How to diagnose ADD-inattentive?

but just for fun you can ask her point blank if she can tell you where she goes in her mind when she checks out. I had several kids who were ADD-Inattentive and easily distracted while I was working one on one with them or in a small group where they were when I asked them. I heard things like…I don’t know what happens, I can’t control it…I was just up at the school playing hockey in my mind…Another one…Oh my cousin is getting up at my house and I want to play with her..

I would defiintely have the mom check to see if she isn’t having some kind of seizures too.

http://www.nimh.nih.gov/publicat/adhd.cfm

http://groups.yahoo.com/group/ADHD_Bulletin_Board/

http://www.emedicine.com/neuro/byname/absence-seizures.htm

The medicines used to treat inattention in epilepsy are different than the medicines used to treat inattention in ADHD. Many of the ADHD meds (the central nervous system stimulants/alerting agents) are known to lower the seizure threshold for some of those with epilepsy.

Sometimes inattention can be correctly recognized but the ability of either the epilepsy or ADHD meds to completely correct the inattention challenge as much as one would ideally hope for is not really achievable due to the underlying cause of the inattention. When the meds don’t work or work poorly, being med-free is an option.

Many inattention difficulties also have a short term, medium term, and long term memory factor which goes along with the inattention. An imperfect memory is a known aspect of some attention challenges.

Regarding inattention, either an ADHD med will work better for a person or an epilepsy med will work better for a person but the two categories of meds (ADHD and epilepsy) are not interchangeable. That’s my understanding.

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I have a 12yo student who has been through multiple therapies but still has severe learning problems. This student will often make “output” type mistakes — saying the wrong color, for example. I have assumed up until now that this is primarily a neurological problem.

However, her mother and I notice that this girl’s attention seems to cycle in and out rapidly when she is performing. These seem to be one-second “blips” where her attention is gone, even though she is trying to concentrate very hard. Frequency seems to be a few of these “blips” per minute. Is this a characteristic of ADD-inattentive? It almost seems to me what I have read about petit mal seizures except that the duration is so short — only a second or so at a time — and it seems to happen (or we notice it) only when she is concentrating on reading or cognitive training exercises.

The mother and pediatrician are planning a trial of ADD medication in a couple of months. I know there must be better approaches to diagnosis of ADD, but don’t know what to recommend. I’m pretty sure this girl has had one or more neurological workups in the past (although, come to think of it, I should ask about this specifically).

Any advice appreciated.

Nancy

I don’t know about the sophistication of testing for ADD… it seems to me to be pretty much - try to rule out other things, try medication and if that works, it’s ADD.

And that’s for ‘run of the mill’ ADD/ADHD. What you’re describing isn’t ‘run of the mill’.

Often in medical diagnoses, you’ll hear physicians say, “It might be this but it also has some things about it that make me think of this but then again it could be __________. Medical science is not an exact science.[/b]

Thanks so much for the insights. I will share them with the mother.

Nancy

there was a study done(dont ask me where)that indicated children on the autistic spectrum took longer to ‘hear’. They didnt say ‘process’ which was odd. My understanding is that one needed to be patient and wait for a response rather than repeat the prompt. I believe it was in the ballpark of 18 seconds(which is an eternity to wait for a response BTW)

I found that revealing. My 11 yr old is dx’d ADDinattentive and I see the attention blips you refer to. Medication helped although we are trying homeschooling and no meds this fall(not a bad thing-more of seeing so much progress as of late I think its time to intensively remediate and catch him up)

Maybe the delay in response is true of any child with weak verbal skills. I always have this picture of the info swirling around in that brain with no clue where to dock and then, finally, it finds its way.

Where do her eyes go when she ‘blips’? I know this is one of those left/right, auditory/visual indicators. If they’re not searching, but glazed over, she may be daydreaming.

A therapist I worked with with could pick up on those ittybitty seizures. She insisted they were seizures(PT with gobs of experience and married to a MD) Personally, I could never see them myself(we did a special needs play group together-not MY kid)but I had lot of faith in her opinion

The following is just my opinion, but:
The diganosis of ADD should be made by a clinical psychologist or a psychitrist. Not because ADD itself is a problem to treat (although it can be) but because a mis-diagnosis can be diastrous. Giving stimulants to a child who has bipolar depression or has seizures can have terrible consequences. Never allow a pediatrician to do a diagnosis. They simply do not have the expertise. Also, a mental health provider is more likely to catch other neurological conditions whose treatment can substantitally affect the child’s life.

You are right, it should be against the law to perscribe narcotics to children who haven’t had a full evaluation and a diagnosis. Parents would be wise to get a second opinion for the results of the evaluation. There are doctors using stims as the test, if they help, then the child has ADD?!! What the heck!? Stimulants will help MOST people, ADD or not, pay better attention…Hello? Its no indicator as to the disorder! Its practices like this that give us moms, who have carefully researched the matter, and made a decision based on the medical facts, a bad name.