Struggling with ADHD: Getting an Objective Diagnosis

In Kindergarten, she wrote most of her numbers and letters backwards. When I voiced my concern, her teacher replied with, “Don’t worry, that’s normal at this age.”

In First Grade, she still wrote many of her numbers and letters backwards and had difficulty reading. When I voiced my concern, her teacher replied with, “Don’t worry, she’s average for first grade.”

In Second Grade, she still had difficulty with letters, numbers and reading and started getting in trouble at school. When I voiced my concern, her teacher replied with, “Don’t worry, that’s typical girl behavior in second grade.”

In Third Grade, all of her problems followed her. When I walked into the parent/teacher conference her teacher started with, “We have a problem.”

Finally! A teacher who saw something that I thought I saw all along.

I know that most people don’t want to hear that something is wrong with their child, but to me it was a relief. I saw the struggle my daughter was having. I comforted her as she cried when she couldn’t figure out a math problem. I watched her frustration when she forgot something she had just read. I saw the rage in her eyes when I corrected her for writing a b instead of a d. I always felt that something was wrong, but since she is my oldest, I had nothing on which to base my suspicions. I had to take what her teachers were telling me at face value….she was average.

Homework was a daily struggle. Some nights we would work on it from the time she got home until she went to bed with only a brief break for supper. I knew she didn’t understand what she was reading, but I couldn’t find a way to help her comprehend it. My friends would suggest that I give it time, eventually everything will click in her head. I tried to be patient. It was hard…for her, for me, for our whole family. So, even though I didn’t want to know that something was wrong with her, I felt a sense of relief in identifying that there was a problem.

Its been six months since that parent/teacher conference, and my daughter has finally got a diagnosis of ADHD from a qualified psychiatrist. Yes, it took that long to isolate the issue. Her teacher has been wonderful through it all. He’s made every available resource her school offers available to her…tutors, special reading groups, and before school programs. All of those things weren’t enough, she was improving minimally and her behavior was getting worse.

It was during a meeting for the council members of one of her special groups that a school psychologist suggested that she be tested for “attention issues,” even then, no one even wanted to say the dreaded word ADHD. At the time, I wasn’t even sure if they were talking about ADHD, but I signed the papers agreeing to let the school test her for “attention issues.” I would do whatever it took to get answers.

I have to admit, when I saw that one of the tests was based on my observations, I was skeptical. To me, it didn’t make any sense that I would be the one judging my daughters actions. I thought she was just a lively active kid. To use my opinion seemed entirely to subjective to me. I still went along with the tests, but was hesitant, I knew wanted an objective opinion.

The day the school called to tell me that they had the results of her testing and wanted to have a meeting to discuss it with me, I called and made an appointment with a psychiatrist. My assumption was that if their findings warranted an appointment at the school, the results would not be favorable.

I was glad I made that doctor’s appointment after that meeting at the school. I felt like I was being steamrolled into medicating my child. Everything they showed me was subjective. A social worker sitting in the room watching her and comparing her to other students? Really?!? I wasn’t trying to refute their findings, it just seemed to me that there had to be a better way to identify that she might have a problem with ADHD.

Thankfully, the next week was my appointment at the psychiatrist. Unsure of what to expect, I decided to go alone to that first appointment. I wanted to find out what the doctor could do in the way of evaluation and testing before brining my daughter in to the office. The doctor and I went over the common symptoms of ADHD first.

ADHD Symptoms

Inattentive

• Difficulty paying attention to detail
• Unorganized
• Frequently loses items
• Trouble completing tasks
• Poor listening skills

Impulsive

• Frequently interrupts or speaks out of turn
• Impatient
• Trouble taking turns

Hyperactive

• Trouble sitting still
• Restlessness
• Runs and climbs on things
• Excessive talking

When he asked me if my daughter showed any of these symptoms, my answer was simple. “Of course she does, she’s a kid.” My reply made him laugh, and then he explained to me that this was the reason ADHD was so difficult to diagnose. The symptoms are similar to normal childhood behaviors, and no matter if it was a teacher, a school social worker, or a parent the observations would still be subjective.

He had an option for me though. A relatively new test, the Quotient ADHD system, would be able to objectively measure her motion and shifts in attention to give an objective view of the 3 common symptom areas for ADHD: Inattention, Impulsiveness, and Hyperactivity . The test only would take 15 minutes, could be conducted in his office, and the results interpreted almost immediately. This test is the only test approved by the FDA to diagnose ADHD, and was over 88% accurate in diagnosing ADHD.

I was sold.

He sent me on my way with a handful of brochures and an appointment to have my daughter come in for an evaluation and be tested in two weeks.

When we returned, the doctor first did a clinical evaluation on my daughter. He asked both of us many questions about her behavior and study habits. He then reviewed the information the school had given me on their findings. After that, she was brought into a separate room to take the test.

The Quotient ADHD system looks something like a desk and computer all molded into one. Reflectors were attached to her head and legs during the testing to monitor her movement as geometric patterns were flashed on the computer’s monitor. When certain pattern were flashed, she was instructed to hit the space bar. When a four pointed star was flashed she was to do nothing. After she completed the test the information was uploaded to a database of similar age and gender groups, and viola the results were printed out for the doctor to review.

Not more than five minutes after she completed the test, the doctor called us back into his office and handed me a 7 page report. He reviewed it all with me. Each page had different analyses on it. One page in particular was of interest to the doctor. The page with the ADHD system index. He explained that it was one of the great things about the Quotient ADHD system. It assigns a number that summarizes the degree of agreement between her test results and patients who have already been diagnosed with ADHD. A system scaled score they call it. The score consists of three things:

Motion Scaled Score: How the patient’s motion correlates to a community sample

Attention Scaled Score: How the patient’s attention correlates to a community sample

Global Scaled Score: Indicates the combination of the two scores as compared to the community sample

Of the possible 10 points. My daughter’s score for inattention was 9.59, for motion was 5.91, and her global score was 7.75. Even I could figure out that the problem was attention by reviewing the results. I felt comfortable with an ADHD diagnosis since it was not only based on the subjective testing done in her school, but also, based on an objective diagnostic tool partnered with a comprehensive evaluation done by a qualified psychiatrist.

In discussing treatment options with the doctor, we decided that medication along with therapy was the best course for her. Did I want her to be on medication? No. But my husband and I were desperate, something needed to happen. She was failing all of her core subjects except math. The doctor’s evaluation in conjunction with the Quotient test made me feel confident enough to say, yes, she has ADHD and medication was an option. Is her treatment working? As of yet, I don’t know. One thing I do know though is that we are headed in the right direction.

20 - 30 percent of children with ADHD also have learning disorders, that number is disheartening to me. But, that’s a bridge we will cross if the ADHD treatments aren’t affective enough for her to improve significantly in school.

My daughter will take the Quotient test again soon to see if the medication is helping her with attention. I’ll be keeping my fingers crossed. She will have an uphill battle, but identifying what is wrong with her hopefully will give her a fighting chance at succeeding in school and in life.