Neuropsychological Assessments for ADHD Treatment

A neuropsychological assessment is a powerful tool used to identify someone’s strengths and weaknesses. This information then allows a neurologist to diagnose neurological conditions.

A neuropsychological assessment evaluates many areas, including:

  • language
  • memory and learning
  • attention and executive functions
  • motor coordination
  • visual-spatial skills
  • academic skills
  • social skills
  • emotional skills

Neuropsychological assessments are commonly acknowledged as a way to diagnose ADHD, and they do serve that purpose, but they are also vital in the treatment of ADHD. The biggest reason for this is that other neurological disorders often accompany ADHD. In fact, it’s estimated that over 60% of those with ADHD also have another condition.

These co-morbid conditions can affect treatment. For instance, if someone has a learning disorder in addition to ADHD, ADHD medication may not seem to be effective when it comes to improving school performance, when in reality, the continued difficulties are due to the learning disorder.

Without diagnosing the learning disorder, modifications may be made to the ADHD treatment that do not need to occur and may, in fact, negatively impact the individual, all the while never helping to address the existing learning disorder.

 

What Is the Purpose of ADHD Treatment?

The symptoms of ADHD that a child presents with can vary significantly from person to person, but some of them can be:

  • forgetfulness
  • difficulty focusing or concentrating on tasks
  • talking excessively
  • frequently losing items
  • interrupting others
  • difficulty with organization
  • making frequent mistakes or missing details

 

Many of these symptoms can negatively affect someone’s school/work performance and their ability to make and retain peer relationships.

As far as school performance, it can be frustrating for children with untreated ADHD to complete their tasks. They may have difficulty retaining focus on what they have to do and may also find that they have to repeatedly reread sentences or instructions.

Building peer relationships is an essential aspect of childhood and sets a foundation for the many social skills needed throughout our lives. Children with ADHD may be very impulsive, which can lead to them frequently interrupting others. These actions may make it harder for them to make and retain friendships.

Both of these components can have additional effects of damaging someone’s self-esteem. Many children with ADHD internalize their struggles and may develop low self-esteem from constantly feeling as though they are not doing things the right way when in reality, they are just trying to work against the way their brain wants.

ADHD treatment provides a way to “rewire” the brain, reducing a child’s ADHD symptoms. Other forms of treatment focus on teaching the child, parents, and teachers how to work with the child and the way their brain works.

 

ADHD Treatment Options

There are numerous treatments for ADHD, and the best treatment, or combination of treatments, depends on the child. Neuropsychological assessments, and their ability to determine strengths and weaknesses, can help determine what the best type of treatment would be for a child in terms of effectiveness.

 

Medication

When the brain sends signals, they transmit their messages from neuron to neuron. This is done by sending neurotransmitters from one neuron to the next, and then the process repeats. However, those with ADHD experience problems with this process, such as not sending enough neurotransmitters or not allowing the neurotransmitters enough time to reach its destination. Medicine works to address these problems, helping those with ADHD pay attention better and process new information

However, ADHD medication only works as long as the person with ADHD takes it, so taking it consistently is essential for the best results.

 

Behavior Therapy

Behavior therapy is often recommended as a co-treatment with medication to treat ADHD, andhas the goal of helping to improve the physical and social environments the child is in to improve their behavior.

Behavioral therapy relies heavily on the collaboration of parents, teachers, and other caregivers to ensure that they all enforce rules, use discipline effectively, and encourage the same standard of good behavior. Through behavior therapy, individuals with ADHD will learn better ways to control their behavior.

 

Executive Function Therapy

Executive function skills refer to the cognitive abilities that allow you to focus your attention and remember instructions. They are essential for succeeding in school and work, and many children with ADHD may lack or struggle with these skills.

 

Through executive function therapy, children with ADHD can improve their ability to

  • stop inappropriate actions
  • initiate tasks
  • maintain emotional control
  • think before acting
  • easily shift from one task to the next
  • plan and organize
  • self-monitor

 

Neurofeedback

Many people with ADHD show low arousal levels in frontal brain areas, and neurofeedback works to address this by training the brain to increase arousal, which involves increasing beta waves and decreasing theta waves.

This treatment involves placing electrodes on the head to monitor brain activity. With the electrodes on the head, the individual then works to increase arousal levels, with certain triggers (such as a beep) as evidence that their arousal levels are where they should be. When the individual learns how to increase arousal levels, they will find that their attention improves, and they won’t be as hyperactive or impulsive.

 

Neuropsychological Assessments and ADHD Treatment

There are three primary facts to consider before we explore how neuropsychological assessments aide ADHD treatment, and they are:

  1. pediatric and primary care physicians do not often adhere to published diagnostic guidelines for ADHD
  2. ADHD most often co-exists with other disorders
  3. Children with untreated ADHD (or untreated comorbidities) are at a greater risk of poor outcomes in academic, social, practical, and vocational settings

 

Neuropsychological assessments benefit both the diagnosis and treatment of ADHD. They help with the diagnosis because they use published diagnostic guidelines for ADHD, and they can also diagnose any co-existing conditions. The information gained during a neuropsychological assessment then allows the clinic to create an individualized treatment plan that also addresses any co-existing conditions, improving treatment outcomes.

Various studies have examined the benefits of neuropsychological assessment for ADHD treatment, and the evidence undoubtedly supports this application. Comprehensive neuropsychological assessments allow for a thorough consideration of co-occurring disorders and provide targeted recommendations for treating ADHD and any co-morbid conditions.

One study compared treatment with and without neuropsychological assessments for individuals between the ages of 3 and 17. The study found that, while both groups experienced significant improvements in behavioral/emotional symptoms, the group with neuropsychological assessments had more parents who started behavior management training and a greater initiation of medication management.

 

Neuropsychological Reevaluations

While the initial neuropsychological assessment is beneficial for planning ADHD treatment, the ability for reevaluations truly creates a treatment that evolves with the child.

It can often be hard to tell just how effective ADHD treatment is, especially if the child has more internal ADHD symptoms. Neuropsychological reevaluations offer a way to compare current assessment results to those from before treatment started to determine if the treatment is successful, in what areas it is helping, and where more assistance is still needed.

In addition, reevaluations offer a way to determine if there is a co-morbid condition present that ADHD had been masking.

Written by Richard D. Abbey, Ph.D.

Dr. Abbey is a licensed clinical neuropsychologist. He provides neuropsychological evaluations for infants, children, and adults. He is the director of neuropsychological services and is involved in every case in his clinic. His research focuses on learning disorders, Attention-Deficit/Hyperactivity Disorder (ADHD), and the neurocognitive effects of cancer treatments.

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