ADHD Assessment

Attention Deficit Hyperactivity Disorder (ADHD) 
Approximately 30 to 50% of children with reading difficulties also experience ADHD, and nearly all children with ADHD have some difficulties with reading. There are several types of ADHD. Although all of the types involve a child not being able to maintain attention, not all of the types involve hyperactivity. Therefore, your child could struggle with keeping attention during demanding or less stimulating tasks which do not involve excessive amounts of behavior. Some areas of ADHD involve children simply not being able to attend to the task at hand. There is no jumping out of one's seat or excessive amounts of inappropriate behavior. So, it is possible for a child to have ADHD primarily inattentive type without you really knowing. Of course, you might notice that your child may not be able to remember instructions or "forget" to do something that you just asked him or her to do.

At the CARRD, we routinely assess all of our children for Attention Deficit Hyperactivity Disorder (ADHD). We do this because many times a parent will bring in his or her child to be assessed because of a reading problem only to find that his or her child has good phonological processing and reading skills, but has difficulties with attention. It is sometimes difficult to know which difficulty is present without a thorough examination of both possibilities.

As can be seen in the table below, there are four classifications of ADHD:

ADHD Categories and Descriptions
ADHD CategoryDescription
Predominantly Inattentive Type
Characterized by difficulty in sustaining attention, distractibility, lack of task persistence, and disorganization.
Behaviors:
  • often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  • often has difficulty sustaining attention in tasks or play activities
  • often does not seem to listen when spoken to directly
  • often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
  • often has difficulty organizing tasks and activities
  • often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
  • often loses things necessary for tasks or activities
  • is often easily distracted by extraneous stimuli
  • is often forgetful in daily activities
Predominantly Hyperactivity-Impulsive Type
Characterized by excessive motor activity and impulsive responding.
Behaviors:
Hyperactivity
  • often fidgets with hands or squirms in seat
  • often leaves seat in classroom or in other situations in which remaining seated is expected
  • often runs or climbs excessively in situations in which it is inappropriate to do so
  • often has difficulty playing or engaging in leisure activities quietly
  • is often "on the go' or often acts as if "driven by a motor"
  • often talks excessively
Impulsivity
  • often blurts out answers before questions have been completed
  • often has difficulty awaiting a turn
  • often interrupts or intrudes on others
Combined Type
Characterized by inappropriate levels of both inattention and hyperactivity-impulsivity.
Behaviors:
  • Same as those listed above for both categories
Not Otherwise Specified (NOS)
This category is for disorders with prominent symptoms of inattention or hyperactivity-impulsivity that do not meet the criteria for ADHD.
For example:
  • The individual's symptoms do not meet the full criteria for ADHD, but his or her behavioral patterns marked by sluggishness, daydreaming, and hypoactivity
  • Individuals whose symptoms meet the criteria for ADHD Predominantly Inattentive Type but whose age of onset is 7 years or later.


An appropriate diagnosis of ADHD should occur only after a team of individuals have each provided their expertise. The information that is necessary for an accurate diagnosis of ADHD involves each of the following;

  1. Family History
  2. Medical History as assessed by medical personnel
  3. Physical Examination
  4. Parent/Teacher Survey of Child's behavior at home and at school
  5. Continuous Performance Test

You could have your child assessed by the appropriate individuals who can determine if your child has ADHD. It is important that the diagnosis involve the types of information described above.

If you would like, you could have your child take a continuous performance test to get an idea of further consideration is warranted. This might be particularly important if you have no other clues that your child might be experiencing ADHD. This is more likely going to be the case for ADHD Primarily Inattentive Type than it would be for ADHD Primarily Hyperactivity-Impulsive Type. Children who have ADHD Primarily Hyperactivity-Impulsive Type are usually quite obvious in their excessive and inappropriate levels of behavior, while children with ADHD Primarily Inattentive Type are very often not obvious in their inattentiveness. When children's behavior in a classroom is disruptive, every one notices. When a child is sitting quietly in his or her seat, not disrupting the class in any way, but also not able to stay on task or to attend to the instruction, it may be difficult to immediately notice. It is for this reason, that we typically request that parents consider ADHD testing to factor out attentional difficulties and how attentional problems might be affecting reading.

If you are not interested in doing a full-scale assessment for ADHD, you can have your child take a continuous performance test. If the results of the continuous performance task suggest that your child might have ADHD, then you can do a more formal assessment and then, perhaps, diagnosis.

Click here for more information regarding assessing your child on-line with the Test of Variables of Attention (TOVA).