For IEC4020 activity 4

1. IEC 4020: ADHD
Section Four
Diagnosis and Treatment

2. ADHD:
Diagnosis

3. Making a diagnosis
• Diagnosis of ADHD to be made by medical and mental
health professionals (mainly pediatricians, psychiatrists,
psychologists)
• Three Major Components of this assessment process:
1. Interview with the parents/main caregiver/teachers.
2. Interview with the child/adolescent.
3. Investigation & psychological testing (to rule out other
disorders/conditions)
• Rating scales and specific questionnaires may be included
before the interview.

4. Interview with the parents
• A detail interview about each 18 symptoms listed in DSM-V.
• For each symptoms, information on the following is
obtained:
• Age of Onset ( Childhood )
• Duration ( Chronic )
• Frequency ( More days than not )
• Impairment/dysfunction and settings ( Do not confuse
with symptom)
• Family history of psychiatric illnesses
• School and social history
• Perinatal history, development history, milestones, medical
history and mental health history.

5. Use of Rating Scales
Common rating scales used:
Academic Performance Rating Scale (APRS)
ADHD Rating Scale-IV
Child Behavior Checklist (CBCL)
Conners Parent Rating Scale Revised
Conners Teacher Rating Scale-Revised
Conners Wells Adolescent Self-Report Scale
Vanderbilt ADHD Diagnostic Parent and Teacher
Scales
Benefit: provide additional information, especially when
conducting interview is not possible.

6. Investigation & Psychological Testing
• For unremarkable medical history- no investigation required.
• Psychological Testing: Not mandatory
 Need to differentiate between ADHD and learning disorder.
 Academic impairment can be from ADHD or learning
disorder or both.

7. What Can An Educator Do If Some Symptoms
Appear To Be Present?
Maintain behaviour logs citing observations of behaviours and
situations.
Inform parents of behavioural concerns and understand
child’s behaviours at home.
Request meeting with parents, special education teachers,
school counsellor, psychologist, etc. to discuss concerns. If
parents agree, refer to REACH. This allows for professional
assessment and design an intervention plan for the student.
Work with professionals to find interventions that work well
with the child with the ultimate aim of helping the child to
learn in school.

8. ADHD:
Treatment

9. Treatment for child
• Who are involved in treatment?
• Child
• Parents
• Family members
• Doctor/Psychiatrist/Psychologist
• Teachers
• Therapists

10. ADHD treatment
• Use of medication Ritalin was introduced in 1955
• This has been the main stay of treatment
• Increasingly, research and clinical evidence have supported
the importance of including behaviour therapy and
parenting training in ADHD treatment
• In most cases, the best treatment is a combination of
medication and behaviour therapy.

11. Medication
• When a student is on medication, things that teachers may
need to be aware of:
 Regular monitoring of the student’s behaviour
 Be informed of side effects
 Most common side effects are appetite decrease,
weight loss, insomnia, and headache.
 Less common side effects are tics and emotional
lability/ irritability.
 If side effect is present, do inform the parent.

12. Psychosocial Treatment
• This treatment includes different modalities:
• Academic organization (e.g., learn to organise, avoid
distraction, increase memory strategies)
• Parent training
• Behaviour modification
• Social skills training
• Cognitive–behavioral therapy (CBT)
• Individual therapy
• Parent training, intensive behavior modification, and social
skills training are reported to be the most effective for
children with ADHD in controlled trials.

13. Psychosocial Treatment
• In Singapore, we have the Triple P and Incredible Years
Parenting Programs run by IMH and NUH respectively for as
part of parental training for ADHD
• It is crucial to evaluate parents and family for dysfunction
related to the child's ADHD. Family dysfunction can result in
ineffective use of parental strategies in the management of
ADHD.
• ADHD in parents may interfere with behavioural
modification programs, may need to treat affected parent
before starting child's intervention

14. End of section Four
Your Task:
Please complete the final quiz