Neuropsychological Testing for ADHD Diagnosis

[cara susanna]

My favorite was when I read a report from a community provider that diagnosed ADHD. The report talked a TON about the performance on neuropsych tests, but nothing about, you know, childhood symptoms or even grades.

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[AcronymAllergy]

There's a little irony here, right? Barkley was the dude who "cracked the ADHD code" by emphasizing the role of executive functioning in and coalescing a very compelling executive functioning based model/description of impairments in ADHD.

This undoubtedly led to massive push for testing of ADHD that is executive function based. His model may very well be a reason for the controversy around testing because we have a (A) well accepted model, (B) the lack of empirical support for neuropsych testing, and (C) that the relationship between A and B is disorienting for the psychologist who want a tidy narrative for the disorder and for patients that we thought we were getting.

You probably already know, but Barkley has also published a few rating scales for ADHD and executive functioning, per the manuals exactly for these reasons (i.e., that it's suspected as relating to the role of executive dysfunction, but with neuropsych tests not being particularly good at detecting such).

 

[texanpsychdoc]

You probably already know, but Barkley has also published a few rating scales for ADHD and executive functioning, per the manuals exactly for these reasons (i.e., that it's suspected as relating to the role of executive dysfunction, but with neuropsych tests not being particularly good at detecting such).

I use the Barkley measures routinely. What I find interesting is the fact that there are no norms for the "other-report" scales.

 

[cara susanna]

I use the Barkley measures routinely. What I find interesting is the fact that there are no norms for the "other-report" scales.

Yup, we use the BAARS-IV and I find that irritating. I also don't love the lack of validity indicators.

 

[AcronymAllergy]

I've used the BDEFS and have found it to be useful, but yeah, the general lack of validity checks can be problematic.

 

[Chyby]

I am having like 3-6 referrals/week for adult ADHD evaluations, and I live in Europe (EU). Here we don't do neuropsych testing unless there is a history of neurological disorder (epilepsy, TBI) or suspected learning disorder. There is no single battery that will say that an adult has ADHD. I see a lot of impairments on NEPSY-II tests in children with the exception of gifted kids.

Most of them have comorbid disorders (depression + ADHD; anxiety + ADHD, and many more).

We use DIVA-5 for interview for DSM-5 criteria as it is a comprehensive interview for present symptoms and past symptoms. The interview is done with a relative present also. That is the most important part of the assessment, being a neurodevelopmental disorder, we look for symptoms and impairments starting with childhood.

If I am doing a short statistic of the past 1 year, I didn't have an adult patient with ADHD and low scores on WCST, Stroop, d2, TMT, WAIS Working memory index. They all had impairments on Brown EF/A or BRIEF-A and lots of proof of life situations on DIVA-5 in present and in the past.