Q&A: Is distractibility always due to ADHD?

ADHD is not the only cause of inattention, inability to focus, and/or hyperactivity. Emotional reactions to things like bullying or traumatic events can cause inattention. Anxiety and depression can also cause these problems. For example, children who are depressed often have symptoms similar to those of adults, which include lack of ability to concentrate, low energy, and inability to get started on tasks. Children may also respond to depression by acting out, “losing it,” or becoming angry or agitated. Anxiety can also result in inability to concentrate on what is going on in a classroom or homework assignment, frustration leading to agitated or aggressive behavior, or “shutting down.” To complicate things further, if your daughter does have ADHD, she may also develop some anxiety and depressed mood due to the challenges of navigating her world in a distracted state. And because her social skills may also be affected, she may also experience meanness and exclusion from other kids. All this combines to make diagnosis a complex process. This is where a Comprehensive Individualized Assessment comes in.

One of the tools that psychology has to offer is a Comprehensive Assessment or a psycho-diagnostic evaluation. It is difficult, based on observation alone, to understand exactly what is going on with your daughter. A Comprehensive Assessment provides some tools that can help. First of all, we can ask you or your child’s teachers some specific questions that have been asked of numerous parents and teachers before. We then can compare your answers and the teachers’ answers to the answers of parents and teachers of children who did not have ADHD or who clearly did have ADHD. Such a comparison can help decide if the behaviors we are seeing are really pretty normal for a child that age, or whether those behaviors really look like those of a child with ADHD. We can also do some tests in the neuropsychological realm which quantitatively measure reaction time, capacity to hold attention on a task, ability to switch attention from one task to another and back without getting lost, ability to suppress impulses, and so on. In order to understand more about feelings of anxiety, worry, sadness, or depressed mood, we use psychological tools to measure your daughter’s inner experience as compared to a large pool of children the same age.

It is my job in doing a Comprehensive Assessment to gather all of these data, look at them together and make a judgment about (1) whether your child has difficulty with attention, focus, concentration, or impulsivity compared to her peers, (2) what the extent of this difficulty is, and (3) whether the difficulty is likely because of ADHD or some other psychological issue. I am a big believer in the value of recommendations and school accommodations to help girls thrive. Included in the Comprehensive Assessment are extensive recommendations that can be employed in the classroom, at home, and with your daughter’s therapist if she has one.

Response by Dr. Chris D. Cooper, Clinical Director of Assessment at the Institute

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