rushing through tasks,
interrupting others, impatience). About two out of three children and
half of adults with ADHD show difficulties with both inattention and
hyperactivity, while the remainder primarily show difficulties with
inattention, and only mild or no difficulties with
hyperactivity/impulsivity. While everyone's ability to control their
attention and impulses is limited, and all people will have occasional
difficulties with inattention, forgetfulness, or impulsive behaviour
(especially when overtired, anxious or otherwise stressed), people with
ADHD have these difficulties consistently, across different environments
and situations, to a degree that interferes with their ability to
function in their daily lives.
As a result, while most people with ADHD have average or above
intellectual abilities, students with ADHD often under-perform relative
to their ability level in academics, and must work harder than their
peers to achieve the same results. They often show inconsistent
performance, doing well when motivated and interested in what they are
doing, but having difficulty consistently working to the best of their
ability. Even when work is done well, they can have difficulties with
losing work or handing it in late, forgetting important parts of tasks,
procrastinating until the last minute, and balancing school work with
other activities. Some students may have difficulty learning key
academic skills due to their difficulties attending and memorizing
material, while others may be successful in learning what they are
taught, but have difficulties with completing work, avoiding errors, and
working efficiently, that result in their performance being below the
level that their actual skills would usually allow. Some but not all
children with ADHD can have social or behavioural difficulties related
to impulsivity and difficulties picking up on social cues, difficulties
controlling strong emotional reactions, and resistance to being asked to
do tasks or activities that put strain on their attentional weaknesses,
which can manifest in oppositionality, difficulties avoiding conflicts
with others, and/or anxiety in situations in which the person lacks
confidence in their ability to succeed.
The long-term effects of ADHD are most noticeable in the tendency for
individuals with ADHD to not achieve the same level of academic success
as their abilities would normally allow, and to have difficulties
achieving the same level of occupational success as their academic
success would normally predict. While some individuals with ADHD can
encounter more serious consequences, and have an increased risk of
difficulties with substance abuse, rule-breaking behaviour, injuries, and
accidents, the most common consequences of ADHD are systematic
under-performance in many areas of functioning, which can lead to
feelings of anxiety, alienation, and depression in older adolescents and
adults, as well as problematic coping behaviours such as reliance on
substances, dropping out of school, and instability in employment and
relationships.
How is ADHD Assessed?
While ADHD is thought to be a neurological
disorder which often has a genetic component, there are currently no
genetic, biochemical, or imaging-based tests that can reliably identify
individuals with ADHD. As a result, the diagnosis of ADHD is based on a
pattern of behaviour and functional impairments seen through
observation, reports from parents and teachers, self-reports in
adolescents and adults, school records and other available documents,
and sometimes psychometric testing. We assess ADHD according to the best
practice guidelines developed by CADDRA by carefully examining the history, development, and current strengths
and weaknesses of our clients. Many individuals with ADHD may benefit
from psychoeducational assessment to provide another way of measuring
their strengths and weaknesses, to identify gaps in their skills
requiring remediation, to screen for other co-occurring learning
disabilities, and to provide documentation of their learning needs for
schools, colleges, or universities which may require such testing. As a
result, while psychoeducational testing is not required for a diagnosis
of ADHD, it is useful as part of a broader assessment in many cases.
Having worked with children and adults with ADHD since 2001, including
over ten years in both clinical and research roles in the Provincial
ADHD Program, Dr. Gibbins is highly experienced in working with children
and adults with ADHD and their families to help identify their areas of
strength as well as their challenges, and thus to help support them in
their functioning at home, in school, and in the community so that they
can better reach their potential.
Help for Children with ADHD
When undiagnosed,
children with ADHD are prone to being underestimated and stigmatized as
lazy, less intelligent than they are, unmotivated, or badly behaved, and
often receive feedback that ultimately does not help them learn to cope
with their difficulties ("Be more careful!" "Try harder next time!" "Try to
do your best!" "Stop and think first!"). As a result, they can show
greater difficulties over time as the demands on their attention and
organization increase with age. However, research has shown that with
effective support, treatment, and management, these risks can be
substantially reduced, and individuals with ADHD who have received
adequate support can, in the long term, achieve the same outcomes as
their typically developing peers. People with ADHD who learn to cope
effectively with their challenges and to make effective use of their
strengths are able to function successfully as adults and have the same
range of educational and employment options as their peers, particularly
if they learn to channel their interests and passions in their
education and work. As we all find it easiest to pay attention to things
we love to do, people with ADHD whose work allows them to do things
they are passionate about can excel, sometimes even in areas
traditionally considered challenging for people with ADHD.
A careful diagnosis is often the first step to gaining a better
understanding of the difficulties children and adults with ADHD face,
and helping them get the support and skills they need to learn to cope
effectively with their challenges. A range of treatments and supports
are available for people with ADHD, including both medical and
non-medical interventions aimed at either reducing symptoms or improving
coping and compensatory skills. Current research suggests that, as is
the case for many other disorders, acquiring effective coping skills is
of key importance in overcoming the negative effects of ADHD.
While only a medical doctor can prescribe medication, we can provide
assistance in learning about the scientifically supported treatments for
ADHD, how to work with your doctor to find the best treatment for your
individual symptoms, and what non-medical strategies and resources can
help improve the functioning of people with ADHD.
What is AuDHD?
AuDHD is an unofficial term used to describe individuals who have both ASD and ADHD. Some symptoms can overlap, but others can contradict and even mask the other condition. A person who is AuDHD may for example crave routine and order, finding them comforting (ASD), but difficult to maintain (ADHD). They may carefully sort some items (LEGO, beads, toys) but also have cluttered or messy spaces. Students with AuDHD may show an uneven profile of skills, excelling in areas they find engaging and struggling in areas that they may find boring. When a child has both ASD and ADHD, it is important to take into account both conditions when working to support them.
Are you a clinician with an interest in ASD and
Psychoeducational Assessment?
We have space available in our office for licensed clinicians who would like to work in an environment where neurodivergent children make up the majority of our patients. Currently our office offers two main services: ASD assessment (1-18) and Psychoeducational assessment (6-18), though we are open to welcoming clinicians who would like to offer other services as well. We also work with Sunny Hill to do some of their assessments through BCAAN, and there may be opportunities to do some assessments for them through our clinic. If you think you may be a good fit to work with our team, please contact our office for more information.