I have an 11-year-old daughter who I think has some issues, her teachers believe she may have ADHD, how do I get her tested?
The diagnosis of ADHD can be done by a psychologist, psychiatrist or a pediatrician who specializes in this area. Diagnosis is based on systematic review of reports of behavior from parents and teachers. It is also important to investigate other problems that are commonly associated with ADHD. These problems include learning problems, opposition defiant disorder, anxiety and depression. In addition, her family doctor can check her for general good health. Depending on your community you may be able to obtain an appropriate assessment in several different ways. Let’s look at each in turn.
Child Psychologists are professionals usually with a doctorate but sometimes with a master’s degree. It is important that they have specialized in children with behavior and learning problems. Psychologists systematically gather information from the school and home and do an assessment of related problems including learning problems. They can also develop and implement behavioral interventions with parents and schools that can be very helpful. One disadvantage is that psychologists cannot assess for or prescribe medications that are sometimes very helpful for ADHD. Families can access psychologists through their school if the school district has this service. Psychologists may also be available through a mental health clinic or privately.
Child psychiatrists are physicians with special training in mental health problems of children. Many child psychiatrists have the appropriate training for ADHD assessments. Psychiatrists are experts on medications and might, but usually don’t, have expertise in developing behavioral interventions. Child psychiatrists may be available via public mental health clinics or in private practice.
Pediatricians are physicians with special training in child health. Some pediatricians have special training to help children with problems such as ADHD. Pediatricians can prescribe medication and may have the skills to develop and implement behavior programs. Pediatricians may be available via community clinics or in private practice.
Sometimes family doctors or social workers or Occupational Therapists have special expertise in child behavior problems and they may be appropriate to assess and treat problems such as your daughter is having.
There are two major problems with getting the right help for your daughter. The first is the system is often not well organized. What would be best is a clinic with several different disciplines that families could access that would give a comprehensive assessment. They could also develop and monitor a plan for treatment. At the moment it is often hard to know where to go and even if you can get to see the right professional, they may only be able to do part of the job. It would not matter if the clinic were in the school or in the health system.
The second problem is that there is a shortage of professionals who can do the job. Many school boards don’t have the services to diagnose and treat children. The mental health system often has very lengthy waiting lists.
So what is a parent to do?
First, I would encourage you to be persistent and polite and document your requests. Start with an appointment with your child’s teacher and then speak to the principal. Ask them for advice on what to do and for action to get it done. After each appointment, write a short thank you note that includes your request that they organize an assessment. Follow up with a note every two weeks. Keep a copy of every note.
Second, approach your child’s family doctor for help. He or she will know how to access mental health services or pediatrician services. Family doctors often know of private practitioners or clinics.
Third, send a brief note or go and visit your provincial member of the legislature to lobby for you getting help for your daughter.
Fourth, find a parent group (or maybe you will have to create one). Parent groups can be very helpful to give you support in your journey, to help you figure out what to do and to lobby for better services.